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Bipolar 2 Disorder: Symptoms, Difference Between Bipolar 1 Disorder and Treatment

Bipolar 2 disorder is a form of mental illness that is similar to bipolar I disorder, with moods cycling between high and low over time. However, in this condition, the up moods never reach full-blown mania. The less-intense elevated moods in this disorder are called hypomanic episodes, or hypomania.

woman wearing white shirt confused and scratching head

Signs and Symptoms of Bipolar 2 Disorder

  • Flying quickly from one idea to the next
  • Hypersexuality
  • Inflated self-image
  • Making and pursuing grandiose, unrealistic plans
  • Increased energy and hyperactivity
  • Decreased need for sleep
  • Substance abuse
  • Excessive spending
  • Rapid, uninterruptable, and or loud speech

Most people with bipolar 2 disorder have also experienced periods of depression which may include:

  • Depressed mood 
  • Feelings of persistent sadness
  • Feelings of guilt or worthlessness
  • Loss of interest or pleasure in activities
  • Low energy and activity

Bipolar 1 Disorder Vs Bipolar 2 Disorder

Bipolar I disorder requires symptoms to meet the full criteria for what is known as a manic episode. The diagnosis of Bipolar I is not dependent on depression, but many people with the diagnosis experience both types of mood episodes. At least three of the following symptoms can determine the diagnosis:

  • Increased talkativeness
  • Increased self-esteem or grandiosity
  • Decreased need for sleep
  • Increase in goal-direct activity, energy level, or irritability
  • Racing thoughts
  • Poor attention

Mania is more extreme than a sudden burst in energy, motivation, or a happy mood. It often causes problems at work, school, and in relationships, and in some cases it may require hospitalization. A manic episode is also just as frequently characterized by an irritable mood as an elevated one for people with Bipolar I.

For bipolar 2 disorder, on the other hand, a person has to have experienced a depressive episode and a less severe form of mania which is known as hypomania. Mania occurs when an individual displays manic symptoms but is able to carry on with day-to-day responsibilities. In fact, job performance or other goal-directed activities may even improve. To meet the diagnosis of a depressive episode, a person must experience 5 or more of the following symptoms:

  • Sleep and eating changes
  • Lack of energy or fatigue
  • Restlessness or slowing down
  • Indecision or difficulty concentrating
  • Loss of pleasure in activities once enjoyed
  • Feelings of worthlessness or guilt
  • Depressed mood
  • Suicidal thoughts

Many people with bipolar 2 disorder are diagnosed with depression because they fail to report the elevated mood symptoms of hypomania to their doctor. Furthermore, people with bipolar 2 disorder are more likely to suffer from substance abuse and eating disorders, as well as have a family member suffering from a mental illness.

Treatment and Management of Bipolar 2 Disorder

woman in red with green background waking pills

The types and doses of medications prescribed are based on your particular symptoms of bipolar 2 disorder. Whether you have bipolar I or II, medications may include:

  1. Mood stabilizers. You will typically need mood-stabilizing medication to control episodes of mania or hypomania, which is a less severe form of mania. 
  2. Substance abuse treatment. Drugs and alcohol may seem to ease symptoms, but they can actually worsen depression or mania. If you have a problem with alcohol or other drugs, tell your provider so that both your substance use and bipolar disorder can be treated.
  3. Treatment programs. Participation in an outpatient treatment program for bipolar disorder can be very beneficial. However, hospitalization is needed if your condition significantly affects your functioning or safety.
  4. Antipsychotics. Your psychiatric care provider may add an antipsychotic medication alone or along with a mood stabilizer.
  5. Antidepressants. An antidepressant can sometimes trigger a manic episode, it needs to be prescribed along with a mood stabilizer or antipsychotic in bipolar disorder.
  6. Psychotherapy. To identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones, your psychiatric care provider may recommend cognitive behavioral therapy. 
  7. Self-management strategies. The best way to manage your condition is to live a healthy lifestyle, including getting enough sleep, eating healthy foods, and exercising regularly.

Medication Used for Bipolar 2 Disorder

Chlorpromazine. It is used to address symptoms of mania, psychosis, or agitation and not for long-term bipolar 2 disorder management. It works by helping to restore the balance of certain natural substances in the brain. It can reduce aggressive behavior and the desire to hurt yourself or others.

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