Bipolar II Disorder: Symptoms, Treatments, Causes, and More

Bipolar II is a mental health condition that falls under the umbrella of bipolar disorder. It’s a condition that significantly affects your mood, emotions and behaviour. It can be challenging to live with under any circumstances but will become even more difficult if left untreated.

Bipolar II affects many facets of your life, from friends, family, and relationships to maintaining a professional career. It’s a complex and often misunderstood condition with lots of stigma, but with prompt and proper care, many function well and lead fulfilling lives. This can include a combination of therapy, medication, and support.

Much is still unknown about bipolar II and bipolar in general, but there are many treatment options and management techniques that offer relief and help to those struggling with it.

What is Bipolar II Disorder?

Bipolar II is similar to bipolar I in that it involves moods cycling between highs and lows. However, there are some significant differences. Namely, the “high” moods associated with bipolar II do not reach full-blown mania as they do with bipolar I. Instead, the episodes are less intense but may last longer. These are known as hypomanic episodes or hypomania.

Someone affected by bipolar II disorder has experienced a minimum of one hypomanic episode in their lives, though most people with bipolar II have depressive episodes more often. This is another distinct difference between bipolar I and II. According to some research, those with bipolar II spend more than 50% of their time depressed, whereas those with bipolar I are closer to 30%.

Although bipolar II sees less severe “highs,” it often sees more severe and prolonged depressive episodes. It’s important to remember that bipolar II is not simply a “milder” form of bipolar I; they are separate diagnoses with distinct characteristics and unique challenges.

Bipolar II Causes

While research is always being done, no definitive cause has been identified for bipolar disorder. That said, most agree that two main factors are likely to contribute:

• Genetics. Generally, bipolar is more often found in those with a first-degree relative with bipolar disorder, such as a parent or sibling. Research is still being done into what in the genes specifically may be causing bipolar.
• Biology. Some studies indicate that those with bipolar have certain physical changes that are lacking in those without, such as aspects of brain structure and functioning. These differences are constantly being studied, with the hopes that the information may help determine a specific cause.

Bipolar II Risk Factors

While an exact cause hasn’t been identified, many known risk factors still exist for or triggering the first episode. This includes:

• Excessive drug or alcohol use. While not thought to be a direct cause, excessive substance use may trigger various symptoms and drive one to an episode.
• Stress. Highly stressful events can trigger either a hypomanic or depressive episode in those with bipolar II.
• Lack of sleep. While also not a cause of the condition, extreme lack of sleep or highly irregular sleep patterns may be enough to trigger a hypomanic episode.

These things will only trigger a hypomanic or depressive episode in someone who already has bipolar II disorder, they will not cause the condition to develop. Bipolar usually starts presenting when an individual is in their teens or early twenties, so this is likely when you’ll start to see symptoms and perhaps even episodes occurring.

Bipolar II Symptoms

Bipolar II disorder often comes with longer and more frequent depressive episodes, but hypomanic episodes are still possible. While hypomania is not as severe or disruptive as mania, it can still lead to unpredictable behaviour and a host of other side effects and consequences. The episodes also tend to last longer, which in itself can be a struggle.

Hypomania

With bipolar II disorder, a hypomanic episode often presents as a “high” or a feeling of euphoria but can also appear as irritability and crankiness. Generally, an episode is classified as hypomania if the individual experiences three or more of these symptoms:

• An inflated sense of confidence and well-being, known as euphoria
• Increased energy, activity, or agitation
• Reduced need for sleep
• Excessive talkativeness
• Racing thoughts
• Loud, rapid speech
• Increased distractibility
• Unusually upbeat, jumpy, wired

Overall, those amid a hypomanic episode are often pleasant and energetic. This can come across as positive to others, and the individual can experience confidence, productivity, and overall enjoy the feelings. The problem is that these episodes can also lead to erratic, unhealthy, and potentially extreme or dangerous behaviour. They may spend money irrationally, seek attention from people they normally wouldn’t, and take impulsive risks. These episodes are usually also followed by a depressive episode, either immediately after or sometime later.

When left untreated, a hypomanic episode can last anywhere from a few weeks to a few months.

Depressive Episode

While those with bipolar II will experience hypomanic episodes, depressive episodes are more common and often more severe than with bipolar I. These episodes feel very similar to clinical depression. During these episodes, individuals may find it difficult to go to work, socialize, and maintain relationships. It can also affect regular functioning as basic, everyday tasks and activities can become a struggle to complete.

Symptoms include:

• Low energy and activity.
• Loss of interest. Hobbies and activities that once brought fun, pleasure, and joy will lose their appeal.
• Depressed mood. This comes with feelings of sadness, hopelessness, emptiness, and irritability.
• Feelings of guilt and worthlessness.
• Thoughts of suicide.
• Irregular sleep. A depressive episode may cause either oversleeping or insomnia, both of which can lead to fatigue.

These episodes can last anywhere from a few weeks to several months and, in rare cases, a year or more.

Bipolar II Treatment

Various treatments exist for bipolar II, and everyone will be a little different. There are medications you can take to help improve and balance mood, in addition to psychotherapy options. Hypomania often presents as feelings of optimism and happiness, so it can go unnoticed and often untreated. Therefore, it can be good for those with bipolar II to go on preventative drugs that help stabilize and balance moods in the long term. This can help prevent the negative effects of hypomania and help prevent depressive episodes.

Medications

There are a few common medications that doctors may prescribe for bipolar II:

Mood stabilizers. These are designed to help keep moods stable and balanced. A common misconception is that they prevent mood swings entirely – this isn’t true. An individual’s mood can still change as they go through the day and react to things around them. What they help prevent are the extreme highs and lows that can bring them into a hypomanic or depressive episode that lasts weeks or months.

Some examples of mood stabilizers include:

• Lithium (Eskalith, Lithhobid). This one is particularly effective in controlling mood swings, particularly the “highs” that come with bipolar II. It’s been used to treat bipolar disorder for over 60 years. This one can take up to a few weeks to start working fully, but it’s good for long-term treatment rather than treating episodes.
• Carbamazepine (Tegretol). This is an anti-seizure drug that’s also been used to treat mania since the 1970s. It’s well-known for treating bipolar depression and for preventing extreme highs and lows. This medication does require monitoring of white blood cell count and liver function.
• Lamotrigine (Lamictal): This drug is approved by the FDA for use in adults only, but it’s exceptionally good at helping to prevent the lows of bipolar II. It can also help delay mood episodes of mania, hypomania, and depression in those already being treated by standard therapy.
• Valproate (Depakote): This is an anti-seizure drug that’s also known for helping to level out moods and has an “off-label” use in preventing highs and lows. It also has a faster onset than lithium.
• Oxcarbazepine (Trileptal): This anti-seizure medication and others like it are sometimes prescribed as “experimental” and can help treat mood symptoms and other features in those with bipolar II, though they are less proven.

Antipsychotics. Although hypomania, by definition, does not involve psychosis, antipsychotic drugs may still be used. They can be helpful in treating a hypomanic episode and can help with depressive episodes. Some of these drugs include:

• Aripiprazole (Abilify)
• Asenapine (Saphris)
• Cariprazine (Vraylar)
• Lumateperone (Caplyta)
• Olanzapine (Zyprexa)
• Quetiapine (Seroquel)
• Risperidone (Risperdal)
• Ziprasidone (Geodon)

Benzodiazepines. Commonly known by brand names such as Xanax, Valium, and Ativan, these are known as “minor tranquillizers.” They are most often used for short-term treatment of acute symptoms that may come with hypomania, such as agitation or insomnia.

Antidepressants. Common antidepressants such as fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft) may be prescribed for bipolar II as they are thought to be less likely to cause or worsen hypomania than in those with bipolar I. However, only Seroquel and Seroquel XR are FDA-approved to treat bipolar II depression specifically.

Medication Side Effects

Like many drugs on the market, those used for bipolar II treatment can come with side effects. Some are more unpleasant than others, but most do subside after a few weeks at most. The side effects will vary depending on the medication you’re prescribed, but they commonly include things like:

• Nausea
• Hair loss
• Tremors
• Weight gain
• Kidney damage
• Skin reactions
• Stomach pain
• Diarrhea
• Liver damage
• Sexual issues

In addition, some medications may affect how your liver works and/or the amount of platelets and white blood cells you have. This can require regular testing to ensure you’re staying healthy. If side effects are unbearable and/or do not subside after a few weeks, it’s best to get in touch with your doctor. There may be other medications you can try that will achieve the same results. The most important thing is that you do not stop or reduce your medication without your doctor’s input and approval. This can create additional problems and cause more health issues.

Taking medication for bipolar II should be a regular part of your everyday routine. A weekly pill organizer can help you remember, as can getting into the habit of taking it alongside another daily activity like brushing your teeth or getting into bed. Before starting, it’s best to speak with your doctor or pharmacist about the best time of day to take it – some are best taken in the morning, at night, or with food, for example.

Lastly, it’s also important to follow your doctor’s instructions carefully and not sway from them. Bipolar II medications are effective and can be life-changing, but they’re also powerful and shouldn’t be misused. You should also know what to do if you miss a dose. Simply taking it as soon as you remember or doubling up the next day may not be safe or effective – always call your doctor if you realize you’ve missed one.

Other Bipolar II Treatments

While medication is commonly used to treat those with bipolar II disorder, patients often benefit from regular psychotherapy as well. This involves one-on-one sessions with a trained professional. Many forms of therapy have been effective in helping manage bipolar II; cognitive behavioural therapy, interpersonal therapy, and family-focused therapy are among the most successful, but a treatment plan can be tailored to the individual.

Regular therapy sessions can help individuals with bipolar II disorder work through interpersonal problems, create good lifestyle habits, etc. It’s also good for managing medication – patients can regularly report how they’re feeling, how they’re dealing with side effects, and if they think the medication is helping. This also provides a good opportunity to make efficient changes in medication if necessary.

Lastly, some have found electroconvulsive therapy effective for treating those who are at high risk for suicidal behaviour or for pregnant women who are experiencing severe depressive or hypomania episodes.

Bipolar II Prevention

Since the direct causes of bipolar disorder are unknown, true prevention is difficult. However, there are many ways in which individuals can manage symptoms and prevent serious, prolonged, and frequent episodes. Taking prescribed medication and attending regular therapy sessions is a great start. Some other things include:

• Learn your triggers. Regular therapy sessions can help you identify what triggers an episode. Knowing this helps you be prepared and gives you more time to prevent and manage episodes.
• Help others learn your triggers. Whether it’s family members, a partner, or caregivers, those around you can also learn your triggers and help you identify when an episode may start.
• Avoid drugs and alcohol. Even when on medication and in treatment, the use of these substances can create or worsen symptoms and potentially affect your medication.
• Seek treatment as soon as possible. If you suspect an episode may be coming on, contact your doctor immediately. Early treatment is crucial for preventing worsening symptoms and prolonged episodes.

Is Bipolar II Disorder Preventing You From Working?

Although there are many ways to treat and manage bipolar II, it’s still a severe and challenging mental health condition. Individuals suffer from extreme mood swings that have a significant impact on their mental health and day-to-day functioning, often making it difficult to perform consistently at work and maintain stable employment.

There are many reasons why individuals may struggle in the workplace and will require financial support in the long term:

• Discrimination and stigma. Although awareness and understanding of mental health conditions have increased, many with bipolar disorder face stigma from those around them and discrimination in the workplace. This can mean a lack of support and accommodation, being unfairly passed over for a promotion, or even wrongful termination. This only makes maintaining employment and income more challenging.
• Unpredictability. Although depressive episodes are more common, bipolar II disorder still sees patients experiencing mood swings, sometimes with extreme highs and lows. The instability of an individual’s mood can make performing at work difficult, with frequent absenteeism, unpredictable behaviour, poor mental health, and struggling with their core responsibilities.
• Manic episodes. Manic episodes bring an elevated mood and high energy levels, which can lead to poor decision-making, impulsive and risky behaviour, and lack of concentration. These episodes can make it extremely challenging to focus on work tasks and often create strain in relationships with co-workers and managers, further disrupting job stability.
• Depressive episodes. More common in those with bipolar II specifically, these episodes include feelings of profound hopelessness, sadness, worthlessness, and guilt. Individuals often experience an extreme lack of energy and interest in everything around them. With bipolar II, these episodes can last a long time, making it extremely difficult to perform well at work, meet deadlines, concentrate properly, and communicate effectively.
• Side Effects. Most people going through treatment for bipolar II disorder will go on medication. While medication can help with many aspects of bipolar II, it can also come with unpleasant side effects. This can include things like cognitive impairment, nausea, chronic pain, fatigue, tremors, and more. These can significantly disrupt an individual’s ability to concentrate and perform consistently.

If bipolar II disorder is making it extremely challenging or impossible to work, you may be able to apply for disability benefits. These benefits provide the financial support those with bipolar II will need to cover living and medical expenses in lieu of the wages they’d otherwise be earning.

To apply for these benefits, you’ll need to provide extensive and thorough medical evidence demonstrating the disorder’s severity and how impactful it is on your life. You’ll need to demonstrate that you suffer from a total disability, meaning that bipolar II disorder must prevent you from performing the core duties and responsibilities of your job. This alone can be challenging and overwhelming, and the insurance company won’t make it easy.

It’s a long and complex process, and many are wrongfully denied their benefits when applying alone. To ensure a smooth and successful application, it’s advisable to work with an experienced disability lawyer. They can help you gather the necessary evidence and documentation, ensure it’s submitted on time, and guide you through the process while protecting your rights.

Can you get Disability Benefits for Bipolar Disorder?

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Have you Been Denied Benefits for Bipolar II Disorder? Contact our Disability Lawyers Today for a Free Consultation

Any form of bipolar disorder is a serious mental health condition that can be quite severe. For many, it significantly affects their mental health and profoundly impacts their ability to navigate daily life and maintain steady, stable employment. Challenges like unpredictable moods and behaviour, extreme and severe depressive episodes, medication side effects, and even stigma can make it difficult for individuals with bipolar II disorder to perform their jobs, maintain work relationships, and enjoy job security; thus making long-term disability benefits necessary.

If you or a loved one has been denied benefits for bipolar II disorder, don’t hesitate to contact our disability lawyers. We offer free consultations wherein we will thoroughly assess your case, answer your questions, and provide advice on your rights and possible next steps. Navigating life with bipolar II disorder is difficult enough, you shouldn’t have to worry about paperwork, documents, and the complex legal system; we will handle your case while you focus on yourself and your mental health.