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Bipolar II Disorder: Information, Symptoms, Treatment and More

Modified date: April 7, 2025

Bipolar II Disorder is a mental health condition characterised by mood swings, feelings of highs, along with depressive lows. It typically causes a substantial impact on day-to-day life.

Bipolar II Disorder is characterised by at least one episode of Hypomania and at least one episode of major depression.

Someone with Bipolar II will have never experienced a manic episode (which is seen in Bipolar I). Episodes of hypomania and depression can last for weeks, causing significant distress.

Bipolar II Disorder is a very difficult condition to live with. However, with the right treatment and support, symptoms can be controlled more, which should lead to an improvement in quality of life. Unfortunately, Bipolar II Disorder is a notoriously difficult condition to diagnose.

Bipolar II Disorder can feature a wide range of mood states

What are the symptoms of Bipolar Disorder Type 2?

The symptoms of Bipolar II Disorder typically fall into two categories – hypomania and depression. An individual with Bipolar II Disorder will tend to encounter periods of both hypomania and depression, with either capable of lasting from days to weeks, to even months.

The behaviour exhibited during the hypomanic and depressive phases will differ from individual to individual.

An individual with Bipolar II Disorder will have experienced at least one hypomanic episode in their life, along with at least one depressive episode. The depressive episodes are typically more intense and long-lasting than the hypomanic episodes.

In between episodes, an individual with Bipolar II Disorder can usually lead a relatively normal life.

As mentioned, both hypomanic and depressive episodes are exhibited.

Hypomania

Happy feeling, euphoria
Excitable
Racing thoughts
Higher confidence than usual
Not needing much sleep
Acting impulsively
Taking risks
Irritable

Depression

Sadness
Hopelessness
Lack of energy
Loss of interest in formerly enjoyable activities
Feelings of guilt
Changes in appetite
Insomnia
Low self-esteem
Poor concentration
Suicidal or Self-Harm Ideation

This isn’t an exhaustive list of symptoms. These symptoms will typically lead to an individual behaving in a markedly different way from their normal self.

For example, someone who is in a depressed state may feel suicidal, or avoid social activities wherever possible. Alternatively, an individual in a hypomanic state may be prone to spending much more money than usual, which may cause financial issues.

What are the causes of Bipolar Disorder Type 2?

It isn’t known what causes Bipolar II Disorder. Similarly, it isn’t known why some people have certain types of Bipolar Disorder compared to others.

Most scientists believe that multiple factors can contribute to the onset of Bipolar II Disorder. Genetics appears to be a significant risk factor – with Bipolar Disorder often running in families [1].

A common potential cause put forward to explain mental health conditions is a chemical imbalance, which is linked to key neurotransmitters in the brain.

Being the victim of trauma or abuse, or a major life event, can also be a trigger for Bipolar Disorder.

Additionally, other mental health conditions can eventually result in Bipolar Disorder. For example, some people will have Depression for several years, before later having a hypomanic episode – which would make them qualify for a diagnosis of Bipolar II.

Diagnosis of Bipolar Disorder Type 2

When a person is displaying the symptoms of Bipolar II Disorder, it is very important to visit a doctor. When left untreated, Bipolar II Disorder can have disastrous consequences.

At an appointment, a doctor will ask several questions to the patient. They will ask about their symptoms, how episodes manifest, potential causes, general thoughts and feelings, and anything else relevant.

If the doctor suspects that the individual has Bipolar Disorder, the patient will be referred to a mental health specialist for a diagnosis.

When meeting a mental health specialist, a full assessment of the individual’s condition will be conducted. This will include more detailed questions regarding the symptoms. In the build-up to an appointment, they may request that a mood diary is used to aid a diagnosis.

For Bipolar II Disorder to be diagnosed, an individual will:

Have experienced at least one hypomanic episode in their lifetime
Have experienced at least one major depressive episode in their lifetime
These episodes will have caused impairment for the individual.

In some cases, a different type of Bipolar Disorder will be diagnosed. Or, a patient may be diagnosed with Cyclothymia (a milder version of Bipolar Disorder).

Unfortunately, due to the crossover between Bipolar II Disorder and several other conditions, it can take a long time to receive the correct diagnosis.

Therefore, a diagnosis is seldom made over one appointment. A specialist may want to observe the behaviour of an individual over a period of time, due to risks of misdiagnosis.

For example, Bipolar Disorder can easily be confused with other conditions like Depression, Schizophrenia and various Personality Disorders.

How is Bipolar Disorder Type 2 treated?

Treatment is available for Bipolar II Disorder. In many instances, with the right treatment plan, symptoms can be controlled much more. Treatment normally consists of:

Talking Therapy

Talking therapy can be used when an individual is first diagnosed with the condition, as it can help them to come to terms with their illness.

As a person learns to live with the condition, they will generally stop using talking therapy. Talking therapy can be particularly useful for helping an individual to recognise episode triggers, and to come up with healthy coping mechanisms.

There are a range of other types of talking therapies available. Among the most common are:

Psychoanalytical Psychotherapy: Psychoanalytical Psychotherapy is a talking therapy that aims to help uncover and resolve unconscious beliefs that cause psychiatric conditions. Traumatic experiences that may or may not be buried in the unconscious mind can be highlighted and processed. Psychoanalytical psychotherapy involves talking to a trained therapist. The therapist can show the individual how early memories and past traumas have affected their thinking, behaviour and attitude in the modern day. Psychoanalytical psychotherapy is especially useful for any condition that involves past trauma. Renowned neurologist Sigmund Freud developed this therapy, which is typically completed over a long-term basis.

Schema Therapy: Schema Therapy is a talking therapy that combines aspects of Cognitive-Behavioural Therapy, Gestalt therapy and psychoanalytical thinking into one form. It can be useful in treating personality disorders due to its ability to help people change longstanding patterns of thought and behaviour. The therapy is normally based on the idea that childhood needs were not met, leading to deeply-held obstructive beliefs. The therapist will attempt to change long-standing patterns that have contributed to problems, and can be very useful. Schema therapy is mainly intended for use in the treatment of personality disorders.

There are many ways that talking therapy can help. We have more information on our Therapy section.

Medication

Medication forms the main part of treatment for Bipolar II Disorder. Mood stabilisers like Lithium are often used.

Anticonvulsant medicines are also commonly used. These include Lamotrigine, Valproate and Carbamazepine. However, these aren’t always suitable for everyone.

While antidepressants shouldn’t be used as a standalone treatment for Bipolar II Disorder, they can be prescribed alongside a mood stabiliser or anticonvulsant – especially in cases where depressive episodes are primarily seen.

Additionally, antipsychotic medicines can occasionally used. This is especially the case when agitation is very common.

Mood Stabilisers: Mood stabilisers can help level out moods, meaning fewer lows, and fewer euphoric highs are felt. Lithium Carbonate is the best-known mood stabiliser. Others include Lamotrigine and Sodium Valproate, which are anticonvulsant medicines that have mood stabilising properties. These medicines are generally taken on a long-term basis.

Antidepressants: Antidepressants can help to improve and regulate mood. They should improve motivation and restore energy. SSRI Antidepressants are the most commonly prescribed. They act on the brain chemical serotonin – which is thought to help in regulating mood and emotion. They may include side-effects such as a dry mouth, sexual problems and nausea, though these should hopefully be short-term. Other classes of antidepressants are available in the event of an inadequate reaction.

Antipsychotics: Antipsychotics (also known as neuroleptics) block the effect of dopamine – a chemical in the brain that is heavily linked to psychotic symptoms like hallucinations. They can also be useful for stabilising mood, and treating anxiety. They are not suitable for everyone however, and are often associated with many side effects like weight gain, dizziness and dry mouth.

Other

In severe cases, Electroconvulsive Therapy can be used. This should only ever be used in cases when a range of treatments have failed, or a life-threatening episode of depression or hypomania is taking place.

Electroconvulsive Therapy (ECT): Electroconvulsive Therapy (commonly referred to as shock treatment) is a treatment that sees an electric current sent through the brain of an individual. The aim is to trigger an epileptic seizure, with the ultimate objective to relieve symptoms of a mental health problem. The human body is fully restrained during the procedure, which also involves a general anaesthetic. Electroconvulsive therapy is normally a last resort. Despite this, ECT actually has an impressive efficacy rate, with many people finding it helps immeasurably.

It is very rare for an individual with Bipolar II Disorder to require hospitalisation.

Summary

Bipolar II Disorder is a very challenging condition to live with. Depressive phases are often long-lasting and debilitating. Hypomanic episodes also cause impairment.

The two mood states combined can cause many issues, making Bipolar II Disorder a condition that needs treatment. There is a lot of information on our website to assist and support you.