Bipolar disorder type 2: characteristics, symptoms and treatments
Bipolar disorder is characterized by the intermittent presence of manic episodes and episodes of depression. For this reason it is called 'bipolar' disorder and is also known as manic-depressive disorder (because the manifestations oscillate from one pole to another).
Within this broad spectrum it can happen that the manic episodes are more intense than the depressive ones, or vice versa. For this reason, they are currently recognized Two types of bipolar disorder: Type I Bipolar Disorder and Type II Bipolar Disorder .
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What is Type 2 Bipolar Disorder?
Bipolar disorder type II, also written including Roman numerals (Bipolar disorder type II) is a pattern of mood that is characterized by major depressive episodes, alternating with hypomanic episodes. That is to say, Depression manifests with greater intensity than mania.
Currently, Type 2 Bipolar Disorder is one of the clinical sub-categories that fall within the category of "Bipolar Disorder and Related Disorders" in the fifth version of the Diagnostic and Statistical Manuals of Mental Disorders (DSM-V, by its acronym in English).
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Diagnostic criteria for Type II Bipolar Disorder (according to the DSM-V)
As we have said, Type 2 Bipolar Disorder can be diagnosed in the presence of two large and complex phenomena: a hypomanic episode and a major depressive episode . In turn, these phenomena must have a series of specific characteristics (in order to differentiate Type II Bipolar Disorder).
In addition, during your diagnosis you must specify which of the episodes was most recent, and how it has been, for example, if it has occurred in fast cycles, if there are psychotic characteristics , if it is accompanied by other elements such as anxiety, if there is a seasonal pattern, and if the severity is mild, moderate or severe.
The hypomanic episode
It refers to a period of mood that is too high, for example, more expansive or more irritable than normal, characterized by a visible and persistent increase in energy. For diagnosis, this period must have lasted at least four consecutive days and must be present during most of the day.
East visible and persistent increase in energy it must have caused a significant change in habitual behavior, but it is not seriously interfering with the fulfillment of responsibilities that are considered socially appropriate for age, gender, social position, etc. of the person.
This increase in energy is characterized by the presence of at least three of the following phenomena, as long as they can not be explained by the physiological effects of any substance or treatment:
- There is an increase in self-esteem and feeling of greatness .
- Even if there is fatigue, there is a little or little need to sleep.
- There is a greater need to talk or to keep the conversation going.
- Feel that the thoughts go at a great speed or that there is a kind of brain drain
- There is a special facility for distraction.
- The activity is exacerbated, which can be seen in a psychomotor agitation .
- Excessive interest in activities that are very likely to cause discomfort (for example, making purchases suddenly, recklessly and unrestrained)
If all this is accompanied by psychotic characteristics, then the episode is not hypomanic, but manic, which requires a different intervention. Likewise, all of the above must be sufficiently noticeable and visible by the closest people.
Episode of major depression
As its name says, the episode of major depression is the presence of a depressed mood that is experienced most of the day and almost every day, which significantly influences the daily activity of the person.
Clinically this episode can be diagnosed when the mood has at least five of the following characteristics, and in addition has produced clinically significant discomfort , that is, it has caused that the person can not fulfill the responsibilities that are considered socially accepted for their age, gender, social status, etc. (eg with work, studies, family):
- The mood has lasted almost every day , what can be known through what the person expresses, in addition to what can be corroborated by what other people have seen.
- Significant decrease in interest and pleasure for practically all day-to-day activities.
- Loss or significant increase and rapid weight (without dieting).
- Insomnia almost every day
- Sensation of restlessness and constant psychomotor agitation and observable by others.
- Fatigue and constant energy loss .
- Excessive or inappropriate feeling of guilt, can even be delirious.
- Lack of concentration and of decision making.
- Ideation of death and constant suicide.
None of the above phenomena can be explained by the effects of a substance or medical treatment. For diagnosis, it is important not only to consider the list, but the clinical criteria of the specialist based on the person's clinical history and cultural norms that cause significant discomfort.
Therapies and treatments
Bipolar disorder type 2 is not so much a disease as a condition of life, however, there are several options for help the person gain more control over their emotions and about the oscillations of his mood.
The most effective options are those that combine adequate pharmacological therapy with long-term psychotherapy. Regarding medications , those that are included with greater frequency are the stabilizers of mood, the antipsychotics and the antidepressants. On the other hand, the most frequent psychotherapies are cognitive behavioral therapy, systemic therapy and psychoeducation.
Many studies and investigations (and even civil associations and critical models) are currently underway to better understand Type 2 Bipolar Disorder, which means that more and more options are being developed so that people who have had this diagnosis and their families can have good living conditions.
Bibliographic references:
- National Institute of Mental Health (2018). Bipolar Disorder Retrieved May 2, 2018. Available at //www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml.
- American Psychiatric Association (2014). Reference guide of the diagnostic criteria of the DSM-5. Washington, D.C: USA.
