Why Bipolar II Goes Undiagnosed

Bipolar disorder (formerly known as manic depression) comes in three types, which may complicate your ability to recognize it, either in yourself or in a loved one. While all three types involve cycling between manic and depressive moods, they manifest differently:

Bipolar I disorder

Severe episodes of both depression and mania. Depressive periods last for at least two weeks. Manic episodes may include delusions or hallucinations, and last at least a week or are severe enough to require hospitalization. 

Bipolar II disorder

Bouts of depression that also last for at least two weeks. However, instead of manic episodes, you experience episodes of hypomania. Hypomania is characterized by abnormally elevated energy and happiness.

Cyclothymic disorder

This rare and milder form of bipolar disorder shows up in frequent episodes of mild depression and hypomania that occur in cycles for at least two years. 

At Precise Research Centers, we conduct ongoing clinical trials for bipolar disorder, under the direction of our experienced and caring psychiatrist, Joseph Kwentus, MD. If you have bipolar II disorder and are accepted into a clinical trial, you receive free medication and treatment at our offices in Flowood, Mississippi.

Approximately 1 in 200 people develop bipolar II during their lifetime. However, many cases are never diagnosed.

Do you think you or someone you love has bipolar II? We’re offering this summary to help you recognize the signs of this serious mental health disorder so you can get the treatment you need.

Bipolar II can look creative and focused

Unlike mania, which can be marked by hallucinations and extreme risk-taking behavior, the hypomania that’s characteristic of bipolar II may not seem like a problem at first. In fact, in the middle of a hypomania episode, you may feel extra happy and productive. 

However, the level of energy and happiness that you (or your loved one) experience seems out-of-character for them. They may exhibit behaviors such as:

• Extremely elevated self-esteem
• Increased talkativeness
• Racing thoughts
• Severe distractibility
• Sleeping only a few hours a night
• Exhibiting risky behaviors
• Becoming irritable when challenged
• Increased goal-directed activity
• Going on “pleasure sprees”

Approximately 60%-70% of hypomanic episodes in bipolar II disorder occur either directly before or after a major depressive episode. Examples of hypomanic behavior include things like suddenly jumping into a risky new business venture, or taking on an all-encompassing project, such as painting or rehabbing an entire house.

The main difference between hypomania and mania is that hypomania may have very little negative impact on your life. However, if you experience bursts of energy and committed activity that are punctuated with longer periods of depression, you may have bipolar II.

Bipolar II is mistaken for depression

Bipolar I is associated with wild swings between depressed and elated moods that can be quite dramatic. In contrast, the hypomania of bipolar II seems rather tame.

In addition, if you have bipolar II disorder, you trend more toward depression than to a hyperenergized state. In fact, you may have more episodes of a depressed mood — and depression that lasts longer — than people with bipolar I. 

Bipolar II seems more ‘normal’

If you have bipolar II, you may not have trouble holding a job or maintaining intimate relationships and friendships — all of which can be challenging in bipolar I. Therefore, your actions and moods seem more “normal” than the behaviors of those with bipolar I.

In fact, it’s easy to ascribe the typical behaviors associated with bipolar II to a personality quirk rather than recognize them as a mental health disorder. However, depressive episodes in bipolar II can become quite severe. Up to 15% of those with bipolar II commit suicide, usually during a depressive episode. 

If you have bipolar II, you may also engage in behaviors and activities that have a negative impact on your life the longer they go on. For instance, you may be hyperfocused on sexual pleasure, which could interfere with your ability to enter into or maintain a committed relationship.

You might also go on spending sprees when you feel happy and energized. Eventually, this could cause financial problems.

Bipolar II episodes aren’t the ‘real’ you

The distinguishing feature between bipolar II and normal quirks of personality is that, in bipolar II, both the episodes of depression and the episodes of hypomania don’t “fit” with the person’s normal personality. You notice the shifts as they move from the person you’re familiar with to being extremely depressed or overly energized. 

If you suspect you or a loved one has bipolar II, call us at 601-685-3457 for an evaluation, book an appointment online, or send a message to our team. You may be eligible for new medications and supportive therapies for bipolar II without charge.