Bipolar II disorder differs from bipolar I in some ways. In general they are both a disorder of mood that ranges from extreme highs to extreme lows. Unlike bipolar I, which emphasizes the manic phase occurrences, bipolar II presents as a serious depressive mood disorder with hypomanic episodes mixed in. These distinctions, presented by the Diagnostic and Statically Manual of Mental Disorders, serve to further individualize people with bipolar disorder.
Hypomania
Dorland’s Illustrated Medical Dictionary defines hypomania as an abnormality of mood resembling mania that includes persistent elevated or expansive mood, hyperactivity and inflated self-esteem, but to a lesser degree.
Hypomanic Behaviors
A person who feels manic often lacks sound judgment and so partakes in daring, dangerous or taboo behaviors while in this mood. The individual tends to be spontaneous or even impulsive and shows a lack of good judgment. In a hypomanic person, these tendencies manifest themselves in the following ways: inability to sleep or requiring less sleep; uncharacteristic or exaggerated self-confidence; increase in substance abuse; increase in sexual activity; infidelity in an otherwise faithful partner; risky or injurious behavior like fast driving; spending money in excess or charging expensive items; venting anger easily and appearing agitated; and eating in excess or hardly eating at all.
The Transition
A bipolar person could exhibit these behaviors for days, weeks or months. The certainty that the cycle will reverse itself often is forgotten in the throes of the exciting hypomania. When at last the person comes down from her manic high, she usually sinks into a troubling depression. He feels remorse for his misdeeds and might have to face enormous bills that mounted during the manic phase. A person of support or a professional must help her put the pieces of her life back together.
Depression
During this phase of a bipolar person's cycle, his self-esteem suffers and he often feels self-hate. She may withdraw into her own world, sleeping constantly and avoiding contact with others. He seems unresponsive or catatonic. This phase poses a danger to the bipolar, as she feels so low that she contemplates, and sometimes executes, suicide. He feels hopeless, ashamed and incapable of looking toward the future. The depth of this mood distinguishes the bipolar II person from the bipolar I person.
Depressive Behaviors
Depressive behaviors associated with bipolar II include the following symptom: sadness apparent in facial expression, posture and tone of voice; unwillingness to participate in normally enjoyed activities; diminished appetite; excessive sleeping; disinterest in surroundings or appearance; disinterest in people and events; desire voiced to end life or make a plan for ending it; and crying easily and often.
DSM Criteria
The DSM requires that the manic and depression phases be repeated in a cycle to make the bipolar disorder diagnosis. Evidence of social and interpersonal impairment must exist as well. Further, the DSM notes that the characteristics must not be related to or the result of any other mental illness. Once the person’s behaviors meet the DSM criteria, the mental health professional treats the disorder with medicine and counseling.
References
- Diagnostic and Statistical Manual of Mental Disorders, 4th Edition; American Psychiatric Association, publisher; 2000
- Dorland's Illustrated Medical Dictionary, 31st Edition; Sanders Elsevier, publisher; 2007
