Characteristics of soft bipolar--included in the Bipolar Disorder II family--are recognized as a part of the bipolar spectrum disorder. Outlined by psychiatrist Dr. Arnold Lieber, the inclusion acknowledges what patients and psychiatrists have long reported: the range of symptoms and lengths of time they are experienced are as diverse as the people who experience them. Because the symptoms are varied, it follows that the treatments to address them may be assorted as well.
Length of Time
Unlike Bipolar I, in which manic and depressive episodes may last for months at a time, soft bipolar may include extreme moods that last two hours or two weeks. More than just a series of bad moods, the moods are elevated in nature and always reoccur.
Mood Polarities
Soft bipolar disorder includes more than simply manic or depressive episodes. The range of symptoms may include mixed states, meaning that mania and depressive symptoms occur at the same time. The rapid cycling bipolar disorder indicates a fast switch between mania to depression, returning again to mania or hypomania. Hypomania includes euphoric (extreme happiness) or dysphoric (acutely sad) periods that may affect behavior but do not reach psychotic proportions. With episodic mood instability, depression is milder and may respond to positive environmental factors temporarily, but inevitably returns to the original depression. At times, the depression may be marked by excesses in eating, sleeping and fatigue, and it often is accompanied by anxiety.
Effects on the Patient
Soft bipolar does not impair a patient's ability to function as seriously as Bipolar I. However, the alternating of major depression with hypomania will affect a patient's behavior and may remain unaddressed for a longer period of time, because often the patient may ignore hypomania symptoms and appear for clinical intervention only when his mood dips into a pronounced depression.
Treatment Options
Often, the mood stabilizers prescribed for Bipolar I are effective for soft bipolar. However, the shifting and varied moods also may respond to anticonvulsants, antidepressants and anti-anxiety medications. It is not uncommon for more than one medication to be prescribed to address the symptoms. Each medication takes several weeks before taking full effect, and the amount prescribed may need to be adjusted as symptoms change. The dose or the combination of medications prescribed is unique to each patient and her symptoms. Ongoing supervision from a doctor is necessary to ensure that the maximum benefit from the medication is being received. In addition to medication management, individual therapy, family counseling and education also are recommended to address the illness.
