Bipolar Type 2 Symptoms

There are two types of bipolar disorder called bipolar 1 disorder and bipolar 2 disorder. Bipolar 2 disorder is a mental health illness similar to bipolar 1 in that moods cycle between depression and hypomania that can last for days, weeks, or longer. Depression is the predominant symptom and the mood swings are less severe with bipolar 2 disorder.

This article discusses symptoms, diagnosis, risk factors, and treatment for bipolar 2 disorder.

Depression

With bipolar type 2 disorder, similar to bipolar type 1 disorder, episodes of depression are often the first symptoms to be experienced.

Symptoms of depression may include:

• Feeling very down, sad, or anxious
• Feeling slowed down or restless
• Trouble concentrating or making decisions
• Having trouble sleeping or sleeping too much
• Lack of interest in most activities
• Unable to do even simple things
• Feeling hopeless or worthless, or thinking about death or suicide

A person with bipolar disorder will experience five or more symptoms during a two-week period, with at least one of the symptoms being 1) depressed mood most of the day nearly every day or 2) loss of interest or pleasure.

Hypomania

Along with depression, another distinguishing symptom of bipolar 2 disorder is hypomania. A person with bipolar 2 disorder does not experience full mania like people with bipolar 1 disorder.

Symptoms of mania and hypomania can include:

• Feeling elated or irritable
• Feeling unusually important, powerful, or talented
• Feeling jumpy or wired
• Talking faster than usual about a lot of different things 
• Excessive appetite for food, drinking, sex, or other pleasurable activities
• Racing thoughts
• Needing less sleep
• Feeling able to do many things at once without getting tired

Mania

People with bipolar 1 disorder have manic episodes that last at least 7 days (most of the day, nearly every day) or can have manic symptoms that are so severe hospital care is needed.

A key difference between the two types of bipolar disorder is that people with bipolar 2 disorder experience symptoms that are usually less severe and might not inhibit their ability to function in daily life.

If you experience periods of elevated mood or excitability in between depressive episodes, tell a mental health professional to ensure you receive an accurate diagnosis and correct treatment.

Diagnosing Bipolar 2 Disorder

Diagnosing bipolar 2 disorder can be difficult because it can look like other mental health disorders such as:

• Anxiety disorders
• Obsessive-compulsive disorders
• Personality disorders
• Schizophrenia

Bipolar disorders are generally diagnosed by psychiatrists, medical doctors, and licensed mental health professionals. Typically, they will ask a series of questions about symptoms and diagnosis is based on the severity, length, and frequency of symptoms. They may use a screening tool, like the Mood Disorder Questionnaire (MDQ) or the Hypomania/Mania Symptom Checklist (HCL-32).

Diagnostic criteria include:

Bipolar 1 disorder: A person will have at least one manic episode, with or without an episode of depression. A manic episode may involve psychosis, which can include hallucinations or delusions. During mania, a person may need hospital care.

Bipolar 2 disorder: A person will have at least one depressive episode and at least one episode of hypomania, which does not involve psychosis. Depression is often the dominant mood.

According to studies conducted years ago, researchers determined that people with bipolar 2 disorder typically have depression more than 50% of the time, while people with bipolar 1 disorder experience depression about 30% of the time.

Who Is at Risk for Bipolar Type 2 Disorder?

There are several factors that can contribute to someone having the disorder.

Genetics. Bipolar disorder is highly genetic. Those with a first-degree biological family member (parent or sibling) with bipolar disorder are at the highest risk of developing the disorder. Having a family history of bipolar disorder also is a strong predictor of developing it.

Brain structure and functioning. Some studies show that the brains of people with bipolar disorder differ from the brains of people who do not have bipolar disorder or other mental disorders. However, more research and understanding are needed.

Environmental factors. Stress and traumatic events may contribute to triggering bipolar disorder in people with a genetic predisposition. Symptoms may also appear during pregnancy, after childbirth. More research is needed to understand the connection between genetics and environmental factors and how they might interact.

Others who should be screened for bipolar disorder include those for whom antidepressants are not effective or that worsen mood symptoms and those who frequently experience depression that is interrupted by periods of feeling "better than good." Also, teenagers between the ages of 13 and 18 who experience frequent depression should be screened for bipolar disorder.

Bipolar 2 Disorder Treatments

Treatment of bipolar disorder is an ongoing process and must be maintained by a mental health professional to manage symptoms and ensure the person's safety and healthy functioning. Though bipolar disorder is a lifelong illness, medication and mental health therapy can stabilize moods and allow a person to live a healthy life.

Treatment and management of bipolar 2 disorder may include:

• Psychotherapy: cognitive behavioral therapy and family-focused therapy.
• Medications: mood stabilizers and antipsychotic medications, such as Lithium, Depakote (valproate), Tegretol (carbamazepine), and Lamictal (lamotrigine)
• Self-management strategies: education and recognition of an episode’s early symptoms
• Complementary health approaches: aerobic exercise, meditation, faith, and prayer can support, but not replace, treatment

Summary

Bipolar 2 disorder is a type of mental illness that is characterized by swings in mood that vary between periods of depression and periods of hypomania. Hypomania includes persistently elevated, expansive, or irritable moods and increased energy.

Although the mania in bipolar 2 is less severe compared to bipolar 1, bipolar 2 disorder is a serious illness that must be diagnosed, treated, and managed by a mental health professional. The depression that is part of this illness can be quite severe and persistent. Left untreated, bipolar disorder can become highly disruptive and can cause significant distress in those affected and their loved ones.

A Word From Verywell

Learning you have bipolar disorder can be scary and overwhelming. If you think you might have bipolar disorder or you have already been diagnosed, know that there is treatment available that can help you manage the illness and live a happy, stable life.

The most important measure you can take for your mental health is be open with your doctor or mental health professional about any periods of high energy, irritability, risk-taking behaviors, or other uncharacteristic behaviors that occur in between episodes of depression.

Receiving a correct diagnosis, beginning treatment right away, and continuing to work with mental healthcare professionals to manage your disorder will help you to feel like yourself again and prevent future disruptive episodes.