Bipolar ii

Bipolar II Disorder is characterized by one or more depressive episodes accompanied by at least one hypomanic episode. A hypomanic episode is defined as a distinct period of persistently elevated, expansive, or irritable mood, lasting at least 4 days, that is clearly different from the person’s non-depressed mood. Hypomanic episodes have symptoms similar to manic episodes (found in Bipolar I Disorder), but are less severe. In general, hypomania is not severe enough to cause notable problems in social activities, work or to necessitate hospitalization, and there are no psychotic features. When four or more episodes of illness occur within a 12-month period, a person is said to have rapid-cycling bipolar disorder. Some people experience multiple episodes within a single week, or even within a single day. Rapid cycling tends to develop later in the course of illness and is more common among women than among men.

Bipolar Disorder, also known as a "manic-depressive illness" or "manic depression", is a complex mood disorder characterized by dramatic mood swings - from hypomania and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. Severe changes in energy and behavior go along with these changes in mood. Bipolar Disorder typically develops in late adolescence or early adulthood. However, some people have their first symptoms during childhood.

Individuals with Bipolar Disorder often suffer from other, comorbid psychiatric conditions. In one study of 60 patients with Bipolar Disorder, 23 (38%) fulfilled the diagnostic criteria for at least one personality disorder, most commonly narcissistic, borderline, antisocial, obsessive-compulsive, or avoidant disorder. The presence of these disorders may make Bipolar symptoms more intense and more difficult to treat and appears to increase the risk of suicide.

Although currently classified as separate illnesses, there is increasing interest in the psychiatric community in viewing unipolar depression, Bipolar Disorder, and anxiety disorders as part of a larger, overlapping spectrum of mental disorders. This trend is supported by findings that many individuals who are first diagnosed with unipolar depression are eventually diagnosed as actually suffering from Bipolar Disorder. One interesting study, Diagnostic conversion from depression to bipolar disorders, tracked 406 patients with major mood disorders over a 20-year period. Of 309 patients presenting with depression, 121 (39.2 percent) eventually manifested as Bipolar (24.3 percent to Bipolar Type I, 14.9 percent to Bipolar Type II). One reason for this finding may be due to improperly diagnosed Bipolar Disorder – estimates are that on average it takes 7 1/2 years before a Bipolar diagnosis is made. This growing debate over the accuracy of diagnostic classifications might seem to be purely academic except for the effect it has on treatment protocols. As antidepressant mono-therapy is the mainstay treatment for depressive, and to some degree anxiety disorders, it is typically not recommended for Bipolar Disorder without the addition of mood stabilizing medications.

Treatment
Because Bipolar Disorder involves both depression and times of overly elevated mood, it is seen as a greater challenge to treat than unipolar depression. Individuals with Bipolar Disorder typically are depressed three times longer than they experience mania or hypomania and Bipolar depression is associated with a greater risk of suicide and of impairment in work, social, or family life than mania/hypomania. Treating Bipolar Disorder can be very challenging. Traditional antidepressants are not recommended as monotherapy as they can induce switching to mania/hypomania. Instead, individuals are often treated with a mood stabilizing medication such as Lithobid etc. (Lithium Carbonate / Citrate), or Lamictal etc. (Lamotrigine); new generation atypical antipsychotic medications such as Seroquel (Quetiapine); and an antidepressant medication.