Bipolar II Disorder

Requires at least one major depressive episode and one hypomanic episode (but no full manic episode).

Etiology (Biopsychosocial Model)

Biological: Similar heritability to Bipolar I; abnormal serotonin/dopamine functioning.

Psychological: Perfectionism, cognitive distortions.

Social: Early trauma, stressful relationships.

Symptoms & Diagnosis (Mnemonic: HIDE ME)

  • H - Hypomania (≥4 days, not severe enough to impair)
  • I - Impulsivity and increased activity
  • D - Depression episodes lasting ≥2 weeks
  • E - Energy fluctuations
  • M - Mood instability
  • E - Exclusion of past manic episode

Treatment

Mood stabilizers: lamotrigine, lithium.

Psychotherapy: CBT, interpersonal and social rhythm therapy.

Antidepressants: Used cautiously (risk of switching to hypomania).

Info

DSM-5-TR Code

F31.81

Prevalence

12-month prevalence: ~0.8% U.S. adults; often underdiagnosed.