Bipolar Type 2
Bipolar type -II Disorder is characterized by one or more Major depressive episodes accompanied by at least one hypomanic episode
The person with Bipolar II Disorder may not see his or her own behavior as out of the ordinary, but others around the person may see the behavior as erratic.
The classic form of the illness, which involves recurrent episodes of mania and depression, is called bipolar I disorder . Some people, however, never develop severe mania but instead experience milder episodes of hypomania that alternate with depression; this form of the illness is called bipolar II disorder.
Bipolar II –In Bipolar II disorder, the adolescent experiences episodes of hypomania between recurrent periods of depression. Hypomania is a markedly elevated or irritable mood accompanied by increased physical and mental energy that last 3-4 days. Bipolar II Disorder is 5-10 more common than Bipolar I Disorder.
Diagnosis criteria for Bipolar type-II Disorder are:
Many patients with bipolar disorder are initially misdiagnosed. This occurs most often either when a person with bipolar II disorder, whose hypomania is not recognized, is diagnosed with unipolar depression, or when a patient with severe psychotic mania is misjudged to have schizophrenia. Some of the diagnosis criteria are as follows:
- Person may have one or more Major depressive episodes
- Person have at least one Hypomanic episode
- There has never been a manic or mixed episode
- Another disorder is not responsible for symptoms
- Bipolar II Disorder Symptoms cause distress or impair functioning
Effective treatment is available for bipolar disorder. Treatments include medication, supportive psychotherapy and occasionally ECT. The treatment of mania and hypomania has two phases: an acute phase, in which the acute syndrome is quelled and social and occupational impairment is improved; and a maintenance phase, in which medications are administered long term to prevent the recurrences of the condition.
Widely used to treat bipolar disorder, lithium (lithotabs, Eskalith) has proven highly effective in relieving and preventing manic episodes. It curbs accelerated thought processes and hyperactive behavior without producing the sedating effect of antipsychotic drugs or medications. In addition, it may prevent the recurrence of depressive episodes. Even so, it’s ineffective in treating acute depression.
Because lithium has a narrow therapeutic range, treatment must be initiated cautiously and the dosage adjusted slowly. Therapeutic blood levels during the active manic period are 0.4 to 1.4 mEq/L. For safety, the level should never exceed 1.5 mEq/L. Therapeutic blood levels must be maintained for 7 to 10 days before the drug’s beneficial effects appear; for this reason, antipsychotic drugs are commonly used in the interim to provide sedation and symptomatic relief. Because the kidneys excrete lithium, any renal impairment necessitates withdrawal of the drug.
Anticonvulsants, such as carbamazepine (Tegretol. Carbatrol), valproic acid (Depakene), and clonazepam (Klonopin), are used either alone or with lithium to treat mood disorders. Carbamazepine, a potent antimanic drug, is effective in many lithium-resistant patients.
Antidepressants are used to treat depressive symptoms, but they may trigger a manic episode.