Bipolar II Disorder

Bipolar II is mental illness similar to Bipolar I disorder with two extreme mood cycles between high and low. The difference between bipolar I and bipolar II is that in bipolar II disorder the mood elevation symptoms never reached full manic episodes. The person with bipolar II disorder have at least one hypomanic episode in his or her life.

Diagnostic criteria of Bipolar II Disorder

According to DSM 5TR the diagnostic criteria of Bipolar II disorder is as following:

For the diagnosis of Bipolar II Disorder it is necessary to meet the criteria of a hypomanic episode and major depressive episode.

Diagnostic criteria of Hypomanic Episode

Diagnostic Criteria A.

Individual have elevated and irritable mood symptoms persistently with abnormally increase in energy and activity for the duration of 4 consecutive days, nearly every day.

Diagnostic Criteria B.

Three or more than three of following symptoms must be present during the period of increased energy and the presence of these symptoms bring a change in usual behavior of the individual which is noticeable as well.

Grandiosity or exaggerated self-esteem.
Lack of need of sleep (3 hours sleep is enough to feel rested)
Talkative than usual or keep talking.
Flight of ideas individual feels like his or her thought are racing.
More distractibility, attention of individual is drawn easily even due to irrelevant stimuli.
Psychomotor agitation and increase in goal directed activities.
Involvement in activities with high painful consequences like foolish business investments.

Diagnostic Criteria C.

A very slight change in functions and daily life of the individual.

Diagnostic Criteria D.

The disturbance in the functions and behavior of individual is observable.

Diagnostic Criteria E.

The hypomanic episode is not to that intensity that causes impairment in daily social or occupational life of the individual.

Diagnostic Criteria F.

The hypomanic mood symptoms of the individual are not due to any physiological effect of a substance.

Note: sometime the symptoms of full hypomanic episode occur due to antidepressant medications, but as these are due to the physiological effect of substance so this is insufficient for the diagnosis of bipolar II disorder.

Diagnostic criteria of Major Depressive Episode

Diagnostic Criteria A.

Five or more than five symptoms from mentioned below must be present in the individual for the duration of 2 weeks. The symptoms must be to the intensity that cause change in daily functioning of the individual. At least one symptoms either depressed /irritable mood or loss of interest must be present.

Person feels sad, depressed and hopeless most of the day or every day as per subjective reports or been observed by others (in children it can be observed as irritable mood)
Loss of interest or lack of pleasure in almost all activities of everyday life as per subjective description or been observed by others.
Significant weight loss even without dieting or weight gain and either loss of appetite or increase in appetite and the change in body weight is more than 5% in a month (in children there is failure to gain expected weight in ratio to age).
Lack of sleep, no sleep or sleep more than usual in every day routine means individual have insomnia or hypersomnia.
Individual experience psychomotor agitation and restlessness or slowdown, this is either observed by others and not by the individual itself.
Individual experience loss of energy or fatigue most of the day or every day.
Individual feels worthlessness or inappropriate guilt which is usually delusional and this guilt is usually delusional and it is felt most of the day or nearly every day.
Indecisiveness or lack of ability to concentrate or think is felt nearly every day.
Persistent suicidal ideas or recurrent thoughts relevant to death even without any specific suicidal plan for committing suicide.

Diagnostic Criteria B.

The above mentioned symptoms are causing significant issue and distress in daily life functioning of daily life of individual.

Diagnostic Criteria C.

The symptoms are due to any psychological effect of substance or not due to another medical condition.

Note: The symptoms mentioned in Criteria A–C can cause major depressive episode. The symptoms of Major depressive episodes are usually found in Bipolar II disorder but on the basis of only major depressive episodes symptoms we cannot diagnose bipolar II disorder.

Note:

As a result of any significant loss in financials, loss in any natural disaster, any bereavement, and any physical illness or disability can cause the feelings of intense sadness, loss of appetite, lack of sleep and weight loss mentioned in Diagnostic criteria A of major depressive episode. Such symptoms are understandable and these can be a normal response to significant loss. So to declare the diagnosis of major depressive disorder in such cases needs wide clinical expertise and individual life history as well.