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Bipolar II Disorder

Difference from Bipolar I Disorder

Diagnostic Criteria and Descriptors

Manic v Hypomanic

  • 1 week v 4 days
  • less severe energized episode

Bipolar II requires major depressive episode for diagnosis

https://www.medicalnewstoday.com/articles/323854

depressed mood

loss of interest/pleasure

Need at least 5 symptoms

feelings of worthlessness/guilt

weight loss/gain

Major Depressive Episode for at least 2 weeks

insomnia/hypersomnia

suicidal thoughts/ideation

  • cannot be a physiological side effect from a substance
  • it should be considered if in response to a major loss

fatigue/loss of energy

indecisiveness/inability to concentrate

  • Inflated Self-Esteem
  • Decreased need for sleep
  • More talkative
  • Excessive involvement in activities that are likely to have major consequences

Need at least 3 symptoms

Hypomanic Episode for at least 4 days

  • Increase in goal-directed activity
  • Racing Thoughts

Use code 296.89 (F31.81 )

Subtypes and Specifiers

specify current or most recent episode of hypomania or depression

with anxious distress

with peripartum onset

with mood-congruent psychotic features

with rapid cycling

with catatonia

Specify...

with mixed features

with seasonal pattern

with mood-incongruent psychotic features

Specify severity if full criteria are met for a mood episode

severe

mild

Specify...

moderate

partial remission

Specify...

Specify course if full criteria for a mood episode are not met

full remission

Cultural and Gender Related Diagnostic Issues

Is there a gender difference?

Females are slightly more likely to be diagnosed

Yes, but no

However, this could be explained by the fact that women are more likely to seek therapy/treatment

Childbirth

Women do have different patterns

In some cases, childbirth may precede the onset of the first episode

Patterns of Illness

post-partum hypomania

Rapid Cycling is more common in women

Hypomania with mixed depressive features is more common in women

post-partum depression

difficult to distinguish from normal post-birth behavior

Attendance issues

Disengagement during practice

Mood Swings

How might a performer behave if they have bipolar II?

Perceived Implications/Occurrences in Sport and Performance

Increase/decrease in energy

something to note: onset is typically not until mid-20s, but can occur earlier

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