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Bipolar II Disorder

Bipolar II Disorder is a topic covered in the 5-Minute Clinical Consult.

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Bipolar II (BP-II) is a mood disorder characterized by at least one episode of major depression (with or without psychosis) and at least one episode of hypomania, a nonsevere mood elevation.

Geriatric Considerations
New onset in older patients (>50 years) requires a workup for organic or chemically induced pathology.

Pediatric Considerations
Diagnosis less well defined

Pregnancy Considerations
  • Pregnancy does not reduce risk of mood episodes.
  • Need to weigh risk of exposure to mood episode to that of medication
  • Avoid divalproex due to high teratogenicity risk.
  • Postpartum caries risk of severe acute episode with psychosis and/or infanticidal ideation.


Onset usually between 15 and 30 years of age

  • 0.5–1.1% lifetime prevalence
  • More common in women

Etiology and Pathophysiology

Dysregulation of biogenic amines or neurotransmitters (particularly serotonin, norepinephrine, and dopamine)

Heritability estimate: >77%

Risk Factors

Genetics, major life stressors, or substance abuse

General Prevention

No known way to prevent onset, but treatment adherence and education can help to prevent further episodes.

Commonly Associated Conditions

Substance abuse or dependence, ADHD, anxiety disorders, and eating disorders

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Stephens, Mark B., et al., editors. "Bipolar II Disorder." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116900/all/Bipolar_II_Disorder.
Bipolar II Disorder. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116900/all/Bipolar_II_Disorder. Accessed March 22, 2019.
Bipolar II Disorder. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116900/all/Bipolar_II_Disorder
Bipolar II Disorder [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 March 22]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116900/all/Bipolar_II_Disorder.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Bipolar II Disorder ID - 116900 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116900/all/Bipolar_II_Disorder PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -