Bipolar II Disorder
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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.
New onset in older patients (>50 years) requires a workup for organic or chemically induced pathology.
Diagnosis less well defined
- 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%
Genetics, major life stressors, or substance abuse
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