The key diagnostic points for a diagnosis of Bipolar II disorder are the presence of depressive and hypomanic episodes. At the time of your diagnosis, you've experienced periods when everything in life seems crushing, when you don't even want to get out of bed, when dragging yourself to work feels like you have lead weights on your body and spirit.
You've also had periods when life seems awesome or even too fast, when you can bounce out of bed and whiz through your responsibilities, when you might talk too fast or be overwhelmed by racing thoughts or hurt yourself through poor judgment.
You may also have had periods when the symptoms of depression and hypomania are mixed - for example, when racing thoughts are driving you mad yet you feel unable to cope with even simple tasks.
But now, some years later, things have changed. It's been forever since you had a hypomanic episode. You alternate between depressive or mixed episodes and a more stable state that may or may not qualify as being in a "good" mood.
And that's not at all unusual. In all types of bipolar disorder, depressive episodes are more common than hypo/manic episodes. In Bipolar II, depression is much more common. And over time, hypomania can grow even more infrequent or can merge into mixed episodes.
People with Bipolar II disorder tend to have more, longer, and more severe depressive episodes than those with Bipolar I. They are spared some of the terrible torments of mania, but the fact is that as time passes, people with Bipolar II - particularly those whose condition isn't well-controlled - may find themselves having more and more difficulty pulling out of depression, with fewer and fewer periods of hypomania.
Researchers have found that in general, repeated Bipolar II depressive episodes lead to feeling more depressed between episodes. Here's a representation:
Although this is highly condensed, you can see that as time goes by, the "stable" level between high and low episodes gets lower, and this is what studies have found in Bipolar II.
I know this is kind of a downer, but I also find it validating. It isn't my imagination!
But neither should it be an excuse. Yes, there's a reason why even after I pull out of a bad depressive episode, I still don't feel as good as I think I should. But now that I know why, I can cope better. I can do the things I know will improve that mood - not just for the short-term, but for the length of the stable period. Those things ought to help me stay out of the depressive episode longer, too.
I'll set timers to tell me when to get up and walk around instead of staying at the computer too long. I'll make sure I get outside. I'll make healthy meals that will give me several days of leftovers. You all know what works for you. Make a list. Refer to it every day.
Published On: June 23, 2011
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