Depression Wiki

Bipolar II disorder is defined by the DSM as having one or more major depressive episodes as well as one or more hypomanic episodes.

Major depressive episode[]

A major depressive episodes is a period of two weeks or more where a person has either

  • depressed mood (can be irritable in children) or
  • the loss of interest or pleasure in nearly all activities

and may also have the following symptoms (at least 5 or more) nearly every day:

  • depressed (or irritable for children) mood by a person's own report or as observed by others
  • significantly diminished interest or pleasure in all, or almost all, activities most of the day
  • significant change in weight (not due to dieting) or appetite
  • insomnia or hypersomnia
  • observable physical agitation or lethargy
  • fatigue or loss of energy
  • feelings of worthlessness or excessive or inappropriate guilt
  • having difficulty thinking clearly or concentrating or indecisiveness
  • regular thoughts of death or suicide (either unplanned, planned, or attempted)

Hypomanic episode[]

A hypomanic episode is a period of 4 days with abnormally and persistently elevated, expansive, or irratible mood.

and may also have the following symptoms (at least 3 or more) are persistent:

  • inflated self-esteem or grandiosity
  • decreased need for sleep
  • more talkative than usual or pressure to keep talking
  • flight of ideas or racing thoughts
  • distractability
  • increase in goal-directed activity
  • excessive involvement in pleasurable activities that have high potential for painful consequences

To meet clinical standards these symptoms also must cause significant distress or impairment in social, occupational, or other important areas of functioning.

The condition is also not caused or explained by the following:

  • Due to effects of drugs or medication*
  • Due to a medical condition

*Monothearpy with antidepressants can cause severe manic epsiodes in some people with bipolar disorder, which happens when they are treated for unipolar depression. Sometimes doctors use this unusual reaction to aid in diagnosis along with reviewing the patient's history and talking to other people in the person's life to see if the person had symptoms of a past manic or hypomanic epsiode. DSM-5 will allow this to be a consideration in diagnosing bipolar disorder, though it encourages caution.

This diagnosis is not used if the person has had any of the following:

Mood disorders as diagnosed by the DSM edit
Mood episodes: Major depressive episode Manic episode Mixed episode Hypomanic episode

Depressive disorders: Major depressive disorder Dysthymic disorder Depressive disorder NOS (PMDD)

Bipolar disorders: Bipolar I disorder Bipolar II disorder Cyclothymic disorder Bipolar disorder NOS

Other mood disorders: Mood disorder due to a general medical condition Substance-induced mood disorder Mood disorder NOS

Episode specifiers: Severity Psychotic Remission Chronic Catatonic Melancholic Atypical Postpartum

Course specifiers: Longitudinal Seasonal (SAD) Rapid cycling