Bipolar disorder is a psychiatric diagnosis defined by one or more episodes of abnormally elevated mood which can be combined or not with one or more depressive episodes.
There are three main types of bipolar disorder, including bipolar I disorder characterized with at least one manic or mixed episode, bipolar II disorder defined by at least one hypomanic and at least one depressive episode and bipolar NOS which does not belong to either of the subgroups.
This paper will discuss the difficulties of identifying the symptoms of bipolar II disorder which is recognized as the most frequent one, the stages of assessment required for the adequate diagnosis of condition and the effectiveness and challenges of different treatments and their combination.
Regardless of the fact that the bipolar disorder is the sixth recognized cause of disability in America, it is a chronic psychiatric disease which can often be misdiagnosed (Leahy 417).
Diagnosing of the bipolar II disorder is complicated with its complex and diverse presentation of the symptoms. Medical comorbidity characteristic of this condition is another influential factor which should be taken into account for assessing all the symptoms in their complexity.
“Medical conditions found at increased rates include coronary heart disease, hypertension, hyperthyroidism, diabetes, dysplidemias, and hepatitis” (Leahy 418). These comorbid medical conditions can be the consequences of the reduced self-care which exacerbate the depression and stress in patients with bipolar II disorder.
Practitioners have to recognize not only mania itself as the diagnostic sign for the bipolar disorder, but also hypomania and mixed states (Leahy 419). Patients can quickly move from one condition to another and try to conceal certain symptoms which are critical for diagnosing this psychiatric disease.
The process of the premedication assessment is significantly complicated with the fact that patients with bipolar II disorder frequently have more than one mental dysfunction. This group of comorbid conditions includes anxiety, personality disorders and substance abuse which in their turn can increase the rates of aggressively, impulsivity and even suicidality.
A comprehensive and detailed clinical assessment of the prior history of psychiatric conditions and the current mental state should be undertaken for formulating the right diagnosis, developing and implementing the most effective intervention strategies (Malhi et al 2065).
Taking into account the fact that patients with bipolar disorder not only frequently do not recognize their disease, but also can have poor recollections of concrete episodes, it is necessary to consult their friends and family members for obtaining more accurate information and identifying the symptom patterns.
Thus, the adequate diagnosis of bipolar II disorder requires a detailed assessment of not only actual symptoms, but also the possible comorbid physical and mental conditions, analysis of the past psychiatric history and the current condition.
The common treatments used for the patients with bipolar II disorder include the combination of psychological treatments and pharmacotherapy. Thus, the common psychological treatments include interpersonal social group, family-focused and cognitive-behavioral types (Leahy 419).
Regarding the pharmacological treatments for bipolar depression, the drugs which can be effective for improving the patients’ condition and reducing the risks of suicide include anti-depressants and non-antidepressants. The group of non-antidepressants includes lithium salts, anticolvunsants and antipsychotics.
Currently, polytherapy as a combination of different drugs and treatment patterns is recognized as the most effective intervention strategy (Baldessarini 148).
It should be noted that the abrupt drug discontinuation causes the recurrence of anxiety and can be followed by hypomanic episodes. Thus, the treatments for the patients with bipolar II disorder need to include a combination of drugs and psychosocial rehabilitative efforts.
Taking into account the fact that the adequate diagnosis and effective treatment of the bipolar disorder II remains an unsolved challenge for modern psychiatric practitioners, it can be stated that serious consideration should be given to complex approaches to the assessment, diagnosing and treatment of the patients with the symptoms of bipolar II disorder.
Baldessarini, Ross, Eduard Vieta, Joseph Calabrese, Mauricio Tohen and Charles Bowden. “Bipolar Depression: Overview and Commentary”. Harvard Review Psychiatry May/June 2010, 18: 143-157.
Leahy, Robert. “Bipolar Disorders: Causes, Contexts, and Treatments”. Journal of Clinical Psychology 2007, 63(5): 417-424.
Malhi, Jin, Danielle Adams, Catherine Cahill, Seetal Dodd and Michael Berk. “The Management of Individuals with Bipolar Disorder: A Review of the Evidence and Its Integration into Clinical Practice”. Drugs 2009, 69(15): 2063-2101