Bipolar II Disorder is an abnormal mental health condition described by frequent depression and hypomanic episodes. Abnormal mood changes are also common symptoms of the condition. Like most bipolar conditions, Bipolar II is inherited and poses a greater risk to immediate relatives of people with bipolar disorders. The condition may also be caused by neurochemical poisoning or other environmental factors. Approximately 2.5% of people in the US live with the condition (Pratt, 2022). The condition affects not only patients’ physical and mental health of patients but also their social and occupational lives. The symptoms of Bipolar II disorder may be confused with symptoms of other disorders as listed in the DSM-5 TR criteria. The condition is diagnosed through brain scans, among other evaluations. This paper discusses the prevalence and neurobiology of the condition. Different populations have different prevalences for the condition. To distinguish the symptoms of this condition, I will compare and contrast it with Bipolar I disorder. The FDA has various approved pharmacological treatments for Bipolar II disorder with different effects and prescriptions. Bipolar II disorder is a common mental health condition with similar symptoms as other disorders but different treatments.
The specific cause of Bipolar II disorder is yet to be determined. However, scientists’ research shows about a 10% possibility of inheriting the condition from a parent to a child (Pratt, 2022). Other causes of Bipolar II disorder are extreme stress, drug, and substance use, and lack of enough sleep. Social factors such as poverty and religion may also cause Bipolar II disorder. The normal structure and function of the brain are distorted upon acquiring the condition. This lays the basis for the diagnosis of the condition. Neurotransmitters such as dopamine, serotonin, and epinephrine in the brain of a Bipolar II disorder patient are imbalanced leading to different symptoms in different patients. Research shows that people with the condition have reduced gray matter in the brain (Chen et al., 2019). The gray matter is responsible for movement, memory, and emotions. The hippocampus also shrinks in people with the condition.
Most mental health disorders in the DSM-5 TR are difficult to differentiate from with respect to the symptoms as they are similar. Disorders with similar symptoms as Bipolar II disorder include Bipolar I Disorder and Cyclothymic Disorder (Beunders et al., 2022). The major distinguishing factor between Bipolar I and Bipolar II is the severity of hypomanic episodes. There are minor hypomanic episodes in Bipolar II compared to Bipolar I (Beunders et al., 2022). Severe hypomanic episodes in Bipolar I are characterized by hallucinations and delusions. During diagnosis, Bipolar I disorder necessitates the presence of a manic episode and no depression history, while Bipolar II requires a hypomanic and depressive episode. Precise diagnosis is required to differentiate these two disorders.
Although the hypomanic symptoms in Bipolar II disorder have been described as less severe compared to Bipolar I disorder, the severity is higher compared to Cyclothymic disorders. The symptoms of Cyclothymic disorders include elevated mood and depression symptoms such as anxiety (McIntyre et al., 2020). The symptoms are similar to those of Bipolar I and II disorders but are less severe.
Children and youths show rare signs of Bipolar II Disorder. This may be attributed to other mental health conditions such as Attention-Deficit/ hyperactivity disorder (ADHD) (McIntyre et al., 2020). Treatment for these individuals is limited with the effects of the medications being a major societal issue. Women have been identified to be affected by depressive disorders more compared to men. They contribute to a larger population of bipolar-affected individuals among the affected people in the world.
During pregnancy, women suffer the risk of mood changes which contributes to bipolar II disorder (McIntyre et al., 2020). Medication use places the fetus at risk and therefore is not advisable. After pregnancy, women may also face stress after giving birth leading to bipolar disorders. The elderly are the last group affected by bipolar II disorder. Underlying health conditions could cause the condition, environmental factors and social factors. Some naturally occurring symptoms, such as those from dementia, could be confused with those of Bipolar II disorder.
Legal difficulties such as those relating to capacity, competency, and legal responsibility may be faced by people with Bipolar Disorder II. For instance, someone experiencing a manic episode may act impulsively or recklessly, which may have legal repercussions. Due to the disease’s effects on functioning, people with bipolar disorder may also struggle with employment-related problems, including discrimination or trouble keeping a job (Beunders et al., 2022). Before judgment is adjourned in a court of law, the mental health status of a person is examined to ensure they are of sound mind. Families and the community need to understand the effects of a disorder and refrain from judging the patients for their actions. The community and the government are responsible for ensuring the legal rights of a Bipolar II disorder patient are followed.
The treatment of people with Bipolar Disorder II involves a number of ethical issues. Making sure people are well informed before initiating therapy with drugs that could have serious side effects or long-term dangers is important (Gitlin & Malhi, 2020). Also, there are worries regarding the potential for improper or excessive use of restraints or involuntary hospitalization in managing people with bipolar disease. Although the patient’s mental status is under scrutiny, it is important to ensure the family members of all possible therapies and their effects. In most cases, people with Bipolar II conditions may be unable to pay for medical services. Healthcare officials must ensure they help the patients in every possible way, including referring them to charity funding.
Healthcare professionals must consider the variances in how different cultural groups may suffer from Bipolar Disorder II (Gitlin & Malhi, 2020). For instance, some cultural groups might be more inclined to consider mental illness a sign of weakness or shame, affecting their motivation to seek treatment. A person with Bipolar Disorder II may benefit from a particular treatment style depending on cultural ideas about the importance of family and community in providing support. Medical practitioners must respect the culture and simultaneously offer unbiased education on the treatment methods available for the disorder.
Different social determinants of health may lead to severe conditions of Bipolar II disorder. Factors such as housing, access to healthcare facilities and employment may affect the recovery process of Bipolar II patients (Gitlin & Malhi, 2020). The patient’s environment could also trigger memories that would severely affect their recovery. Since these social determinants could cause the disorder’s development, a lack of change in the environment would lead to severe cases of memory loss, suicide and accidents.
For the treatment of Bipolar Disorder II, several drugs have been clinically shown effective and have received FDA approval. Acute and mixed episode treatment and maintenance treatment are the two basic groups into which these drugs can be separated (McIntyre et al., 2020). The following drugs are suggested for treating acute and mixed episodes: lithium, valproate, carbamazepine, lamotrigine, and quetiapine (McIntyre et al., 2020). These drugs have been proven to be successful in treating mania, hypomania, and depressive symptoms in people with bipolar illness. Lithium and lamotrigine are the most frequently suggested medications for maintenance therapy. It has been demonstrated that these drugs help people with bipolar disorder avoid relapsing and lessen the frequency and severity of mood episodes.
There are a variety of potential adverse effects, FDA approvals, and cautions associated with each medicine used to treat Bipolar Disorder II. For instance, lithium may cause side effects like tremors, weight gain, and gastrointestinal irritation. Also, it carries a risk of toxicity, which may result in negative side effects like seizures or kidney damage (McIntyre et al., 2020). The pharmacokinetics and pharmacodynamics of a drug need to be explained to the patient to choose from.
Examples of Proper Prescription Writing
Lithium Prescription
Drug: Lithium Carbonate
Dosage: 1200 mg per day (2 or 3 times)
Period: 6 Months
Prescription for Lamotrigine:
Drug: Lamotrigine
Dosage: 200-400 mg per day (once or twice)
Prescription for Valproic Acid:
Drug: Valproic Acid
Dosage: 250 mg (twice)
Bipolar II disorder is a common mental disorder affecting children, youth, women and the elderly. The disorder is characterized by symptoms similar to other disorders making it difficult to diagnose and treat. The disease is less severe than Bipolar I disorder but more severe than Cyclothymic disorder. Various HIPPA regulations provide guidelines on the social determinants and legal, cultural and ethical considerations that must be followed when dealing with these patients. The FDA has authorized various drugs for the disorder, such as lithium, and the side effects have been identified. The prescription of various drugs differs based on their pharmacodynamics and pharmacokinetics.
References
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Chen, G., Zhao, L., Jia, Y., Zhong, S., Chen, F., Luo, X., Qiu, S., Lai, S., Qi, Z., Huang, L., & Wang, Y. (2019). Abnormal cerebellum-DMN regions connectivity in unmedicated bipolar II disorder. Journal of Affective Disorders, 243, 441-447. https://doi.org/10.1016/j.jad.2018.09.076
Gitlin, M., & Malhi, G. S. (2020). The existential crisis of bipolar II disorder. International Journal of Bipolar Disorders, 8(1). https://doi.org/10.1186/s40345-019-0175-7
McIntyre, R. S., Berk, M., Brietzke, E., Goldstein, B. I., López-Jaramillo, C., Kessing, L. V., Malhi, G. S., Nierenberg, A. A., Rosenblat, J. D., Majeed, A., Vieta, E., Vinberg, M., Young, A. H., & Mansur, R. B. (2020). Bipolar disorders. The Lancet, 396(10265), 1841-1856. https://doi.org/10.1016/s0140-6736(20)31544-0
Pratt, E. (2022). Effects of bipolar disorder on the brain. Medical and health information. https://www.medicalnewstoday.com/articles/bipolar-disorder-and-the-brain#affected-structures
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