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Treating Bipolar II Effectively

written by: BettyHolt • edited by: Paul Arnold • updated: 8/15/2011

Effective treatments for Bipolar II disorder include medication, psychotherapy, lifestyle changes, and in rare cases, hospitalization. Although Bipolar II is a milder former of Bipolar I disorder, many of the treatments are similar.

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    Bipolar II

    While Bipolar I consists of extreme highs and lows, Bipolar II does not have the extreme state of mania. Milder episodes of mania, called hypomania, are characteristic of Bipolar II. People who experience hypomania are not usually delusional and neither do they require hospitalization. The patient with hypomania may be experiencing increased energy, heightened or irritable mood, a decreased need for sleep and increased social or sexual activity. The depression that accompanies Bipolar II is usually more severe than in unipolar depression and is associated with an increased risk of suicide as well as more social and vocational disability.

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    Medications

    Although the types and dosage of medications vary according to symptoms, mood stabilizers are usually prescribed for both Bipolar I and Bipolar II. Examples of these type medications include lithium, known as Lithobid; valproic acid, called Depakene; divalproex sodium, known as Depakote, and lamotrigine, called Lamictal.

    Antidepressants are sometimes used if the mood stabilizer is not enough to control depression. Common antidepressants include Prozac, Zoloft, Paxil and Wellbutrin. However, caution must be used when taking antidepressants. They can sometimes trigger a manic episode, although this is more common in Bipolar I than Bipolar II. Treating the depression that accompanies Bipolar II is usually of more concern than hypomania.

    Antipsychotic medications are sometimes used if other treatments do not resolve the problem. Zyprexa, Risperdal and Seroquel are examples.

    It is important that you follow up with your doctor with regular blood tests to ensure that your medication levels are right for you. Sometimes it is a delicate balance, so close supervision is necessary. As you start to feel better, don't discontinue your medication. Most people need to take medication long-term, even though it will not solve all the problems associated with the disorder. Having a healthy lifestyle and getting enough rest is important, along with psychotherapy and the support of others.

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    Psychotherapy

    Psychotherapy is a popular treatment for Bipolar II. Working with a therapist can help the individual cope with uncomfortable feelings and manage stress. In cognitive behavioral therapy you learn how to examine the way your thoughts influence your feelings. CBT helps with overcoming negative thinking patterns and encourages a more positive way of responding to life events.

    Interpersonal and social rhythm therapy is another type therapy that is helpful for Bipolar II. Interpersonal therapy's focus is on your present relationships and aims to help you improve them with the important people in your life. If you can have successful relationships with significant people, it will reduce your stress load, and stress is a trigger for bipolar episodes.

    Sometimes interpersonal therapy is combined with social rhythm therapy. People with Bipolar II often have sensitive biological clocks and can easily be thrown off by variations in normal routine. This type therapy focuses on stabilizing activities such as sleeping, eating and exercise because there is a connection between social rhythms and the biological rhythms that influence mood.

    Having a member of the family who is bipolar can significantly affect other family members. Family therapy is important from the standpoint of educating them about bipolar disorder and what they can expect. It can help significant others create a healthy and supportive atmosphere in the home by improving communication.

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    Lifestyle Management, Education and Support

    People with Bipolar II can keep their symptoms to a minimum by regulating their everyday lives. Keeping a regular sleep schedule, avoiding both drugs and alcohol, exercising on a regular basis, and doing what is necessary to reduce stress are all measures that will help you.

    Learn as much as you can about your disorder. The more you know the better you will become at dealing with setbacks and avoiding the things that cause them in the first place.

    Treating Bipolar II effectively may mean being a part of a bipolar support group that offers an opportunity to share your experiences with others who relate to what you are going through. Support of those in a group can be very helpful, as can the support of friends and family.

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    Complementary Therapies

    Alternative treatments for Bipolar Disorder II are used by some people in conjunction with medication, psychotherapy and lifestyle remedies. They are not used as a substitute for them. Some of the complementary therapies in use include:

    Mindfulness meditation uses breathing exercises, yoga and meditation to focus on the present moment and alter negative thinking patterns.

    Acupuncture is being studied for its effect on both depression and mania. There seems to be evidence that it reduces symptoms in both conditions and may modulate the stress response.

    NB: The content of this article is for information purposes only and is not intended to replace sound medical advice and opinion.

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