Bipolar 2 disorder means you experience periods of hypomania. Hypomania is a temporary surge in emotions, energy levels, self-esteem, and drive. This is followed by periods of deep depression.
Learning how to live with a mental health diagnosis can be like beginning an entirely new life. Now that you know you have bipolar disorder 2, you can:
- learn what to expect from this condition
- plan how you’ll respond to changes in your health
- discover systems of support
- practice habits to help you create a greater sense of balance
- fine-tune your treatment plan so it works for you
Here’s a good starting place: a quick primer on this condition and science-backed strategies for a healthier life.
Having bipolar 2 disorder means you experience periods of hypomania, during which you have a temporary surge in emotions, energy levels, self-esteem, and drive. These bursts of feeling, motivation, and activity are followed by periods of deep depression, when your feelings may be overwhelmingly dark — if you have any feelings at all. During an episode of depression, it can be tough just to get on your feet in the morning.
Though your highs may not be as extreme as those with bipolar disorder 1, these cycles can nevertheless be damaging to your self-concept, your finances, your career, and your relationships.
As you might expect,
Here’s what hypomania symptoms can look like:
- feeling elated or high
- feeling jittery, restless, or irritable
- tackling a large number of projects at the same time
- tumbling, racing thoughts
- speaking with haste
- behaving recklessly with money or sex
- staying up all night without feeling exhausted
Here’s what depression symptoms can look like:
- feeling numb, drained, or “dead” inside
- feeling sorrowful, sad, or hopeless
- having trouble falling asleep or waking up
- sleeping at times of the day when you’re usually active
- losing pleasure in things you usually enjoy, including sex
- losing the ability to focus or concentrate
- having little desire to speak, or speaking slowly
- feeling little or no motivation to act
It’s possible that you could have mixed symptoms in one episode—for example, feeling anxious and jittery, while also feeling unmotivated and drained. How long periods of depression or hypomania last varies from person to person.
People with BPD 2 describe living with the disorder like this:
When I am having an episode of hypomania, I:
- feel as though I don’t need sleep.
- have so many ideas it’s impossible to act on them all.
- talk so fast other people can hardly keep up.
- feel unconquerable, ecstatic, powerful, completely unique.
- drain my bank account.
- complete huge projects in short periods.
- create things feverishly.
- stop eating or eat just enough to keep going.
- sometimes do risky things like having sex with strangers.
- sometimes believe I am hearing directly from God.
When I am having an episode of depression, I:
- can feel lost and invisible.
- cannot seem to find the words to say what’s going on.
- sleep so much — but never feel rested.
- lose all motivation and passion for living,
- can’t seem to do things I know I should do.
- crave unhealthy food.
- eat to try and feel better.
- hide from the people in my life.
- stop performing with my usual vigor at work or school.
- have trouble concentrating.
- feel like a failure.
- am convinced things are hopeless.
- sometimes feel like folding up and dying.
Exactly how you experience the practical and emotional effects of bipolar disorder 2 will be unique to you, but you may recognize some or all of the above effects.
Living with bipolar disorder 2 isn’t just about participating in therapy and taking medication. There are many other ways that you can work toward a more balanced, healthy life.
Become an active part of your treatment team
Bipolar disorder 2 generally requires a combination of medication and therapy for the best results. While your doctor will recommend and prescribe medications and your therapist will guide your therapy sessions, you are an expert on what you’re experiencing. And you can become an expert on bipolar disorder 2 in time.
To help your treatment team with your care, you can read up on the disorder yourself. Equipped with science-supported information on available treatment, accounts from other people about what they’ve experienced, and what to look for when an episode of hypomania or depression is on the horizon, you’ll be ready to help create a wellness plan that works for you.
What to read if you need more than words
These graphic memoirs capture what it’s like to live with bipolar disorder 2 and some of the other mental health conditions commonly diagnosed at the same time. The combination of art and story may be more telling than words alone.
Monitor your moods, symptoms, and triggers
Managing a condition like bipolar disorder 2 is not a one-and-done situation. Over time, you will go through periods where stressors in your life, changes in your body, and many other variables will alter how effective your treatment plan is.
If you develop a practice of kind and respectful self-monitoring, you may be able to keep symptoms from escalating into a full-blown hypomanic or depressive episode. Here are a few areas to watch:
- Keep track of your feelings. You can use a journal, a mood chart or calendar, an app, or any other method that allows you to take a frequent inventory of your emotions. What are you looking for? Any change in your mood or outlook that feels like a familiar sign of a mood shift. Electronic and digital methods of tracking mood are also increasingly being
researched. While there’s no evidence yet that these methods prevent an episode, people do seem to use them faithfully and the apps are valid measures of changing symptoms.
- Notice changes in your desires and habits. Healthy routines, schedules, and structures may feel unfamiliar at first, but they are a key part of maintaining your mental health. When desires and habits start to change, it can be an early indicator of a brewing mood shift. You may notice, for example, that you no longer feel like cooking or exercising long before you notice any change in your emotions.
- Anticipate your triggers. In time, you may come to recognize that certain kinds of life events — loss of sleep, financial stress, relationship conflicts, or traumatic experiences — can make it more likely that you’ll have a relapse. In
a recent studyinvolving people who had experienced a relapse of bipolar symptoms, nearly 70 percent had gone through a stressful life event in the days just before the relapse. Knowing these triggers in advance may help you take extra care of yourself or reach out for extra support at critical times.
- Consider interpersonal and social rhythm therapy (IPSRT). IPSRT equips you with skills to help you maintain the daily routines that protect you from escalating episodes, including sleep schedules, taking your medications daily, sticking to healthy eating and exercise patterns, and responding to stressful situations in healthy ways.
Studiesshow that IPSRT reduces anxiety, hypomania, and depression symptoms in people with bipolar disorder.
Create an action plan for when symptoms change
There’s always the possibility that you’ll have breakthrough symptoms or a relapse at some point in your life. If you’ve made a plan to guide how you and those around you will respond, you may be able to minimize the disruption and quickly get the help you need.
The National Alliance on Mental Illness (NAMI) suggests that your plan include these items:
- names and contact information for your healthcare team, including your primary care doctor, psychiatrist, therapist, and any other healthcare professionals you need
- names and contact information for key family members you trust
- phone numbers for local crisis centers and healthcare facilities near you, especially those with respected mental health centers
- a list of your medications and any allergies you may have
- a brief timeline of any other mental health crises, hospitalizations, or suicide attempts
- information about your triggers, special needs, and what has helped in the past
Some people decide to include a psychiatric advance directive, which is a legal document that names a person to make decisions on your behalf if you’re not in a position to make them.
It’s a good idea to let the people you trust know that the plan exists and where they can read it if necessary. You may also want to keep copies of the plan in several easy-to-find locations in your home, as well as in your vehicle and on your phone.
Develop a Wellness Recovery Action Plan (WRAP)
Because healthy routines are so important for maintaining wellness and preventing a crisis, you may want to create a WRAP. They typically include:
- a brief description of what you and your life look like when you are healthy
- an inventory of your wellness tools: people, routines, and resources you need to keep symptoms in check and keep your treatment plan active
- a list of your triggers
- a list of early warning signs that could mean you’re headed for a hypomania or depression episode
- problem-solving strategies, including a list of people you trust to help you devise solutions
- indications that you are in a mental health crisis and need help
Stay connected to people who support you
When you are not feeling your best, it can be tempting to withdraw from the people who know you and care about your wellbeing. You may start to miss appointments with your therapist or physician. You may skip social events that usually appeal to you. You may avoid conversations with people who can help you.
It’s a good idea to develop a wide, diverse support network. You could connect with professionals in the mental health community, local or virtual support groups, people in volunteer organizations, civic groups, or faith communities, colleagues, family, and friends. At different times, these connections may be able to support in a variety of ways — reminding you that you are much, much more than a diagnosis.
Take good care of your physical health
The health of your body and the health of your mind are related.
- Rest. One of the most important areas to safeguard is your sleep patterns.
Researchis clear: Loss of sleep can trigger episodes of hypomania and depression. For a closer look at sleep and its effects on bipolar disorder, go here.
- Move. Another important health habit to cultivate is physical exercise. Vigorous physical activity can elevate your mood, relieve depression and hypomania symptoms, and help you sleep better at night.
- Eat well. Your body and mind are more likely to thrive if you’re eating nutritious foods regularly.
Researcherssay a healthy diet can help lower the risk of mental health problems and improve treatment outcomes for people with bipolar disorder.
Bipolar 2 can be diagnosed by a doctor, psychiatrist, psychiatric nurse, or psychologist. To arrive at a diagnosis, a healthcare professional will ask you about your symptoms and how they affect your life. You’ll also be asked about your family’s medical and mental health history. Your doctor may give you a blood test to rule out other conditions that could destabilize your moods.
Bipolar 2 is most often treated with a combination of
- mood stabilizers
- atypical antipsychotics
- anxiety medications
- medications to help you sleep
The types of psychotherapy most helpful in treating bipolar 2 include:
- interpersonal social rhythm therapy
- cognitive behavioral therapy
- family-focused therapy
- dialectical behavior therapy
- group therapy
How to help someone with bipolar 2
- help to recognize that they’re in a depression period
- encouragement to follow through on treatment
- acceptance, tolerance, and empathy
People with bipolar disorder are likely to feel worried about relapse, fearful of the stigma, and guilty about the impacts the disorder has on other people. As a family member, you also experience considerable stress because of the practical ways the disorder affects everyone in the family. For some people, family therapy may be a good option for increasing support and resolving conflicts.
Bipolar disorder is not curable, but treatment can be effective in managing symptoms. If you follow your treatment plan and take care of yourself, you may go for long periods where you have few or no symptoms and your moods are stable. That’s not the case for everyone, of course — some people may have symptoms even when they carefully follow a treatment plan.
Without treatment, the picture looks different. People with untreated bipolar disorder are more likely to have severe mood shifts, and they may be at greater risk of harming themselves.
If you or someone in your life has been diagnosed with bipolar disorder 2, you’re embarking on a new course: one that could help you even out some of the highs and lows that have disrupted your life.
The hypomania and depression that have made your life so hard can be managed with medication, therapy, support, and healthier habits.
It will take time to get your treatment plan in place, and you may need to tweak it from time to time as your body, mind, and life go through changes. But bipolar disorder 2 can usually be treated successfully, and you can find your way to more balanced mental and physical health.