Bipolar I and Bipolar II: Diagnosis and Treatment
Hello everyone, today’s post will be about Bipolar I and II disorder and the accepted treatment. If you remember I discussed the various episodes that are needed to diagnose someone with either Bipolar I or Bipolar II disorder. I will briefly review this below and then go directly into the accepted treatment that has shown success in those that have been diagnosed with one of these disorders.
Bipolar I
(A) For someone to be diagnosed with Bipolar I disorder, they would have to meet the criteria needed for a manic episode. In my effort to not repeat myself too much on this blog, click here for the criteria needed to diagnose someone with a manic episode. This is one of the main aspects of this disorder. The description continues to state that the manic episode may have been preceded by or followed by a hypomanic or major depressive episode. However, it is more important that they fit the criteria for a manic episode solely so that they can gain the diagnosis of Bipolar I disorder.
(B) After this criterion is met the last criteria for Bipolar I would be to confirm that the symptoms are not better explained by schizoaffective, schizophrenia, schizophreniform disorder, delusional disorder, unspecified schizophrenia spectrum or delusional disorder or other psychotic disorder.
After this diagnosis is made it is important to determine the severity and other specifiers for the individual.
Bipolar II
Now Bipolar II is a little trickier.
(A) The person must meet the criteria for both a current or past hypomanic episode and a current or past major depressive episode. The criterion for those episodes can be found here.
(B) Once this criterion has been met, the next criterion for this specific type of bipolar disorder states that the person has not had a manic episode. If the person has had a manic episode, then this person more likely has Bipolar I disorder rather than Bipolar II.
(C) The third criterion for this disorder is to confirm that the hypomanic and major depressive episodes are not better explained by schizoaffective, schizophrenia, schizophreniform disorder, delusional disorder, unspecified schizophrenia spectrum or delusional disorder or other psychotic disorder.
(D) Lastly, the depression or the frequent changing in mood between the symptoms of the depressive episodes and the hypomanic episodes have caused significant enough issues in reference to the individual’s social, school, work, or other important areas of functioning.
After this diagnosis is made it is important to determine the severity and other specifiers for the individual.
Treatment
For these two disorders it appears, like most other disorders, the accepted treatment is a mix of antipsychotic medications and ongoing therapy. Due to these disorders being an issue of the mood of an individual, stabilizing the mood is an important aspect and often the first step in treating this disorder. Not everyone will respond to the same cocktail of medications so there may be some trial and error at this stage. I wouldn’t be surprised if people get discouraged from treatment because the medications aren’t working as intended at first. I would encourage anyone with this diagnosis to try to stick with it until that perfect combination is found however at the same time be vocal with your providers if the medication has provided you with any adverse reactions.
Once the mood is stabilized, then it is recommended to begin therapy. According to the Mayo Clinic, some of the accepted therapy styles are Cognitive Behavioral Therapy (CBT), Interpersonal and Social Rhythm Therapy (IPSRT), psychoeducation on bipolar disorder and family therapy. I’ve discussed CBT on this blog already and you can find that information here. IPSRT aims to focus on regulating the normal routines that we experience on a daily basis. The thought process behind this is by regulating someone’s daily routines it will help in regulating their mood as well. I will write a post about this at some point in the future. Psychoeducation is important because it allows both the individual and their support system to better understand what is going on with the individual and it will allow the support system to better support them as well. Lastly family therapy aims to allow the individual to strengthen their support system to provide better care to the individual. During my time within this field, I’ve ran into individuals without the best support system and their level of wellness in relation to the individuals with a good family or friend support system is often drastically different. Family therapy helps to strengthen those bonds and understanding for those that aren’t too knowledgeable of the disorder that their family member is experiencing.
Conclusion
I hope this post was understandable for everyone. Please reach out if you believe something I have said is incorrect or if you just want to discuss this further. Leave comments, whether you like or dislike the content from this post. Otherwise I hope someone gains some insight from this and until next post, have a great day.