Living With Bipolar 2: How To Manage Symptoms (And Thrive)

Bipolar disorder is a serious mental health condition with three main subtypes: bipolar I disorder, bipolar II disorder, and cyclothymic disorder. Bipolar II disorder is characterized by depressive and hypomanic episodes, which can present a range of challenges. If you've been diagnosed with bipolar II disorder (“bipolar II”), your next step toward managing your symptoms might be learning what can trigger them, what strategies you can use to address them, and how to seek help from others if you need it. 

Identifying trigger episodes, maintaining a consistent treatment plan, taking care of your physical health, and learning effective coping skills can help you live a full and satisfying life with bipolar II disorder. 

Below are some tips that may help you discover how to take charge of this mental health condition and lead the life you’d like to.

What is bipolar disorder?

Bipolar disorder (previously called manic depression) is a mental illness that causes extreme mood swings. These mood swings include emotional highs (manic episode or hypomanic episode) and lows (depressive episode). Bipolar disorder is a lifelong condition, however, a manic, hypomanic, or depressive episode can be effectively managed with the right treatment plan.

Mania and hypomania are characterized by the presence of specific symptoms like increased energy levels, poor decision-making and risky behaviors, and exaggerated self-confidence. Though they have the same symptoms, manic episodes are more severe than hypomanic episodes – and the psychotic symptoms of a manic episode may cause noticeable problems at work, school, and social events. A depressive episode, on the other hand, includes depressive symptoms such as loss of interest in activities, depressed mood, and insomnia or fatigue. The symptoms of bipolar disorder can depend on the subtype of the condition an individual experiences. 

There are three types of bipolar disorder:

• Bipolar I disorder

• Bipolar II disorder

• Cyclothymic disorder

Manage your medications well

If you’re experiencing symptomatic changes, you can receive prescription medication from your doctor or psychiatrist to help minimize the impact of bipolar II symptoms. Taking medications consistently, as prescribed, can help balance your mood and promote a positive treatment response. 

If you feel your medication is causing adverse effects or otherwise isn’t working for you, it’s generally best to discuss your concerns with your prescribing provider before making any decisions or changes on your own. 

Trying to cut down or stop your medications on your own can lead to two different concerns:  A rebound effect and withdrawal symptoms. A rebound effect may lead you to experience your original symptoms, sometimes more intensely than ever before. Likewise, stopping medication can cause withdrawal symptoms like insomnia, agitation, dizziness or headaches.

It can be important to ensure that you have the medications when you need them. To do this, you can keep an eye on your supply, and request refills if it looks like you are going to run out. If you travel, you can work with your practitioner to ensure that you bring enough medications for the entire trip.

Get the most out of therapy

Therapy can be beneficial for people living with bipolar disorder. Bipolar II can be a challenging mental illness, and living with bipolar depression and hypomania may feel overwhelming for some. But with the emotional support and guidance of a professional, its symptoms can be managed. Working with a mental health provider who understands your needs and meshes well with your personality can help you feel more comfortable and may lead to more significant improvements, be it physically, psychologically or otherwise.

You might consider that actively working with your therapist and their requests can get you the greatest positive effects of treatment. You can work together to set therapy goals that are generally relevant and meaningful to you. This might include managing relationship conflicts, addressing the negative consequences of certain patterns of behavior, and mitigating risk factors such as unhealthy lifestyle choices.

A helpful tip to consider is to be your truest, most authentic self during therapy sessions. This means that you might stay proactive about bringing up concerns you have and that you’ll work to speak about things that matter to you—even if they are difficult. 

Look for warning signs of manic, hypomanic, and depressive episodes

Bipolar II disorder can have several common warning signs that may precede symptoms like a manic episode or major depressive disorder. 

As there can be many different warning signs, bipolar disorder requires individuals to learn to identify their specific patterns of behavior. Below are some examples that might help you consider and evaluate your own experiences:

• You’ve stopped cooking for yourself or caring about hygiene or other self-care

• You avoid other people

• You have strong food cravings or lack of appetite

• You feel tired, possibly needing more sleep (or you may have trouble sleeping at night)

• You feel irritable

• You talk faster and louder than you usually do

• You feel excessive energy or restlessness (or your exercise patterns may have changed significantly)

• You have trouble concentrating

A mood journal or mood chart can be a helpful tool to identify the symptoms of bipolar II, such as patterns of a depressed or elevated mood, cognitive changes, or fluctuating energy levels. In this journal, you can include details of your physical condition, like your appetite and hours of sleep. You can make notes when you take your medications, too. You may also find it helpful to track things like alcohol, tobacco or other substance use, as these can affect your bipolar episodes, and even trigger depression. 

After you've kept your journal or chart for a while, you can look it over to try to find patterns and triggers for bipolar II symptoms. This alone can be a helpful reason for many to keep a record, as it allows them to have something clear and quantitative to show their healthcare team to determine the next best course of treatment. 

Remain alert to the warning signs prior to a mood shift

Bipolar II disorder can have several common warning signs that may precede symptoms like manic episodes. 

As there can be many different warning signs, it can also be important to notice which warning signs seem to be the most common and significant for you as an individual. Below are some examples that might help you consider and evaluate your own experiences:

• You’ve stopped cooking for yourself or caring about hygiene or other self-care

• You avoid other people

• You have strong food cravings or lack of appetite

• You feel tired, possibly needing more sleep (or you may have trouble sleeping at night)

• You feel irritable

• You talk faster and louder than you usually do

• You feel excessive energy or restlessness

• You have trouble concentrating

One way to be sure that you take notice when warning signs arise is to keep a mood journal or make a mood chart. In this journal, you can include details of your physical condition, like your appetite and hours of sleep. You can make notes when you take your medications, too. You may also find it helpful to track things like alcohol, tobacco or other substance use, as these can affect your experiences living with bipolar II. 

After you've kept your journal or chart for a while, you can look it over to try to find patterns and triggers for bipolar II symptoms. This alone can be a helpful reason for many to keep a record, as it allows them to have something clear and quantitative to show their healthcare team to determine the next best course of treatment. 

Reduce your stress

Stress can be overwhelming for many, but for people with bipolar II disorder, it can be the precursor to a major depressive episode or hypomanic episode. You can begin to minimize stress in your life by finding out what exactly your stressors are. You may consider taking notes as you go through your day about what events increase your stress, actively working to limit them as you encounter them.

You may also find it helpful to practice simple changes to cut down on stress. For example, you may work to keep a healthy work-life balance. You can do this using a few strategies. Some might schedule their day to give themselves some structure. You might also notice when a stressor is temporary and remind yourself that it won't last forever.

It can be helpful to be aware of how much control you have in the situation. If there's something you can do to improve it, you might choose to go for it. For example, joining a local support group may help you confide in other people living through similar experiences.

Additionally, you can try using relaxation techniques—such as mindfulness, deep breathing, or guided imagery—to manage your stress.

Act quickly in an emergency

Although symptoms of bipolar II can be milder than those that might be associated with bipolar I disorder, both can be equally dangerous. Bipolar II depression can last for long stretches of time, which can lead to thoughts of suicide in extreme cases. 

Hypomania can sometimes lead to mania, and either can constitute an emergency. This is because both manic and depressive episodes can create behavioral changes that may lead to risky behavior, injury, and other unintended consequences if left unsupported. 

If you feel comfortable, you might consider talking to your doctor and therapist about what you need to do if an emergency situation were to arise. Then, you can keep all the information that someone would need to treat you handy around the house, or if you’re out and about. 

In this packet of information, you can choose to list who to contact in an emergency, the medications you take (including OTC medications), and how and where you want to be treated.

Take care of your physical health

Your physical health isn't generally considered to be separate from your mental health. They can affect each other tremendously. Eating healthy foods, getting adequate sleep, exercising regularly, and addressing physical health concerns as needed can help you stay mentally and physically healthy. 

Get social support

Finding the right social support can give you a chance to express your feelings, talk about challenges, and recognize symptoms before they escalate

To begin, you can try your best to spend time with those you care about when you can. You might also do things like sign up for a class or get involved with a hobby group. Whatever you do, making an effort to build your connections with other people can help you feel better equipped to navigate any challenges your symptoms might throw your way.

To begin, you can try your best to spend time with those you care about when you can. You might also do things like sign up for a class or get involved with a hobby group. Whatever you do, making an effort to build your connections with other people can help you feel better equipped to navigate any challenges your symptoms might throw your way.

How can online therapy help someone living with bipolar II?

One option that many might find helpful for receiving regular support and managing symptoms successfully is online therapy. Because therapy can be an important component of a treatment plan to manage bipolar II disorder, it may be especially beneficial to find a professional who you enjoy working with and whose schedule can fit yours. 

Seeking help through the web can make achieving each of these goals much easier for many, as you don’t have to be limited by who is locally available. 

Is online therapy effective to treat bipolar II disorder? 

Many studies have suggested that online therapy is as effective as in-person therapy. 

One recent review of several studies analyzing online treatment for bipolar disorder (and other co-morbid disorders) found that both types of treatment could help patients navigate their symptoms with equal efficacy and support. Whether you’re new to therapy or are just looking for a change, online therapy may be the solution you need.