Updated July 21st, 2026
Bipolar II disorder can be difficult to recognize, both for the people experiencing it and for those around them. Unlike the more dramatic mood episodes often associated with bipolar I disorder, bipolar II tends to involve subtler shifts in mood and energy that can be easier to overlook or misunderstand. Some people may go years without realizing that they are experiencing a mood disorder.
You might also hear different terms, labels, or explanations used when talking about bipolar disorder, which can feel confusing and frustrating, especially if you feel like your symptoms are not being fully understood or you have received mixed messages from different providers in your life.
Living with bipolar II disorder can feel emotionally exhausting. Periods of hypomania may feel productive or even enjoyable at first, while depressive episodes can leave you feeling drained, hopeless, or disconnected.
Understanding the signs, symptoms, and treatment options for bipolar II disorder can be an important step toward finding clarity, support, and stability. Keep reading to learn more about bipolar II disorder and where to find support in Chicago.
Let’s start by first explaining what bipolar disorder is in general. Bipolar disorder is a mood disorder. It’s characterized by alternating periods of depression (“lows”) and mania or hypomania (“highs”). There are different types of bipolar disorder. For the purpose of this blog, we’ll be talking about bipolar II disorder.
Bipolar II disorder is a mental health condition that causes noticeable shifts in mood, energy, and activity levels. Those with bipolar II experience periods of depression as well as periods of elevated mood and increased energy called hypomania. Unlike bipolar I disorder, these elevated moods do not become full manic episodes, but they can still affect a person's thoughts, behavior, and daily life.
Those with bipolar II disorder have a different experience from those with bipolar I in the sense that bipolar II disorder causes hypomania but does not involve full-blown manic episodes.
Bipolar II is often misdiagnosed at first. It takes an average of 10 years for a person with bipolar II to receive the right diagnosis.[1] For example, many people with bipolar II are incorrectly diagnosed with major depressive disorder (MDD). Bipolar II also has some overlapping symptoms with other conditions, like borderline personality disorder (BPD) and premenstrual dysphoric disorder (PMDD). This can further complicate the diagnostic process.
The problem is that these conditions are treated differently. Getting an appropriate diagnosis of bipolar II is what opens the door to proper treatment, self-understanding, and effective symptom management.
Bipolar II can only be diagnosed by a professional. But, for many, the first step toward a diagnosis is learning about bipolar II disorder symptoms to look out for. Knowing the symptoms of bipolar II disorder can help you identify them in yourself. Since periods of depression and hypomania alternate in bipolar disorder, we’ll break them down into two separate sections.
During depressive episodes, a person with bipolar II may experience:
Depression symptoms in bipolar disorder are identical to what a person could experience during any other major depressive episode. The difference is that a person will also have episodes of hypomania, which affects what appropriate treatment and management looks like.
Hypomanic symptoms seen in bipolar II include:
Some have euphoric or pleasurable feelings during hypomania. For others, the “up swing” looks more like having a shorter fuse (e.g., less patience, more hostility). This can vary from person to person and episode to episode.
The main signs of bipolar II disorder you’re going to notice are shifts in a person’s mood. While they will not reach full-blown mania, they’ll go through notable highs and lows. Often, with periods of normalcy in between. For weeks or months, they could be “up” , more energetic, whether that’s in the form of happiness, agitation, or restlessness.
At other times, they could seem notably down and have less energy for and interest in activities. This, too, may last for weeks or months. At times, the trickiest part about identifying bipolar II disorder is distinguishing hypomania from genuinely “feeling better.”
A lot of people’s experience with bipolar II is painted by depressive episodes. At least, this is usually when you first notice that something’s wrong. During depressive episodes, you likely feel drained, and your energy is low. You might feel severely depressed, down, sad, or emotionally numb or flat. Even simple tasks like showering, answering a text, or getting out of bed can feel overwhelming.
You may lose interest in things you once enjoyed, feel disconnected from other people, or struggle to imagine things getting better. You might also have negative thoughts about yourself, others, or the world. It’s common to have thoughts like, “What’s the point?” or “the big black dog is back again.[2]”
Hypomania can feel like a positive experience or a negative one. A lot of people with bipolar II initially mistake periods of hypomania as “the good times,” or as a break from depression. You’re productive. You have energy, you’re on a roll, and you’re getting things done. Ideas come quickly, you're productive, and you feel like you're finally getting your life back on track.
Alternatively, it can feel deeply uncomfortable. In that case, you could feel irritable, impulsive, or have inflated confidence. You might do things you later regret. You’re likely easily distracted during these times.
There are also periods spent “in between” or in limbo - not depressed or hypomanic. The lack of predictability and ups and downs in Bipolar II disorder can be exhausting.
A bipolar disorder test can’t diagnose you, but it can help you detect possible symptoms and take the first step toward treatment. Many people with bipolar II describe feeling frustrated, confused, or exhausted by the unpredictability.
Bipolar II disorder is diagnosed by qualified providers, usually psychiatrists, when a person meets the criteria for the disorder. To be diagnosed with bipolar II disorder, a qualified provider will perform a comprehensive evaluation.
They’ll ask questions about your current symptoms and history, rule out other potential symptom causes, and, most likely, have you complete standardized tools, like a written questionnaire.
Some will have you fill out mood logs, but not always; this can be especially relevant if they’re trying to rule out disorders like premenstrual dysphoric disorder, which can present similarly.
All of this is to ensure that the diagnosis you leave with is correct. You must meet the following criteria to be diagnosed with bipolar II.[3]
While symptoms must not be attributed to another disorder, it is possible to meet Bipolar II disorder criteria and have at least one other mental health condition. In fact, this is the case more often than not.
Many people with bipolar disorder have at least one comorbidity.[4] Common Bipolar II disorder comorbidities include:
The high prevalence of comorbidities in bipolar disorder is another factor that can complicate the diagnostic process. Many comorbidities seen in bipolar II share similar causes and contributing factors.
The exact cause of bipolar disorder is unknown.[5] However, we do know that some are more likely to develop it than others. Having one or more risk factors does not mean you will develop bipolar II disorder.
Likewise, some people develop bipolar disorder without any obvious risk factors. Bipolar disorder is a complex mental health condition, and it is never someone's fault.
Those who are already prone to developing bipolar disorder sometimes find that episodes or onset are associated with events, behaviors, and environmental factors. For example:
Bipolar disorder is a complex mental health condition influenced by factors beyond your control, such as genetics and brain chemistry. The good news is that effective treatment can help many people manage their symptoms, reduce mood episodes, and live fulfilling lives.
Bipolar II disorder doesn’t go away and it does require lifelong management. However, it can get better and there are effective treatments. Bipolar II disorder treatment can help you experience the following:
Those with bipolar II disorder can and do live happy, healthy lives. Finding bipolar disorder treatments that fit your unique needs is key.
Bipolar II disorder treatment should be individualized. People respond best to different bipolar disorder treatments. Most benefit from a combination of approaches. Lifestyle factors like sleep are important, so is self-awareness (e.g., the ability to notice warning signs that you’re entering a hypomanic or depressive episode).
Therapy and medication are often combined for optimal management. Therapy for bipolar II disorder helps you look out for warning signs, manage possible triggers for episodes, learn about your condition, use coping skills, create lifestyle structure, and meet other goals.
Medication for bipolar disorder stabilizes moods, manages acute episodes, and (with consistent, long-term use) prevents relapse. Bipolar II disorder medication most often includes mood stabilizers, atypical antipsychotics, and, in some instances, antidepressants mixed with mood stabilizers.
Living with unpredictable shifts in mood can be exhausting, confusing, and at times overwhelming. It can be difficult to know what’s happening, why it’s happening, or where to turn for help.
At Clarity Clinic, we understand that bipolar disorder is more than a diagnosis, it affects your relationships, work, school, daily routines, and overall sense of well-being. Our compassionate team provides individualized bipolar disorder treatment in Chicago and throughout Illinois, including comprehensive evaluations, therapy, and medication management when appropriate.
Whether you've recently started questioning your symptoms, received a diagnosis, or have been managing bipolar disorder for years, we're here to help you find a treatment plan that fits your unique needs and goals. With both in-person appointments across the Chicago area and online services available throughout Illinois, support is accessible wherever you are.
You don't have to navigate bipolar disorder on your own. Reach out today to learn how we can help.
See How We Can Help[1] Swartz, H. A., & Suppes, T. (2023, October). Bipolar II disorder: Understudied and underdiagnosed. Focus (American Psychiatric Publishing). https://pmc.ncbi.nlm.nih.gov/articles/PMC11058947/
[2] World Health Organization (WHO). (n.d.-a). I had a black dog, his name was depression. YouTube. https://www.youtube.com/watch?v=XiCrniLQGYc
[3] Substance Abuse and Mental Health Services Administration. (n.d.-b). Table 3.23, DSM-IV to DSM-5 Bipolar II disorder comparison - impact of the DSM-IV to DSM-5 changes on the National Survey on Drug Use and Health - NCBI bookshelf. Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t23/
[4] Berk, M., Corrales, A., Trisno, R., Dodd, S., Yatham, L. N., Vieta, E., McIntyre, R. S., Suppes, T., & Agustini, B. (2025, June). Bipolar II disorder: A state-of-the-art review. World psychiatry : official journal of the World Psychiatric Association (WPA). https://pmc.ncbi.nlm.nih.gov/articles/PMC12079553/
[5] U.S. Department of Health and Human Services. (n.d.). Bipolar disorder. National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/Bipolar-disorder
Clarity Clinic offers bipolar disorder medication management, therapy, and testing at multiple locations throughout the Chicago area, as well as through secure online appointments across Illinois. Our psychiatric providers work closely with each patient to develop a personalized treatment plan.
Yes. Clarity Clinic provides medication management for bipolar disorder through our experienced psychiatrists, physician assistants (PA-Cs), and nurse practitioners (NPs). We also offer therapy, psychological evaluations, and structured outpatient programs to provide comprehensive care.
The main difference is that people with bipolar II disorder experience hypomanic episodes rather than full manic episodes. Bipolar II also involves at least one major depressive episode, whereas bipolar I is defined by the presence of at least one manic episode.
Without treatment, bipolar II disorder can become more difficult to manage, and mood episodes may become more frequent or severe. Early diagnosis and ongoing treatment can help reduce symptoms and improve long-term outcomes.
Yes. Many people with bipolar II disorder benefit from a combination of therapy and medication management. Clarity Clinic offers both services, allowing your treatment plan to be personalized to your needs.
Pavan Prasad, MD, is a psychiatrist and CEO of Clarity Clinic specializing in adult ADHD and mood disorders. He takes a holistic, patient-centered approach, offering both psychotherapy and medication management to support concerns such as anxiety, depression, self-esteem, and concentration. Dr. Prasad creates individualized treatment plans with a focus on achieving meaningful outcomes using the least medication necessary. He earned his medical degree from St. Matthew’s University School of Medicine.
