Bipolar II Disorder. Not Really a Bipolar Disorder! So What Is It?
Presenting Author(s): Dr. Cynthia Baxter, Dr. Atul Khullar, MDD
Date and time: 21 Mar 2025 from 11:50 to 12:50
Location: Wildrose Salon A/B/C
Abstract
Bipolar II Disorder is very misunderstood, with many questioning whether it truly belongs under the "bipolar" umbrella. This fun and informal debate aims to explore the arbitrary nature, idiosyncrasies and complexities of Bipolar II, challenging traditional perceptions and delving into its true nature.
Dr. Khullar will suggest that it should be viewed more as a variant of major depressive illness with mixed features although medications for bipolar disorder are often used successfully.
Dr. Baxter will suggest that it is often a misdiagnosis driven by overreliance on self-reported symptoms and ambiguous cross-sectional criteria for hypomania. Important questions about diagnostic labels will also be raised.
Both will also debate whether BDII is preferred over other diagnoses (ie borderline personality disorder, ADHD, PTSD) due to misguided attempts to avoid stigma and improve patient access to treatment.
The debate calls for a re-evaluation of current diagnostic practices in opposing potential paradigms. It will also urge clinicians to consider multiple alternative longitudinal explanations for patients’ symptoms, remaining cautious of overdiagnosis yet still potentially treating patient’s symptoms and improving quality of life.
Learning Objectives
1. Discuss the history and diagnostic criteria for Bipolar II disorder as well as the overall concept of a mood disorders spectrum;
2. Critically evaluate whether Bipolar II warrants classification as a “bipolar disorder”;
3. Deepen attendees' understanding of why Bipolar II is a challenging and misleading diagnosis; and
4. Understand differing points of view of what “Bipolar II” can be and how treatment should be adjusted accordingly.
Literature References
1. Malhi GS, Outhred T, Irwin L. Bipolar II Disorder Is a Myth. Can J Psychiatry. 2019 Aug;64(8):531-536. doi: 10.1177/0706743719847341. Epub 2019 May 6. PMID: 31060361; PMCID: PMC6681518.
2. McIntyre, R. S., Lee, Y., & Mansur, R. B. (2016). A pragmatic approach to the diagnosis and treatment of mixed features in adults with mood disorders. CNS spectrums, 21(S1), 25–33.
3. Zimmerman M, Morgan TA. The relationship between borderline personality disorder and bipolar disorder. Dialogues Clin Neurosci. 2013 Jun;15(2):155-69. doi: 10.31887/DCNS.2013.15.2/mzimmerman. PMID: 24174890; PMCID: PMC3811087.