Bipolar disorder of the second type, unlike the first, usually implies a depressive phase. At the same time, periods of slightly elevated mood (hypomanic) are extremely difficult to diagnose. In fact, even for psychiatrists, this disease is an ethical and diagnostic problem.
Firstly, because patients in this condition do not consult a doctor. After all, everything is fine, my mood improved, I want to live and work, new ideas and plans appear ... Secondly, because it is extremely difficult to distinguish such an episode from a usual recovery or improvement in depression.
Bipolar disorder of the second type, like the first, is a mental illness. However, such ethical issues as hospitalization, recognition of disability, assessment of the adequacy and ability to make decisions for patients cause great ethical problems. For example, can a person who is diagnosed with bipolar disorder of the second type dispose of his property and life? Is it possible to admit that he has free will, or is his desire to sell an apartment or need to marry be perceived as a deviation?
The classic version of
manic-depressive psychosis, which occurs with pronounced phases of excessively high and low mood, is diagnosed quite quickly.
Type 2 bipolar disorder manifests itself differently. First of all, the doctor draws attention to the long period of the depressive state, however, the presence of at least one hypomanic episode is a necessary symptom that will allow differentiating the disease with major depression. According to many studies, bipolar disorder of the second type is much less often diagnosed. Nevertheless, according to scientists, it is this disease that often leads to suicide than classical depression.
Patients are much less likely to come to the attention of a psychiatrist, and they do not so often seek help, perceiving their condition as temporary and transient.
Bipolar disorder of the second type is often accompanied by concomitant mental disorders. This is sociophobia and the syndrome of obsessive states. Very often, obsessive-compulsive disorder is perceived as an independent nosological unit, however, patients, ashamed of their quirks, do not try to use the help of a specialist. Sociophobia is manifested in a progressive detachment from public life, a fear of communication, and contacts with other people. This factor further exacerbates the suffering and problems experienced by patients with bipolar disorder. In mental diseases affecting the affective (emotional) sphere, antidepressants, psychotropic drugs, and lithium are most often prescribed.
It can be argued that bipolar disorder of the second type has recently become regarded as an independent nosological unit. It still causes scientific discussions and poses the problems of diagnosis and timely assistance to doctors.