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Why is bipolar II often misdiagnosed as depression?

Updated: Sep 30, 2023

Diagnosing bipolar 2
Bipolar 2

Bipolar II disorder is often misdiagnosed as depression because often times individuals do not understand or know they are having hypomanic episodes. Hypomania can look like the following:

-inflated self esteem

-decreased need for sleep-more talkative than usual

-racing thoughts

-easily distracted

-increased goal directed activity

-spending more money than usual

If you think about it, some of these symptoms could actually be interpreted as a good thing: higher self esteem, needing less sleep, setting multiple goals.

According to the DSM 5, hypomania episodes in bipolar II often times are "not severe enough to cause marked impairment in social or occupation functioning or to necessitate hospitalization."

Hypomania can be harder to address and recognize simply because it is most likely not causing severe enough disruptions in the individual's life. The disruptions are STILL THERE, just not to the point where the individual is needed to go to the hospital which is often the case with individuals with Bipolar I disorder.

The hypomanic episodes are not bringing individuals to the psychiatrist or to a therapist to get help - it is the depressive episodes. When individuals describe what is off with their moods, they often only talk about the depression.

-feeling sad, empty, or hopeless

-suicidal thoughts



-loss of motivation

-feeling worthless When individuals only describe the depression, not the hypomania, they often get misdiagnosed as having major depressive disorder.

Doctors and therapist treat someone with bipolar II differently than how they treat major depressive disorder. This is why if someone comes to me asking for help with depression, I ask them a series of questions just to make sure they don’t actually have bipolar II disorder.

If you think you are bipolar and want to get a proper diagnosis- schedule a consultation with me so I can walk you through the process of how I can help.

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