Bipolar II Disorder - Prognosis

Prognosis

There is evidence to suggest that Bipolar II Disorder has a more chronic course of illness than Bipolar I Disorder. This constant and pervasive course of the illness leads to an increased risk in suicide and more hypomanic and major depressive episodes with shorter periods of time between episodes than Bipolar I patients experience. The natural course of Bipolar II Disorder, when left untreated, leads to patients spending the majority of their lives unwell with much of their suffering stemming from depression. Their recurrent depression results in personal suffering and disability. This disability can present itself in the form of psychosocial impairment, which has been suggested to be worse in Bipolar II patients than in Bipolar I patients. Another facet of this illness that is associated with a poorer prognosis is rapid cycling, which denotes the occurrence of four or more Major Depressive, Hypomanic, and/or mixed episodes in a twelve-month period. Rapid cycling is actually quite common in those with Bipolar II, much more so in women than in men (70% vs. 40%), and without treatment leads to added sources of disability and an increased risk of suicide. In order to improve a patient’s prognosis, long term therapy is most favorably recommended for controlling symptoms, maintaining remission and preventing relapses. With treatment, patients have been shown to present a decreased risk of suicide (especially when treated with lithium) and a reduction of frequency and severity of their episodes, which in turn moves them toward a stable life and reduces the time they spend ill. In order to maintain their state of balance, therapy is often continued indefinitely, as around 50% of the patients who discontinue it relapse quickly and experience either full-blown episodes or sub-syndromal symptoms that bring significant functional impairments.