By Gordon Parker
Reports our wisdom of Bipolar II sickness, protecting its background, category, neurobiology and treatment.
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Additional resources for Bipolar II disorder : modelling, measuring and managing
Isn’t this dilemma precisely what the DSM was designed to address? True, but we can become too wedded to the apparent precision in its rules. We can forget, in our discussions with colleagues, and indeed with patients and their families, that our diagnoses are probabilities, not entities. Rigour lies in characterising the probabilities we are trying to establish; understanding how they can be narrowed by gathering data not just on the presence or absence of hypomania/mania, but also through a systematic assessment of soft signs and collateral data from significant others; and finally, by being scrupulously honest with ourselves and with our patients about what we know and do not know.
E. non-manic features associated with subsequent manic or hypomanic episodes) warrant consideration as at least ‘not unipolar’. But first let us consider the evidence in favour of recognising all these patients as having ‘bipolarity’, if not formal BP II or BP I. Evidence supporting the spectrum perspective If two illnesses present similarly, but are truly independent conditions (different ‘species’), then there should be ‘zones of rarity’ between them: points on a continuum where no patients can be found.
1 on the search engine Google for searches of BP II Disorder. In part due to this position, it receives about 50 000 visits per month, illustrating widespread interest in and use of education resources on BP II – perhaps especially if they are free and have no direct financial connections to any products (ethical issues of using pharmaceutical company honoraria to enable the site are discussed on the Funding page). Solution 3. Teach patients and families what to look for As clinicians know from experience, teaching patients and families about BP II is a crucial initial step toward acceptance of this diagnosis.