Understanding and
differentiating bipolar I
and bipolar II depression

Bipolar depression is debilitating and difficult to diagnose1-3

Bipolar disorder is a chronic mental illness that causes dramatic shifts in a person's mood, energy, and ability to think clearly.3,4 Patients with bipolar disorder can experience highs (mania or hypomania) and lows (depression) in mood. The depressive phases or “lows” of bipolar disorder are often very debilitating and difficult to manage for patients.2

~11 million adults are affected by bipolar disorder in the US with similar prevalence between males and females4,5

Depressive episodes can be longer and more frequent than manic/hypomanic episodes6

Patients with bipolar disorder are 3 times more likely to experience bipolar depression than mania. Approximately 90% reported severe impairment due to depressive episodes1,7

Patients often face delays before receiving appropriate treatment3

~75% of patients with bipolar disorder are misdiagnosed, most often with major depressive disorder (MDD). It may take up to 10 years before patients with bipolar disorder receive a correct diagnosis3

In patients experiencing depressive symptoms, look for the following, which could suggest bipolar depression8,9:

  • Family history of bipolar disorder
  • A younger age of onset
  • Panic and/or anxiety
  • Family history of suicide
  • Past poor response to antidepressants
  • History of treatment-emergent irritability, agitation, or suicidality with antidepressants
  • Psychotic features
  • Other comorbidities (e.g., substance use disorders)
  • Postpartum onset

Differentiating bipolar I and bipolar II disorder hinges on the identification of mania or hypomania1,10

The population size is similar for bipolar I and bipolar II patients1

Bipolar I

characterized by ≥1 manic episode:

  • Functional impairment
  • Hospitalization
  • Psychotic symptoms
  • Lasting ≥1 week

Bipolar I & II

characterized by depressive episodes:

  • Functional impairment
  • Hospitalization
  • Psychotic symptoms

Bipolar II

characterized by hypomania, not mania

  • No marked functional impairment
  • No hospitalizations
  • No psychotic symptoms
  • Lasting ≥4 days

Patients with bipolar II depression are more likely to experience higher frequency of depressive episodes, with greater severity and lower overall functioning than bipolar I.11

Time ill due to depressive episodes12

70% Bipolar I
VS
81% Bipolar II
Unlike some medicines that only treat bipolar I, CAPLYTA treats both bipolar I and bipolar II depression in adults13
See the Efficacy
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References: 1. Merikangas KR, Akiskal HS, Angst J, et al. Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Arch Gen Psychiatry. 2007;64(5):543-552. doi:10.1001/archpsyc.64.5.543 2. Miller S, Dell'Osso B, Ketter TA. The prevalence and burden of bipolar depression. J Affect Disord. 2014;169(S1):S3-S11. doi:10.1016/S0165-0327(14)70003-5 3. Frye MA, Calabrese JR, Reed ML, et al. Use of health care services among persons who screen positive for bipolar disorder. Psychiatr Serv. 2005;56(12):1529-1533. doi:10.1176/appi.ps.56.12.1529 4. National Institute of Mental Health. Bipolar Disorder. https://www.nimh.nih.gov/health/statistics/bipolar-disorder 5. United States Census Bureau. State population by characteristics: 2010-2020. October 8, 2021. https://www.census.gov/programs-surveys/popest/technical-documentation/research/evaluation-estimates/2020-evaluation-estimates/2010s-state-detail.html 6. Baldessarini RJ, Vázquez GH, Tondo L. Bipolar depression: a major unsolved challenge. Int J Bipolar Disord. 2020;8(1):1. doi:10.1186/s40345-019-0160-1 7. Kupka RW, Altshuler LL, Nolen WA, et al. Three times more days depressed than manic or hypomanic in both bipolar I and bipolar II disorder. Bipolar Disord. 2007;9:531-535. doi:10.1111/j.1399-5618.2007.00467.x 8. Osser DN. Bipolar depression: how not to miss the diagnosis. Psychiatr Times. 2021;38(10). https://www.psychiatrictimes.com/view/bipolar-depression-how-not-to-miss-the-diagnosis 9. Bauer M, Pfennig A. Epidemiology of bipolar disorders. Epilepsia. 2005;46(suppl 4):8-13. doi:10.1111/j.1528-1167.2005.463003.x 10. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed Text Revision. American Psychiatric Association; 2022. 11. Karanti A, Kardell M, Joas E, Runeson B, Pålsson E, Landén M. Characteristics of bipolar I and II disorder: a study of 8766 individuals. Bipolar Disord. 2020;22(4):392-400. doi:10.1111/bdi.12867 12. Forte A, Baldessarini RJ, Tondo L, Vázquez GH, Pompili M, Girardi P. Long-term morbidity in bipolar-I, bipolar-II, and unipolar major depressive disorders. J Affect Disord. 2015;178:71-78. doi:10.1016/j.jad.2015.02.011 13. CAPLYTA Prescribing Information.

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