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.4 Patients with bipolar disorder can experience high and low moods—known as mania and depression. The depressive phases or “lows” of bipolar disorder are often very debilitating and difficult to manage for patients.1
11 million
affected by bipolar
disorder in the US4,5
Prevalence of bipolar disorder
similar for
males and females4
Depressive episodes can be longer & more frequent
than manic/hypomanic episodes6
3X
MORE
LIKELY
for patients with bipolar
disorder to experience
bipolar depression
than mania7
˜90%
of patients report severe
impairment due to
depressive episodes1
Patients often face delays before receiving
appropriate treatment3
May take as long as
10 years
to diagnose
patients with bipolar disorder8
75%
BIPOLAR
PATIENTS
misdiagnosed
with unipolar depression
(major depressive disorder)3
See what factors could lead to a change in diagnosis from unipolar depression to bipolar depression9-12
- Family history of mental illness (eg, bipolar disorder, major
depressive disorder, schizophrenia) - 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 (eg, substance use disorders)
- Postpartum depression or psychosis
Differentiating bipolar I and
bipolar II depression
SIMILAR POPULATION SIZE
FOR BIPOLAR I AND BIPOLAR II PATIENTS1
How to identify and differentiate patients with bipolar I or bipolar II1,6,13-17
How to identify and differentiate patients
with bipolar I or bipolar II1,6,13-17
BIPOLAR I
characterized by ≥1 manic
episode:
- Lasting ≥1 week
- Hospitalization
- Functional impairment
- Psychotic symptoms
(up to 75%)
BIPOLAR I & II
characterized by
depressive episodes:
- Hospitalization
- Functional impairment
- Psychotic symptoms
BIPOLAR II
characterized by hypomania, not mania:
- Lasting ≥4 days
- No hospitalizations
- No psychotic symptoms
- No marked functional
impairment
Unlike some medicines that only treat bipolar I, CAPLYTA treats both bipolar I and bipolar II depression in adults20
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. 2. Miller S, Dell'Osso B, Ketter TA. The prevalence and burden of bipolar depression. J Affect Disord. 2014;169(S1):S3-S11. 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. 4. National Institute of Mental Health. Bipolar Disorder. Accessed October 21, 2021. https://www.nimh.nih.gov/health/statistics/bipolar-disorder. 5. United States Census Bureau. State population by characteristics: 2010-2020. October 8, 2021. Accessed December 7, 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. 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. 8. Swartz HA and Suppes T. Bipolar II Disorder: Recognition, Understanding, and Treatment. American Psychiatric Association Publishing; 2019. 9. Osser DN. Bipolar depression: how not to miss the diagnosis. Psychiatr Times. 2021;38(10). Accessed November 16, 2021. https://www.psychiatrictimes.com/view/bipolar-depression-how-not-to-miss-the-diagnosis. 10. McIntyre RS, Berk M, Brietzke E, et al. Bipolar disorders. Lancet. 2020;396(10265):1841-1856. 11. Bowden CL. A different depression: clinical distinctions between bipolar and unipolar depression. J Affect Disord. 2005;84(2-3):117-125. 12. Bauer M, Pfennig A. Epidemiology of bipolar disorders. Epilepsia. 2005;46(suppl 4):8-13. 13. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed Text Revision. American Psychiatric Association; 2022. 14. Carvalho AF, Firth J, Vieta E. Bipolar disorder. N Engl J Med. 2020;383(1):58-66. 15. Hirschfeld RM. Bipolar depression: the real challenge. Eur Neuropsychopharmacol. 2004;14 (suppl 2):S83-S88. 16. Dunayevich E, Keck PE Jr. Prevalence and description of psychotic features in bipolar mania. Curr Psychiatry Rep. 2000;2(4):286-290. 17. Karanti A, Kardell M, Joas E, et al. Characteristics of bipolar I and II disorder: a study of 8766 individuals. Bipolar Disord. 2020;22(4):392-400. 18. Vinberg M et al. Differences in clinical presentation between bipolar I and II disorders in the early stages of bipolar disorder: A naturalistic study. J Affect Disord. 2017;208:521-527. 19. Forte A, Baldessarini RJ, Tondo L et al. Long-term morbidity in bipolar-I, bipolar-II, and unipolar major depressive disorders. J Affect Disord. 2015;178:71-78. 20. CAPLYTA prescribing information.