Mood Stabilizers for Bipolar 2: What Actually Helps?
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At a Glance: Mood Stabilizers for Bipolar Type 2
Bipolar 2 is often misdiagnosed as depression: Many people are treated with antidepressants alone. While antidepressants can temporarily lift mood, they leave the underlying instability untreated.
Mood stabilizers are the foundation of bipolar II treatment: They target both depressive and hypomanic symptoms.
Classic mood stabilizers for bipolar II include: lamotrigine and lithium.
Antipsychotic medications: These are sometimes used as mood stabilizers in bipolar 2.
Finding the right medication takes time. Most people notice subtle improvements slowly.
If you have ever taken bipolar medications exactly as prescribed and it still felt like something wasn’t quite right, you are not alone. Many people living with Bipolar II try one or more treatments before finding something that truly helps.
Mood stabilizers for bipolar type 2 play an important role in the treatment, providing long-term benefits. Below, we’ll look at why they matter in the treatment of Bipolar II, which ones are commonly used, what the benefits are and how they work.
Editorial note: You may see both “bipolar 2” and “bipolar II” being used in this article. We use bipolar 2 (especially in headings) because it’s the term most people search for. But we also use bipolar II in the body for clinical accuracy. Both refer to the same diagnosis.
Why Bipolar 2 Is Often Harder to Treat Than People Expect
With Bipolar II, depression usually takes up the most space, as hypomania tends to blend quietly into everyday life, sometimes going unnoticed. Instead of it being a cause for concern, it can feel like you have regained your energy and motivation after a long-lasting depressive state.
Due to its characteristics, bipolar II tends to be treated as major depressive disorder. This kind of treatment focuses mostly on improving mood, without targeting the instability underneath it, which later on makes symptoms harder to manage.
Why Mood Stabilizers Are the Foundation of Bipolar 2 Treatment
Mood stabilizers are used in the treatment of bipolar II because they address both depressive and hypomanic episodes. Rather than affecting only one part of mood instability, such as temporarily improving your mood, they actually help regulate the driving force behind mood instability, making the episodes less frequent and less intense.
Mood stabilizers for bipolar type 2 lower the risk of relapse, help in preventing the long-term impact of the episodes, and reduce the risk of suicide.
Mood Stabilizers for Bipolar 2
“Classic” Mood Stabilizers
These are called “classic mood stabilizers" because they were among the first medications shown to reliably balance mood.
Lamotrigine (Lamictal): This drug is often considered the "gold standard" mood stabilizer for Bipolar 2. It is exceptionally good at preventing depressive episodes. It is also generally well-tolerated with minimal weight gain. Note: Doctors usually start it at a very low dose and increase slowly over several weeks to avoid a rare but serious skin rash called Stevens-Johnson Syndrome.
Lithium (The Classic Stabilizer): Lithium is the oldest and most-studied mood stabilizer for bipolar 2. While it is most known for stopping severe mania in bipolar 1, it is also effective for BD-II maintenance.
Valproic Acid / (Depakote): More common for Bipolar I, but sometimes used in BD-II if there are "mixed features" (feeling depressed and agitated at the same time) or rapid cycling.
Carbamazepine (Tegretol): This may be tried if other bipolar 2 mood stabilizers haven't worked.
Antipsychotic Medications
Antipsychotic medications are often used as mood stabilizers for bipolar 2. Here are the most common ones:
Quetiapine (Seroquel): Commonly used as a mood stabilizer for depressive symptoms in Bipolar 2. It can help with mood, anxiety, and sleep, and it’s often taken at night because it can be quite sedating.
Lurasidone (Latuda): Approved as a mood stabilzier for bipolar II. It’s less sedating than quetiapine, so it’s a better choice if staying clear-headed during the day is important. It has proven to be very effective with minimal risks of cognitive deficits or weight gain. Note: It needs to be taken with at least 350 calories of food for proper absorption.
Lumateperone (Caplyta): A newer mood stabilizer for bipolar 2. Studies show it’s well-tolerated with minimal side effects.
Why Antidepressants Alone Can Backfire in Bipolar Disorder
Antidepressants can be a lifesaving treatment, especially in cases of major depressive disorder. However, the research shows that in some people diagnosed with bipolar disorder, antidepressants can trigger:
Hypomania
Mixed episodes
Mood cycling
When used alone, antidepressants can worsen this already present mood instability by pushing the mood up without providing stability. At first, it might feel like the treatment is working and that life finally feels manageable.
Unfortunately, after a while, the use of antidepressants can destabilize the emotional baseline, leading to mixed states, quicker cycling between episodes, and even worse, depressive episodes.
In cases where Bipolar II hasn’t yet been clearly identified or it was misdiagnosed, it can also lead to increased emotional distress and suicidal thoughts.
This does not happen to everyone. And, antidepressants combined with mood stabilizers can sometimes be used for bipolar II without triggering worsening mood episodes.
How Doctors Decide Which Mood Stabilizer to Use for Bipolar 2
To decide which mood stabilizer to use, doctors take into consideration the following things:
The severity of your symptoms
How they affect your sleep
If you are also experiencing anxiety or other symptoms
Another thing they look at is your medical history, along with previously used medications and your response to them. This helps them create a treatment plan that will work for you and will have minimal side effects.
What It Feels Like When a Mood Stabilizer Is Working
When a mood stabilizer is working, the effects are usually subtle. Mood instability doesn’t disappear completely, but its intensity is lower, making emotions easier to manage without numbing them.
Another noticeable change is more consistency when it comes to sleep. For some people with bipolar disorder, sleep is a battle. Mood stabilizers for bipolar 2 can help with this. Many people notice clearer focus, and better stress management. These changes often lead to feeling like a steadier version of yourself.
Living Better With Mood Stabilizers for Bipolar 2
Bipolar II is treatable, and the right combination exists, even if it might not feel that way for you yet. Finding the right medication or combination can take time, and it doesn’t mean you are doing anything wrong. It just means you are still adjusting, learning, and moving toward something that fits you better.
FAQS
Where can I find a psychiatrist specializing in bipolar 2 disorder near me?
For many people, online psychiatry makes care easier and more accessible. Talkspace and similar online platforms allow you to schedule an appointment with a licensed psychiatrist or therapist from home. The wait times are often shorter, and scheduling is usually flexible.
How do mood stabilizers for bipolar 2 symptoms work?
These medications work by affecting brain neurotransmitters involved in mood. Common ones include GABA, glutamate, serotonin, and dopamine. These all play a role in emotional balance. With these medications, many people notice more consistent mood, sleep, and emotional balance.
How Long Does it Take for Mood Stabilizers for Bipolar 2 to Work?
The time that it takes can vary depending on the medication. Typically, changes are gradual. Most people begin to notice subtle improvements within several weeks.
