Which form of bipolar disorder involves depression alternating with a milder hypomanic state?

• A. Bipolar I disorder
• B. Bipolar II disorder
• C. Cyclothymic disorder
• D. Major depressive disorder

Answer: (B)

Focus on the mood pattern: depression alternating with a milder elevated state. This form is Bipolar II. It involves at least one major depressive episode and at least one hypomanic episode, with no full manic episode ever occurring. Hypomania means elevated mood and increased energy that last at least four days and are noticeable, but not severe enough to cause marked impairment or require hospitalization. The depressive episodes meet criteria for major depressive disorder, typically lasting two weeks or more and affecting functioning. The combination of a depressive episode plus a hypomanic episode, without manic symptoms, is what defines Bipolar II.

Bipolar I, in contrast, requires at least one manic episode, which is more severe and impairing than hypomania. Cyclothymic disorder involves numerous periods of mood symptoms that are milder and do not meet full criteria for either hypomanic or major depressive episodes. Major depressive disorder includes depressive episodes alone, without any hypomanic or manic episodes.