A mood disorder characterized by at least one hypomanic episode and at least one major depressive episode. Hypomania is less severe than mania and does not cause marked impairment or psychosis. Depressive episodes are typically more frequent and longer-lasting than in Bipolar I, with significant suicide risk.

• 1Detailed history of hypomanic episodes
• 2Structured Clinical Interview for DSM-5
• 3Mood Disorder Questionnaire
• 4Assessment of functional impairment during elevated periods
• 5Differential diagnosis from unipolar depression
• 6Screening for substance use
• 7Thyroid function tests

Depressive episodes predominate (up to 35x more time depressed than hypomanic). Suicide risk similar to or higher than Bipolar I. With proper treatment, 40-50% achieve remission of depressive symptoms. Hypomanic episodes often enjoyable and not reported spontaneously. Misdiagnosis as unipolar depression delays appropriate treatment by average 8-10 years. Functional impairment significant during depressive episodes. Rapid cycling develops in 15-20%. Comorbid anxiety and substance abuse common. Chronic course with relapses, but less severe than Bipolar I.

• Careful screening for hypomania before prescribing antidepressants
• Regular mood monitoring
• Maintaining stable sleep patterns
• Stress management techniques
• Avoiding substance use
• Early intervention for mood changes
• Consistent medication adherence
• Psychoeducation about illness course