An Integrated Treatment Approach for Bipolar II Disorder: A Clinical Case Study

Maria Theodoratou1,2, Basant K Puri2,3

  • 1Social Sciences School, Hellenic Open University, 263 31 Patras, Greece.

PubMed

Background/Objectives: Bipolar II disorder is frequently misdiagnosed as unipolar depression, particularly when depressive symptoms predominate and hypomanic features are subtle or overlooked. This case study describes a patient initially treated for postpartum depression who later developed antidepressant-induced hypomanic symptoms, leading to the correct diagnosis of bipolar II disorder. The objective is to illustrate diagnostic complexities and highlight the value of an integrated treatment approach. Methods: Clinical assessment included standardized mood rating scales, structured interviews, functional evaluations, and monitoring of sleep and physical health indicators. Treatment combined mood-stabilizing pharmacotherapy with cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), psychoeducation, and interpersonal and social rhythm therapy (IPSRT). Lifestyle interventions targeted sleep hygiene, physical activity, and stress management. Results: The diagnosis of bipolar II disorder was supported by the emergence of hypomanic symptoms following antidepressant treatment. The integrated therapeutic plan resulted in sustained mood stabilization, normalization of sleep patterns, improved occupational and social functioning, and reductions in depressive and hypomanic symptom scores. Physical health indicators, including body mass index, also improved. Conclusions: This case underscores the importance of comprehensive assessment and careful interpretation of antidepressant response in suspected bipolar presentations. A multimodal treatment approach integrating medication, psychotherapy, and lifestyle modification contributed to significant clinical improvement and may serve as a model for managing complex bipolar II presentations.

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