The tendency for patients with bipolar II disorder to present with depressive symptoms rather than hypomanic symptoms can lead to a misdiagnosis of unipolar depression. These patients are often treated with antidepressants, which may be inappropriate for patients with bipolar II disorder due to the risk of inducing manic switching or rapid cycling. Misdiagnosis and mistreatment or nontreatment can lead to substantial psychosocial dysfunction, which may be best addressed in the context of psychotherapy. Psychotherapy in conjunction with pharmacotherapy has been shown to be an effective treatment for patients with bipolar II disorder, but more research is needed to better understand how treatment interventions should be used to optimize symptomatic and functional outcomes.

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J Clin Psychiatry 2008;69(5):e15