Jesse Jackson Jr. treated for bipolar II disorder: What is it?

The Mayo Clinic announced this week that Rep. Jesse Jackson Jr. (D-Ill.), who has been on medical leave since June, is at the facility in Rochester, Minn., being treated for a form of bipolar disorder known as bipolar II.

The clinic’s statement says describes bipolar II depression as “a treatable condition that affects parts of the brain controlling emotion, thought and drive.” A combination of genetic and environmental factors are thought to make people vulnerable to the condition, which the National Institute of Mental Health says “is defined by a pattern of depressive episodes shifting back and forth with hypomanic episodes, but no full-blown manic or mixed episodes.”

“Congressman Jackson is responding well to the treatment and regaining his strength,” according to the statement released Monday.

Jackson is one of the millions of people in the U.S. who suffer from bipolar II; altogether, an estimated 5.7 million Americans have some form of bipolar disorder, also known as manic-depressive disorder, according to the National Institute of Mental Health.

David Miklowitz is director of the Integrative Study Center for Mood Disorders at UCLA. He spoke with The Times about the condition that’s suddenly in the spotlight.

What is bipolar II?

Bipolar II disorder is a variant of bipolar disorder in which people go from severe periods of depression to hypomanias.

When people are depressed, they can go weeks or months feeling very low, losing interest in things, feeling like they can’t sleep, feeling suicidal or losing appetite. The depression can be debilitating. Then the person may swing into what we call a hypomania, which is a manic episode where people are extremely high in mood and running a mile a minute. Their thoughts are going very fast and their minds are running with many ideas. They can get away with less sleep. Their mood will change, but it isn’t so severe that they need to be hospitalized.

How is this different than bipolar I?

In bipolar I disorder, people have full manic episodes — a weeklong period where they feel elated and have grandiose ideas about themselves. They speak fast and are hypersexual. But the important difference is that this mania needs intervention and causes significant functional impairment. They need to be hospitalized or have a medicine change.

Sometimes people end up in jail. At minimum they lose their job or cause significant relationship problems.

Both bipolar I and II can have the same level of depression, but bipolar I people have more severe mania for longer periods of time.

How are the symptoms of depression or mania that come with bipolar II different from the normal ups and downs that people feel throughout their lives?

The main symptom of bipolar II disorder is major depression. This would be a two-week or longer period. This is more than being sad — whereas you or I might be sad for a day or two and it might not interfere with our lives, a person with bipolar II disorder can be incapacitated.

On the manic end of things, although you or I might feel energetic or up on a given day, people who are hypomanic go days at a time with very little sleep and take on lots of new projects. They take on impulsive things that are sometimes dangerous.

Is bipolar II disorder harder to detect?

Yes, that is generally true because the hypomanias are less severe. The hard part is knowing whether it is depression or depression with alternating manias. The manias might be easy to miss.

What is the prognosis for a patient with bipolar II?

We worry about continuing depressive episodes for people with bipolar II disorder. People complain of long, slow-burning depressions that cause them to not enjoy their lives.

Medications and psychotherapy have been known to help people make such episodes less frequent and shorter. So the prognosis is good with stabilizing medications and psychotherapy. A combination of the two can effectively treat bipolar II disorder.

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