Yes, it is possible for an individual to be diagnosed with Bipolar II disorder even if they never experience "regular" hypomania. In Bipolar II disorder, individuals experience at least one major depressive episode and at least one hypomanic episode. However, the hypomanic episodes in Bipolar II are typically less severe and do not meet the criteria for full-blown mania seen in Bipolar I disorder.
In the context of mixed episodes, these are episodes where symptoms of both depression and mania or hypomania occur simultaneously or rapidly alternate within a short period. During mixed episodes, an individual may experience depressive symptoms (e.g., sadness, low energy, worthlessness) and manic or hypomanic symptoms (e.g., increased energy, irritability, racing thoughts) concurrently.
While mixed episodes are more commonly associated with Bipolar I disorder, they can also occur in individuals with Bipolar II disorder. So, if an individual experiences exclusively mixed episodes and depressive episodes, but never meets the criteria for "regular" hypomania (non-mixed), they can still be diagnosed with Bipolar II disorder.
The diagnosis of bipolar disorders can be complex, and a qualified mental health professional, such as a psychiatrist or psychologist, should make the diagnosis based on a thorough evaluation of the individual's symptoms, history, and overall clinical presentation. It's essential for individuals experiencing mood-related symptoms to seek professional help for an accurate diagnosis and appropriate treatment plan. Effective treatment can significantly improve the management of bipolar disorder and enhance the individual's overall well-being.