Bipolar Disorder Symptoms in Women

Bipolar disorder is a serious mental health condition characterized by intense mood swings.1 While it’s experienced in similar ways for both men and women, there are some distinct differences when it comes to symptoms. Let’s take a look at the unique ways that bipolar disorder affects women.

What Is Bipolar Disorder?

Bipolar disorder—sometimes referred to as manic depression—causes profound mood swings. People with the disorder usually swing between manic episodes and depressive episodes, though some people experience mixed episodes of both mania and depression.1

These mood swings can cause changes in behavior, and a decreased ability to cope with life, and can impact interpersonal relationships. Bipolar disorder can also cause a person to make irrational decisions and exhibit impetuous behavior. The depressive phase of bipolar disorder puts a person at increased risk of suicide.1

The precise causes of bipolar disorder are unknown and may vary from person to person. Genetics may be at play, brain, and chemical differences may also be a factor, and environmental triggers may contribute.1

How Bipolar Disorder Is Different For Women

Bipolar disorder affects between 3.7% to 6.4% of the population, but it seems to affect men and women in equal amounts.2 However, the way that it affects women has some specific characteristics:

• Women are more likely to experience bipolar II (which is predominated by hypomania) than men2
• Women are more likely to have episodes of mixed mania and rapid cycling than men2
• Women are more prone to serious depression associated with bipolar disorder than men3
• There may be a seasonal pattern for women, with women experiencing more bipolar episodes in the fall and winter3
• Women are more likely to begin experiencing bipolar disorder symptoms at later ages than men3

How Are Bipolar Disorder Symptoms Different in Women?

Just as it is for men, bipolar disorder for women is characterized by severe mood swings, including periods of mania (heightened mood) and depression. However, women are more likely to experience hypomania than men, which means that their experience of mania may be less pronounced and obvious to others.4

Hypomania is a more high-functioning form of mania, and has symptoms such as:5

• Feeling “high” and full of energy
• Feeling like you don’t need to sleep
• Having racing thoughts and making impulsive decisions
• Hypomanic episodes last fewer days than manic episodes
• Although the feelings are intense, they don’t usually impact your ability to function
• Hypomania doesn’t usually result in hospitalization

Women who experience bipolar disorder are more likely to experience “mixed” episodes that have aspects of both mania/hypomania and depression. They are also more likely to experience “rapid cycling,” which means having four or more different episodes in one year.5

Women Are At a High Risk of Depressive Episodes & Suicide

Perhaps the most concerning aspect of bipolar disorder symptoms in women is the fact that depressive episodes of bipolar disorder are more prominent in women than in men. Depressive episodes often dominate over manic episodes in women. In fact, women with bipolar disorder are often misdiagnosed as having major depression.3

Both mania and depression have risks, but the depressive episodes of bipolar disorder put people at high risk of suicide. Indeed, women with bipolar disorder are more likely to attempt suicide or die by suicide than men with bipolar disorder.3

This is one of many reasons why bipolar disorder needs to be taken seriously in women and needs to be properly diagnosed.

The Reproductive Cycle Impacts Symptoms

The hormones associated with women’s reproductive cycles don’t cause bipolar disorder, but they can exacerbate symptoms. For example:3

• Symptoms of bipolar disorder may intensify during PMS, perimenopause, and menopause
• Depression during PMS is experienced by about one-quarter of women who have bipolar disorder
• Pregnancy and childbirth may also exacerbate symptoms, with postpartum women experiencing higher rates of bipolar disorder onset or relapse
• Women with bipolar disorder are at higher risk of postpartum psychosis, a rare, but serious postpartum mood disorder characterized by mania and potential harm to one’s baby or one’s self

Comorbidities

There are certain comorbidities that are more common in women than men when it comes to bipolar disorder. For example, women with bipolar disorder are more likely to experience:

• Borderline personality disorder3
• Eating disorders, such as bulimia3
• Thyroid conditions2
• Medication-induced obesity2
• Migraines2

Bipolar Disorder Treatments in Women

Bipolar disorder is serious, but it can be treated. With treatment, there is hope for living a full and healthy life. The treatments used to treat bipolar disorder are similar for both men and women, and usually involve a combination of therapy, medication, and lifestyle changes.1

Bipolar disorder is frequently misdiagnosed, and women are more likely to receive a diagnosis of depression before they are properly diagnosed with bipolar disorder. So it’s important to seek further evaluations if your symptoms involve symptoms of both mania and depression and you don’t seem to be getting better with traditional treatment for depression.3

Treatment for bipolar disorder in women is often complicated by the fact that women may spend time pregnant or lactating, and medications commonly prescribed for bipolar disorder may be contraindicated. Not only that, but pregnancy and postpartum can exacerbate bipolar symptoms.3

That’s why it’s important to work with a medical provider who understands the necessity for you to be properly treated, even during pregnancy and lactation, and to work with you to make a risk/benefit analysis when it comes to prescribing medications to treat your symptoms.3