Mental illness does not discriminate, as it can affect anyone. That being said, while it does not discriminate, it does not affect everyone the same way. Here, we will look at how symptoms of bipolar disorder affect women compared to men and why there are differences between the two.
The disorder is estimated to affect around some 60 million people globally, according to the World Health Organization. However, bipolar disorder is believed to be more common in women, according to Our World in Data’s report on mental health.
The site presents data showing that 46 million people across the globe had bipolar disorder in 2017, with 52% of them being female. It also reports that women across countries are more likely to experience bipolar disorder than men.
An estimated 2.8% of U.S. adults had bipolar disorder in the past year, according to the National Institute on Mental Health (NIMH), although the number could be higher.
Bipolar disorder is treatable. However, it is a difficult illness to treat, mainly because it is hard to diagnose. Several of its symptoms resemble other conditions, which means many people do not even know they have it. If left untreated, bipolar disorder can cause a number of problems that could result in an unfavorable outcome. Among them are:
- Substance use disorders (SUDs)
- Eating disorders (bulimia, binge eating)
- Other mental health disorders (anxiety disorders, attention-deficit hyperactivity disorders)
- Strained interpersonal relationships
- Poor school or work performance
- Financial problems
- Problems with the law, authority
What Is Bipolar Disorder?
Bipolar disorder is a mental illness marked by episodes of fluctuating changes in mood as well levels of energy and activity. The disorder can happen regularly or irregularly. Either way, it can make it challenging to finish daily tasks or live normally. Manic-depressive disorder or manic-depressive illness are other names for bipolar disorder.
The dramatic mood changes that happen as a result of bipolar I disorder can appear to happen suddenly. These extreme changes are so debilitating that they harm a person’s thinking and reasoning abilities. The ups and downs of the illness can cause energy levels to spike, followed by extreme bouts of depression. This unpredictable cycle of changes in behavior raises the risk of someone acting recklessly in their behavior and choices as well as puts them at risk of entertaining thoughts of suicide.
Three types of bipolar disorder
Per the National Institute on Mental Health (NIMH), there are three types of bipolar disorder. They are: bipolar I, bipolar II, and cyclothymic disorder (cyclothymia).
People with bipolar I disorder experience periods of high energy and high moods that are disruptive to their daily living. Their manic episodes last a minimum of seven days, making it challenging to perform duties at work and socialize and relate to others.
Bipolar I disorder can also involve depressive episodes that last two weeks, and it is possible for a person to have manic and depressive symptoms happen at the same time. Manic symptoms can require treatment in the hospital. Psychosis, a state in which people lose touch with reality, is also another possibility for people with bipolar I.
Many people diagnosed with bipolar have bipolar II, which some consider the most common form. A person with bipolar II disorder can have a cycle of highs and lows but not full-blown episodes of mania. They also can experience several periods of a milder form of mania, known as hypomania, and one depressive episode. Bipolar II episodes can last a few days to a few months.
Cyclothymic disorder (cyclothymia)
A person with cyclothymic disorder experiences a milder form of bipolar disorder. They have hypomanic symptoms and depressive symptoms that, while persistent, do not last long enough to meet the diagnosis required for a hypomanic episode and a depressive episode, per NIMH.
Mayo Clinic recommends that people with cyclothymic disorder seek treatment to manage their symptoms, even if they are not as extreme as those that characterize bipolar disorder. They can still harm one’s functioning ability and increase the risk of developing bipolar I or II.
What Are the Symptoms of Bipolar Disorder?
Bipolar symptoms usually fall into three main categories: mania, hypomania, and depression.
A person having an episode of mania may experience the following:
- A spike in energy or activity
- Strong feelings of excitement or happiness
- Agitation, anger, or restlessness
- Decreased need for sleep or trouble sleeping
- Fast-paced thoughts
- Sped-up rate of speech; loud speech or talking more than usual
- Tendency to ramble so that speech is hard to understand or doesn’t make sense
- Boost in the desire to take risks, engage in reckless behavior
- High interest in pleasure-seeking activities, such as sex, substance use
- Inflated self-esteem
- Risky spending habits
Hypomania symptoms closely resemble those that characterize manic episodes. However, it may be harder to identify them because they present as a mix of symptoms, which include:
- Energy boost, increased agitation
- Changes in appetite
- Less need for sleep or feeling unable to sleep
- Racing thoughts
- Fast, loud talking
- Increased risk-taking or reckless behavior
In many cases, a person can experience a depressive state after having a manic or hypomanic state. Major depressive episodes include the following symptoms:
- Low energy
- Sad, hopeless, or worthless feelings
- Low to no interest in one’s usual hobbies or leisure activities
- Sleep trouble (having trouble falling asleep, staying asleep, or oversleeping)
- Increased withdrawal, isolation from others
- Problems with concentrating
- Non-diet weight loss or weight gain
- Suicidal thoughts or tendencies
Bipolar Disorder in Women: How Is It Different from Men?
Many factors must be examined when treating women with bipolar disorder. It affects almost every facet of their lives, from their biological functions to their mental health and well-being. Below are some ways men and women differ on this illness.
Bipolar II More Common in Women Than Other Types
Women are more likely to have bipolar II disorder, according to the Office of Women’s Health. This means they are more likely to have depressive episodes and experience rapid cycling between the highs and lows of the disorder.
Per Healthline, rapid cycling is a term that describes a bipolar condition that is characterized by four or more distinct mood episodes, which are considered frequent. To compare, one or two episodes usually mark bipolar disorder. These episodes can switch back and forth between mania and depression during a 12-month period.
Women’s Biological Makeup Contribute to Bipolar Symptoms
Various medical sources report that physiological and biological functions unique to women can trigger bipolar symptoms. This includes:
- Childbirth (bipolar disorder can also worsen months after a child is born)
- Hormonal shifts during menstruation and pregnancy
All of these are believed to contribute to women experiencing certain bipolar symptoms at higher rates than men, and all of them can trigger depressive episodes. However, these biological functions are not believed to cause the disorder.
Bipolar Lives also shares that women and men experience bipolar II differently. Depression is the dominant symptom, which often leads to misdiagnosis since depression is a common symptom of other disorders. Many women who go to the doctor about their depression receive the wrong information, which means it could take years to receive the right treatment for their condition.
Women with Bipolar Disorder More Likely to Have Co-Occurring Disorders
Another area where women with bipolar experience challenges are substance use disorders. A Journal of Clinical Psychology study that examined gender differences looked at comorbidity rates with alcohol and other substance use disorders between men and women with bipolar illness.
Of the two groups, women with bipolar disorder are at particularly high risk for comorbidity with these conditions, researchers found. The drugs and alcohol women use to self-medicate to deal with bipolar disorders physically affect them differently from men with the disorder who might use them for the same purpose.
The National Institute on Drug Abuse (NIDA) reports that women’s biology and gender also influence how their experiences with substance use and addiction differ from men’s.
First, women who use substances may find it affects their menstrual cycle, hormones, fertility rates, and pregnancy. It can also affect breastfeeding, menopause, and more.
NIDA also writes about other challenges substance use can pose for women, including:
- Increasing their cravings for addictive substances
- Changing their brains in ways that men do not experience
- Creating physical changes in their heart and blood vessels
- Affecting their sex hormones, which can increase their sensitivity to some drugs and their effects
- Raising their risks of developing cancer, including breast cancer
Women use substances for different reasons than men, NIDA says. Self-medicating against depression is a major reason women use drugs and alcohol. They also use them to control their weight, treat fatigue, and manage other mental illnesses.
They also rely on substances for pain relief, especially since women experience higher levels of pain than men. It also takes shorter periods of time for women to develop an addiction, and they also don’t need as much of a drug or alcohol as men to develop a substance use disorder.
Other Health Conditions Can Accompany Bipolar Disorder
Women are also believed to have more problems with migraines, obesity, and thyroid disease as a result of bipolar disorder. Hormonal issues make women more prone to these health challenges, Sanam Hafeez, PsyD, told Psycom for its article on bipolar gender differences.
Diagnosing Bipolar Disorder and What Women Need to Notice
If you or someone you know has experienced episodes of mania, hypomania, or depression, the next step is to see a medical or mental health professional about your symptoms to see if you have bipolar disorder. It is best to speak up early to get the help you need. An evaluation can lead to insight and answers about what to do next,
Women are more likely than men to seek treatment when they experience depression. Unfortunately, however, they are more likely to receive the wrong diagnosis, delaying the right treatment and medication they need. As mentioned earlier, depression is a symptom of many different disorders.
Women Should Note Any Sudden Shifts in Mood
It could take multiple tries for a woman to get the correct diagnosis she needs. If bipolar disorder is suspected, a woman can start the process of mood charting. This allows her to track changes in her mood and how often they happen. She also will want to track her sleep patterns, appetite changes, and other factors and mark any changes that seem sudden or erratic. Mood charting can be done with a traditional journal, but some may prefer to record videos daily or jot down notes.
It also helps to remember that depression is only one symptom to take into account. Others that must be present before a bipolar disorder diagnosis is made is a person must have had an episode of mania or hypomania. Symptoms of this condition are:
- Mood changes
- Impaired judgment
- Disrupted thought patterns
- Changes in speech
Bipolar Disorder Evaluation
Mayo Clinic describes the evaluation process, saying it can include:
A physical exam and lab tests. Undergoing these examinations can help identify other physical medical problems that could be causing the condition. It can also help your doctor rule out other illnesses that resemble bipolar disorder.
A psychiatric assessment. Examining patterns of thoughts, feelings, and behaviors can point the medical or mental health professional into considering bipolar disorder as the possible cause. This part of the evaluation process will likely involve the patient taking a psychological self-assessment or questionnaire.
Reviewing criteria for bipolar disorder. The professional conducting the evaluation should consult with the latest version of the Diagnostic and Statistical Manual of Mental Disorders and compare your symptoms with what’s there.
Once the results come back from the evaluation and other exams, the health care professional will review them and offer a diagnosis and recommendations for follow-up care.
Bipolar Disorder Treatment for Women
In general, bipolar disorder is treated with medications and psychotherapy. If you have been diagnosed with bipolar disorder and are considering treatment, you are advised to speak with your medical and/or mental health care professional about the best treatment plan for you.
Treatment is usually long-term, as the goal is to stabilize one’s mood to help manage one’s manic and/or depressive states. Hospital care is also an option for bipolar disorder treatment. The Journal of Clinical Psychology study referenced earlier found that women may be more likely than men to receive hospital care for manic episodes.
The medications that are commonly used in bipolar disorder treatment are:
- Mood stabilizers, which help control manic and hypomanic episodes, per the Mayo Clinic. A person with bipolar disorder may be prescribed mood stabilizers such as lamotrigine (Lamictal) and lithium (Lithobid). Per WebMD, doctors prefer lithium for women who are pregnant and receiving bipolar treatment because they are considered safer than newer drugs on the market.
- Antipsychotics, which treat lingering symptoms of mania, psychotic symptoms, and depression. Antipsychotics, which include drugs like aripiprazole (Abilify) and quetiapine (Seroquel), may be prescribed with mood stabilizers.
- Antidepressants, which are prescribed to manage symptoms of depression. Treatment may include an antidepressant along with either a mood stabilizer or antipsychotic.
- Antidepressant-antipsychotic, which is a combination drug that stabilizes mood and helps with depression.
- Anti-anxiety medications, which include drugs like benzodiazepines, are used to help manage feelings of anxiety. These medications are highly addictive, so they are usually prescribed for short-term treatment.
Psychotherapy is also used with medications to treat bipolar disorder in both men and women. Common therapies include:
- Cognitive behavioral therapy (CBT). This therapy approach helps people identify limiting beliefs and behaviors and teaches them how to replace those with ones that encourage health problem-solving and resolution. CBT helps people also understand their triggers that lead to bipolar episodes and how to manage their stress effectively
- Interpersonal and social rhythm therapy (IPSRT). Many people with bipolar find it challenging to complete daily tasks and go about their lives normally. IPSRT may be prescribed to help them find stability in their daily routine. This routine involves their sleep and eating schedule. It is easier to stabilize one’s moods when an established routine is in place.
- Family therapy. Family plays a significant role in a person’s ability to overcome the challenges they experience with a mental health or substance use disorder. Therapy that involves the family can help them learn the most effective ways to support their loved one with bipolar disorder.
Therapy can inform everyone, including the person with bipolar disorder, how to recognize warning signs of pending mood swings and how to go about managing them. Having family support can also encourage the person with bipolar to continue receiving treatment for the long term because they feel like it is possible to achieve.
Women with Bipolar Disorder and Substance Use Disorders
As mentioned earlier, some people use drugs and alcohol to self-medicate against the debilitating effects of mental illness. While using addictive substances may provide short-term relief, the problem is that doing so will worsen both conditions and cause the user to develop a life-threatening substance addiction.
Some people who use substances may not even know they have bipolar disorder because they either have been misdiagnosed or not diagnosed at all. A person who has both a problem with substance use and mental illness has comorbid disorders, which are known by several terms, including dual diagnosis.
Women who are diagnosed with bipolar disorder and a substance use disorder should seek treatment that addresses both disorders concurrently or at the same time. Treatment is more effective when both disorders are addressed. Paying attention to one and not the other only makes treatment ineffective for both.
Programs That Treat Both Disorders Are More Effective
Find an accredited center that offers programs that address dual diagnosis treatment. A program of this kind will want to know how long you have been using drugs to self-medicate against bipolar disorder symptoms and what kinds of drugs you have been using. This is the time to be honest so that they can know how to help you.
Depending on the severity of your condition, you may be required to stay on-site at a facility for residential (inpatient care). For milder conditions, you may be able to get outpatient care, which would allow you to receive therapy and treatment at the facility for a set number of hours every week before returning home.
We Help Women with Bipolar Disorder: Call Us Today for Help
Vista Pines Health, located in Pembroke Pines, helps people in the South Florida area who have bipolar disorder. We understand the unique needs that women with this disorder have and are able to offer treatment that helps them manage their illness the right way.
We also have a sister facility we work with that can treat patients with bipolar disorder and substance use disorders. You do not have to struggle with dual diagnosis; we can help you. Treating both disorders at the same time only helps you improve your chances for an effective recovery and start the new life you’ve always wanted.
We can accommodate people who need a long-term stay. We have a private, comfortable facility that offers 24-hour residential care and supervision.
If you come to Vista Pines, do not expect to be treated like another number. We personalize our treatment programs here, and we pay close attention to every patient, as we have a low clinician-to-client ratio. Every person in our care receives the personal medical care they need. We also look at your medical and mental health history while creating a program that is just for you.
Vista Pines uses psychotherapy and medication therapy as well as evidence-based approaches to help clients with bipolar disorder. We will adjust your treatment program as needed and explain every step along the way so that you will know what is going on with your health.
Give us a call today so that we can learn more about how we can help you. Bipolar disorder is treatable with the right methods. We can help you find the help you need and have been looking for.