Women have everyday difficulties that men don’t have to deal with. Such situations as hormonal differences, periods, and pregnancy can create a change in women’s health, both physically and mentally. However, when it comes to mental health conditions, women can have different symptom sets than men that can be complicated by the natural conditions that women face. One such condition that is different in women than it is in men is bipolar disorder. We’re going to discuss symptoms of bipolar disorder in women and come to understand how they are similar and different from men. 

What Causes Bipolar in Women?

The cause for bipolar disorder in women are the same as it is in men. The most common is a familial history of mental illness, especially if there are direct genealogical indicators for bipolar disorder within close family members.

Although it’s important to note that there isn’t one sole gene responsible for bipolar disorder to occur within family history. Rather it’s predisposition point to the probability of developing bipolar disorder. For example, if a mother or father has bipolar disorder there is a higher likelihood that their children may develop said condition down the road. ¹

The other root cause for bipolar disorder to develop is chemical imbalances within the brain. However, most diagnoses and treatments are based on symptoms shown by the patient. 

Symptoms of Bipolar Disorder in Women

The symptom set for bipolar is generally mood swings, typically from manic highs to depressive lows. These swings occur during an extended period of time and are classified by clinicians as episodes.

Mania

Mania is usually a period of time where you experience an increase in energy and frantic behavior. This can be expressed in a myriad of different ways but the most typical is an increase in productivity, overcommunication, obsessive-related thoughts or behavior as well as a troubling elevation in risk-taking tendencies. There could be outward aggression towards those trying to intervene on the sufferer or outright dismissal to try and slow down thoughts, behaviors, or tendencies. ²

Other symptoms and signs of mania can include: 

• Difficulties in sleeping. 
• Having racing thoughts. 
• Poor impulse control, especially with sexual or financial behaviors. 
• Delusions of grandeur. 
• Hallucinations. 

Hypomania

A less severe form of mania, hypomania shares many aspects and symptoms with mania but in a shorter timeframe. Hypomania is more subdued but it’s still marked by increases in energy levels, higher productivity output, and an inflated sense of self. ³

However, unlike mania, hypomania has shorter effectiveness – typically lasting at most three to four days. Furthermore, it isn’t as severe and doesn’t require involuntary hospitalization.

Depression

Contrasting with mania, depressive episodes are low periods that usually include a withdrawal from normal activities, isolation from friends or family, and having a low mood. Depressive episodes typically last longer than their manic counterparts and can deteriorate to self-harm or even suicide. ⁴

Common depressive episode symptoms can include: 

• Low self-esteem
• Fatigue 
• Irritability 
• Rumination
• Flat affect 
• Loss of appetite or overeating for comfort 
• Loss of concentration
• Social withdrawal
• Noticeable increase or decrease in sleep
• Self-harm or suicide

Mixed Mania

Women with bipolar disorder may also experience an episode known as a mixed mania state. Mixed mania is exactly what it sounds like: It’s a mixing of both depressive and manic states that fluctuate from either end of the emotional extreme in a short period of time. ⁵

Mixed mania shares symptoms from both sides of the episodic equation, with the patient feeling manic one moment and depressive in the next. Naturally, this can be disorientating and exhausting for the patient.

The risk of delusions, hallucinations, isolation, and self-harm, including suicide, all rise during a mixed mania episode. Those that are experiencing a mixed mania episode need to be evaluated by a mental health professional as the patient might need to be hospitalized for their own safety.

Risks of Bipolar in Women

It’s been shown that women have a higher risk of developing bipolar type 2 than other bipolar variations. Women also have a higher risk of developing morbidities such as seasonal changes, depressive-related symptoms, and in extreme cases suicidality. ⁶

Hormonal Conditions

The starkest difference between bipolar disorder in men and women is the higher likelihood of developing and being affected by hormonal conditions. Such conditions as menstruation, pregnancy, and menopause can alter a woman’s mood, mental state, and behaviors – whether or not they are already affected by bipolar disorder. 

Such conditions need to be taken into account during the diagnostic process and in treatment in order to best treat bipolar symptoms along with the natural hormonal shifts that occur in women. It’s also true that women will develop bipolar disorder later in life than men. Concurrent with developing bipolar disorder, older women also start to enter menopause, which creates real changes in mood and behavior. ⁷

Seasonal Impact

Women have a deeper impact on their bipolar symptoms through seasonal changes. This is evident in the changes in the severity of symptoms such as mood swings, and manic and depressive-related symptoms. 

Most of the women who suffer from bipolar disorder have seasonal cycles to their mood wings and their depressive and manic episodes. For example, it’s common for those women that suffer from bipolar disorder to have more depressive lows during the winter and manic highs in the spring and summer. ⁸ 

Co-Morbidities

Women are more prone to having comorbidities than men that resemble bipolar symptoms which can create confusion and misdiagnosis. Women are more prone to developing autoimmune and inflammatory disorders than men and thus ruling out specific conditions can help in the proper diagnosis of bipolar disorder. ⁹

Such conditions that can complicate bipolar patients when it comes to proper diagnosis and treatment are: 

• Thyroid disorder
• Multiple Sclerosis
• Diabetes 
• Obesity 
• Chrone’s disease 
• Frequent migraines 
• Hypertension 
• Asthma 

Suicide

One of the more unfortunate aspects of bipolar disorder and women is the increase in suicidality as well as unwanted suicidal thoughts or feelings. Commonly, suicide occurs during a depressive episode. Particularly a deep and long-lasting depressive episode in which normal daily functioning is effected to a point where the patient cannot cope.

Types of Bipolar Disorder in Women

Bipolar disorder has variations. Each diagnosis has its own effects and impacts on patients. The most common diagnosis of bipolar disorder is bipolar type 1 and bipolar type 2. However, there are other rare diagnoses which include cyclothymic disorder and unspecified bipolar disorder.  

Bipolar I Disorder

Bipolar I is classified as a mental disorder that typically includes mood shifts from highs to lows. These high mood swings are called periods of mania or manic episodes as they usually only last for a short period of time, from a handful of days to a couple of weeks. ¹⁰  

Though it’s likely for those struggling with bipolar I to have depressive symptoms as well. However, they are more commonly affected by manic or hypomanic episodes that vary in duration and in effects.

Bipolar II Disorder

Bipolar II shares features with bipolar I, however, it does have distinct differences. This subset reveals mood shifts involving emotional altercations from a normal state to a depressive one.

Bipolar 2 involves major depressive episodes that usually last from a handful of days to a couple of weeks at a time. It is common for those suffering from bipolar II disorder to go from a depressive state that lasts for several days to a week to a manic one. ¹¹

Cyclothymic Disorder (Cyclothymia)

Cyclothymic disorder (sometimes referred to as cyclothymia) is a mild mood disorder that is defined by swings of hypomania and mild depression. Those who struggle with the cyclothymic disorder will experience two sets of symptoms: emotional highs and emotional lows. While these symptoms are extremely similar to bipolar I and bipolar II disorder, they aren’t nearly as severe. ¹²

Unspecified Bipolar Disorder

While it’s true that those with bipolar symptoms can fall into one of the three earlier-mentioned types, there are those who might not adequately fit into those diagnostic criteria.

In such cases, they may struggle with an unspecified type of bipolar disorder. Unspecified bipolar is when a sufferer doesn’t have the components of all the other kinds of bipolar disorder but still is affected by elevated mood or abnormal mood swings. 

Typically a person who has unspecified bipolar disorder will be clinically classified as having bipolar not otherwise specified. Those with bipolar-NOS exhibit symptoms of one or all of the above subtypes of bipolar disorder. However, the timeframe of experiencing such symptoms are far shorter or not as cyclical. ¹³ 

How is Bipolar Diagnosed in Women

Diagnosis for bipolar disorder in women can be difficult. The diagnosis process can differ from men in that a clinician has to rule out any and all conflicting conditions that may resemble certain symptoms.

In order to properly delineate bipolar amongst the other conditions, tests need to be done by medical professionals to ensure the patient isn’t suffering from a medical condition that could be causing the symptoms. Such tests could include a physical exam by a doctor, lab work, or communicating with loved ones to ensure the symptoms are being defined correctly. 

From there a patient see a mental health professional, such as a psychologist or a therapist. In a mental health setting, a professional will check you for other mental health conditions and discuss their behaviors and experiences through both high and low episodes.

In order for a patient to be diagnosed, they need to suffer from one episode of mania or hypomania. To determine what type of bipolar disorder a person has, mental health care professionals utilize both the patient’s experiences during their most intense episodes as well as the diagnostic code laid out in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). ¹⁴

How Bipolar is Treated in Women

When it comes to bipolar treatment there is good news and there is bad news. The bad news is that bipolar disorder is a lifelong illness with no cure. However, the good news is that there are options to help ease symptoms and regulate manic and depressive episodes. These options break down into three typical avenues of bipolar treatment:

Medication

The purpose of medications for bipolar disorder is to help ease symptoms and regulate episode severity. However, they are also beneficial to create a therapeutic response so talk therapy has the ability to work. 

Medications for bipolar disorder also allow for those suffering to live a functional life and follow their regular routine. The bipolar medication list includes the following types: 

• Lithium 
• Anticonvulsants 
• Antipsychotics 
• Antidepressants 
• Benzodiazepines
• Symbyax

Therapy

While medication can help with the symptoms of bipolar disorder, psychotherapy offers long-term support and improvement. Most think of therapy as a patient in an office discussing their problems with a therapist and while that is true, there are many other options available, such as: 

• Cognitive-behavioral therapy (CBT)
• Family therapy
• Group therapy
• Individual therapy/counseling
• Interpersonal/social rhythm therapy

Lifestyle Changes

Along with medication and therapy options such as talk therapy and CBT, making and sticking to specific lifestyle changes can drastically improve bipolar symptoms. These changes aren’t large life-altering decisions but rather gradual and healthful habits that can increase the potential of living with ease with bipolar disorder. Such lifestyle changes and habits can include: ¹⁵

• Creating a strong support network of friends and family. 
• Taking medications properly and on time. 
• Creating and sticking to a routine. 
• Getting adequate sleep 
• Eating a balanced diet. 
• Maintaining an active lifestyle, including regular exercise. 
• Reducing stress. 
• Avoiding alcohol and drug use. 
• Keeping the treatment team updated and regularly attending appointments. 

Final Word

It is unfortunately true that women face more challenges than men in regard to their health. With hormonal changes, increased chances of suffering from disorders and diseases, and developing mental health conditions like bipolar disorder can be disconcerting. However, with the right knowledge and support group, treatment and long-term improvement can be possible. 

Your Questions

Still, have questions concerning what are the symptoms of bipolar disorder in women.

We invite you to ask them in the comment section below. If you have any further advice to offer – whether personal or professional – we’d also love to hear from you.

Reference Sources

¹ Journal of Clinical Investigation: Bipolar disorder – From genes to behavior 

² Cleveland Clinic: Definition of Mania

³ Cleveland Clinic: Definition of Hypomania

⁴ MindUK: Depressive Episode Definition 

⁵ National Library of Medicine: Mixed States in Bipolar Disorder

⁶ National Library of Medicine: Bipolar disorder in women

⁷ National Library of Medicine: “Is it menopause or bipolar?”: a qualitative study of the experience of menopause for women with bipolar disorder

⁸ National Library of Medicine: Is seasonal affective disorder a bipolar variant?

⁹ National Library of Medicine: Gender Differences and Comorbidities in U.S. Adults with Bipolar Disorder

¹⁰ MedlinePlus: Bipolar 1 Defined

¹¹ Baptist Health: Bipolar 2 Defined 

¹² Mayo Clinic: Cyclothymia Defined

¹³ National Library of Medicine: Differentiating Bipolar Disorder–Not Otherwise Specified and Severe Mood Dysregulation

¹⁴ NYU Langone: Diagnosing Bipolar Disorder

¹⁵ Substance Abuse & Mental Health Services Administration: Living With Bipolar Disorder – Daily Habits Make a Difference