Effects of Premenstrual Symptoms on Bipolar

I would be full of rage and anger about a week before my period.
"I would be full of rage and anger about a week before my period.". Trinette Reed/The Image Bank/Getty Images

Results of another study from the huge STEP-BD program reveal that women whose bipolar disorder gets worse during the premenstrual period are likely to have more episodes - mostly depressive episodes - and a shorter time between episodes than women whose symptoms don't get worse. Overall, the first group had more - and worse - hypo/manic and depressive episodes during the year-long study.

When our readers were questioned about their own experiences, the results seemed to overwhelmingly agree with the findings of the study, with many expressing relief that they were not alone. Following are some individual accounts.

Rider: This hit home for me. I can tell you that premenstrually, I’m a mess with my bipolar! I would be full of rage and anger about a week before my period. Nothing helped that feeling until after I got my period, and then I’d be down in despair again. The yo-yoing was exhausting. I would throw things, cry uncontrollably, not sleep. All the depressive symptoms came back, and I thought, “Here I go again.” I added Abilify to my meds, and it seemed to keep me more level for about a month. It boosted my confidence - and then everything fell apart again. One morning, I had an episode so bad it seemed impossible to get out of the funk. The physical side effects of Abilify added to my depression and made me want to get off the med, so it’s back to the doc for more advice.

Sam: Yes, things definitely got worse premenstrual. My cycles were only 23 or 24 days long, and for a week before and three days after I was awful, a total basket case.

So for 10 out of every 23 days living was hell for me and my partner. I was agitated, angry, argumentative. It was miserable.

Geri: I am so glad to see this addressed. I was diagnosed Bipolar II in my late 30s. Before that, I just figured I had raging PMS. My bipolar symptoms (mostly depression with a few days of hypomania rapidly cycling monthly.

With journaling and my psychiatrist’s help, we were able to distinguish the bipolar symptoms from the premenstrual symptoms, because they didn’t completely match together. It’s a bit like the bipolar cycles on a solar scale (12 months/year) and the menstruation is on a lunar cycle (13 months/year). So, kind of like an eclipse, when they both happen together, it’s a mild explosion. I’m so glad to know I’m not alone. (Now, I won’t even get into what the type 2 diabetes and the fibromyalgia do to this dance.)

Troya: Most definitely, every month there is another dent in the dishwasher from me kicking it! My meds seem to manage the depression pretty well but I do notice that I feel quite low when I’m pre-menstrual. Like most women I tend to be a bit teary and moody, but what is most frightening is that my anger gets out of control and I go into full blown rage. I am normally a very placid person, but I seem to get so wound up over nothing, spit venom at everyone – even strangers on the telephone - and become very violent towards my furniture.

Even my dogs seem to know and stay away. It really does scare me, and it takes me ages to come down from all that dark energy, leaving me totally exhausted afterwards. Not fun at all.

For more results from the STEP-BD program, see The Effect of Anxiety Disorders on Bipolar Disorder.

Source: Longitudinal Follow-Up of Bipolar Disorder in Women With Premenstrual Exacerbation: Findings From STEP-BD

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