Symptoms of Bipolar Disorder in Women

Societal and gender roles may inform nature of symptoms

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While women with bipolar disorder can experience the same manic and depressive episodes as men, the expression of these episodes can often take vastly different forms.

In some cases, it can be directly related to gender roles in society. For example, while excessive spending is a common feature of a manic episode, how a woman might spend her money (and on whom) may be diametrically opposed to how a man might spend in the same situation.

Conversely, the way in which depression manifests in women and men can differ based on by their relationships with others, particularly their spouse. Women in an abusive relationship, for example, will not typically respond with aggression where a man might. 

Society's Perception of Bipolar Disorder in Women

How we, as a society, perceive symptoms of bipolar disorder can also vary. While we might take exception when a man talks excessively or emotionally, discounting them as "abnormal," we will often ascribe the same behavior as being "typical" in women. 

Similarly, we to be put off by acts of aggression by women. Not so with men, who are often praised and rewarded for excessive and even violent behavior.

These perceptions can dramatically alter how bipolar women and men respond to the emotional cycles they experience. This can affect men especially if their illness is perceived as a weakness either by themselves or other.

While social roles may inform the nature of a response during a manic or depressive episode, they have no bearing whatever on the severity or type of symptoms.

Symptoms of Bipolar Mania in Women

In both women and men, manic and hypomanic phases are characterized by the following features:

  • decreased need for sleep
  • talking excessively
  • racing thoughts
  • being easily distracted
  • engaging in multiple activities
  • physical agitation and relentless movement
  • increased sexual desire
  • impulsive risk behaviors (including gambling and lavish spending)
  • grandiosity or inappropriate behavior
  • bright and often inappropriate clothing
  • Irritability, hostility, or aggression
  • delusions

In women, manic behaviors may take form in things we consider to be positive, such as dressing brightly or even provocatively. Conversely, we may attribute changes in behavior to "flightiness" or, worse yet, "typical" female mood swings.

And even when we do notice changes, it not unusual to hear them dismissed, rather cruelly, as symptoms of PMS or menopause.

Symptoms of Bipolar Depression in Women

As with manic behavior, the symptoms of bipolar depression can vary little from women to men and can often include:

  • crying for no reason or prolonged periods of sadness
  • feelings of guilt or hopelessness
  • loss of interest in activities that usually give you pleasure
  • extreme fatigue (including the inability to get out of bed)
  • loss of interest in your health, nutrition, or physical appearance
  • difficulty concentrating or remembering things
  • sleeping excessively or difficulty sleeping
  • suicidal thoughts or an impulse to self-harm

In the same way that people can dismiss manic behaviors in women, the appearance depression can lead some to callously declare a woman "premenstrual."

These same sorts of belief can plague post-menopausal women and new mothers whose depression is often considered a normal facet of their "stage of life."

Take Home Message

Historically speaking, we have long embraced the idea of "melancholy" as a singularly female condition, one that is either innate or will pass given the proper time or distraction.

As much as we like to think we've moved beyond these beliefs, they are rife in many cultures and only serve to distance women from accessing the mental care they need.

If you are experiencing symptoms of bipolar disorder, don't let anyone — including your doctor — minimize them or attribute them to "female troubles." If needed, get a second opinion, ideally from a qualified professional experienced in women's mental health. 

Source:

Parial, S. "Bipolar disorder in women." Ind J Psych. 2015; 57(Suppl 2):S252–S263.

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