Table of ContentsView AllTable of ContentsSymptomsRisksSeasonal MoodComplicationsTypesTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms
Risks
Seasonal Mood
Complications
Types
Treatment
Bipolar disorderin females includes many of the symptoms, like severemood swings, that males have with the same diagnosis.Yet there are differences. Females, for example, are more likely to be diagnosed withbipolar 2 disorder. They may face a higher risk of depression and suicide, though males are often diagnosed earlier.
Identifying and treating bipolar disorder in females can be more difficult due to co-occurring conditions. They may be more likely to relapse during treatment, especially duringpregnancyand its challenges. Researchers are increasingly looking at female hormonal influences in bipolar disorder.
This article discusses the causes and symptoms of the condition, the risks and differences for females, as well as its treatment methods.
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A Note on Gender and Sex TerminologyVerywell Health acknowledges thatsex and gender are related concepts, but they are not the same.Sex refers to biology: chromosomal makeup, hormones, and anatomy. People are most often assigned male or female at birth based on their external anatomy; some people do not fit into that sex binary and are intersex.Gender describes a person’s internal sense of self as a woman, man, nonbinary person, or another gender, and the associated social and cultural ideas about roles, behaviors, expressions, and characteristics.Research studies sometimes don’t use the terminology in this way. Terms that describe gender (“woman,” “man”) may be used when terms for sex (“female,” “male”) are more appropriate. To reflect our sources accurately, this article uses terms like “female,” “male,” “woman,” and “man” as the sources use them.
A Note on Gender and Sex Terminology
Verywell Health acknowledges thatsex and gender are related concepts, but they are not the same.Sex refers to biology: chromosomal makeup, hormones, and anatomy. People are most often assigned male or female at birth based on their external anatomy; some people do not fit into that sex binary and are intersex.Gender describes a person’s internal sense of self as a woman, man, nonbinary person, or another gender, and the associated social and cultural ideas about roles, behaviors, expressions, and characteristics.Research studies sometimes don’t use the terminology in this way. Terms that describe gender (“woman,” “man”) may be used when terms for sex (“female,” “male”) are more appropriate. To reflect our sources accurately, this article uses terms like “female,” “male,” “woman,” and “man” as the sources use them.
Verywell Health acknowledges thatsex and gender are related concepts, but they are not the same.
Research studies sometimes don’t use the terminology in this way. Terms that describe gender (“woman,” “man”) may be used when terms for sex (“female,” “male”) are more appropriate. To reflect our sources accurately, this article uses terms like “female,” “male,” “woman,” and “man” as the sources use them.
Symptoms of Bipolar Disorder in Women
People with bipolar disorder experience manic or hypomanic episodes, depressive episodes, mixed states, or rapid cycling. The “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5) outlines symptoms of bipolar disorder based on the state of the condition.
Females with bipolar disorder are more likely to experience depressive episodes than males. They may require hospitalization during these times to help manage symptoms and potential safety concerns.
Females are more likely to be diagnosed with bipolar II and have more episodes with mixed states and rapid cycling.
Mania
In mania, symptoms may include:
How symptoms present in males and females can be different, though. Studies show that certain symptoms, like grandiosity and aggression, are more common in males than females with bipolar disorder and similar mental health conditions.
Hypomania
Episodes of hypomania include the same symptoms of mania to a lesser degree of intensity, and cannot include psychosis.Hypomania may present with irritability, increased productivity, changes insleep habits, pressured speech, and grandiose thoughts.
Depression
In depressive states, symptoms may include:
Symptoms of depression tend to be more of a risk for females when compared with males.
Mixed Mania
In mixed states, symptoms may include:
Studies that show mixed features of bipolar disorder tend to appear in the research more often with mixed mania episodes, with symptoms more often reported in females.
Bipolar Disorder and Brain ChangesWhat causes bipolar disorder is still unclear. Researchers are trying to understand more about how specific chemical messengers, calledneurotransmitters(e.g.,dopamineandserotonin), as well as activity in the brain, contribute to bipolar disorder.
Bipolar Disorder and Brain Changes
What causes bipolar disorder is still unclear. Researchers are trying to understand more about how specific chemical messengers, calledneurotransmitters(e.g.,dopamineandserotonin), as well as activity in the brain, contribute to bipolar disorder.
Genetic and environmental factors can play a significant role in the onset of the condition:
Certain mental health conditions also are considered risk factors for developing a co-occurring bipolar disorder, but they’re not always as readily identifiable in females. They include:
The onset of symptoms of bipolar disorder in most people is late teens to early 20s. However, females may see a later onset of symptoms, sometimes into their 40s and 50s.If you believe you might have bipolar disorder, schedule an appointment with a mental health professional.
Is Bipolar a Disability? How to Qualify for Benefits
Pregnancy, Menstruation, Menopause, and Bipolar Disorder in Women
Natural fluctuations in hormones that occur in females may contribute to changes in mood. They also may play a role in bipolar disorder that is unique to how females experience it.
Pregnancy
Individuals who are pregnant or considering getting pregnant may want to consult with a healthcare provider, as hormonal changes during pregnancy may also influence mood.The manic symptoms of bipolar disorder have been shown to increase the risk of relapse during pregnancy.
Additionally, certain medications used to treat bipolar disorder can be harmful to pregnant people or the developing fetus. This leads to treatment challenges in pregnant people with bipolar disorder.
Menstruation
People observe differences in energy and mood during a menstrual cycle. People with bipolar disorder may find mood swings challenging due to hormonal changes. They also may experience drug interactions related to treatment.
Depakote (valproate) is a common mood stabilizer used to treat bipolar disorder that can lead to menstrual irregularities and may interact with hormonal birth control pills.
Menopause
Studies estimate up to 15% of people experiencing menopause also are diagnosed with a mood disorder like bipolar disorder.These females may experience an increase in depressive, hypomanic, or manic symptoms at menopause orperimenopause(the time around it).
Though the connection between hormones and bipolar disorder in females needs to be studied further, working closely with a care team can help determine the best course of treatment.
Bipolar Disorder During PostpartumThe postpartum period is an especially vulnerable time for people with bipolar disorder. Discuss the possible benefits and risks of staying on medication during this period and while nursing with your healthcare provider.
Bipolar Disorder During Postpartum
The postpartum period is an especially vulnerable time for people with bipolar disorder. Discuss the possible benefits and risks of staying on medication during this period and while nursing with your healthcare provider.
The Link Between Thyroid Disease and Menopause
Seasonal Mood and Bipolar Disorder in Women
For example, episodes of depression may be more prevalent during the autumn and winter months than in spring and summer. During these times of the year, females with bipolar disorder may notice lower energy levels and changes in their sleeping patterns, often with an increased need for sleep.
Complications of Bipolar Disorder in Women
Certain complications of bipolar disorder are more common in females.
Co-Morbidities
Research indicates that people with bipolar disorder are at a greater risk of having other mental health and physical conditions that occur alongside the disorder.
Some common co-occurring conditions include:
Suicide
Other factors that increase a risk of suicide in females diagnosed with bipolar disorder include:
Help Is AvailableIf you or someone you know are having suicidal thoughts, dial988to contact the988 Suicide & Crisis Lifelineand connect with a trained counselor. If you or a loved one is in immediate danger, call911.
Help Is Available
If you or someone you know are having suicidal thoughts, dial988to contact the988 Suicide & Crisis Lifelineand connect with a trained counselor. If you or a loved one is in immediate danger, call911.
There are various types of bipolar disorder, including bipolar I, bipolar II,cyclothymic disorder, and unspecified bipolar disorder.
Bipolar I Disorder
Bipolar II Disorder
Cyclothymic Disorder or Cyclothymia
There is some evidence to suggest that a cycle of bipolar disorder symptoms linked to anxiety that includes cyclothymic traits may be more common in females, but these sex and gender differences require more study.
Unspecified Bipolar Disorder
Bipolar Disorder Otherwise Not SpecifiedSome people are diagnosed with Bipolar Disorder Otherwise Not Specified. This means that based on their symptoms, they don’t fit neatly into mania or one of the other BD subtypes. This diagnosis is more common in females and puts them at higher risk of clinical symptoms and episodes requiring intervention.
Bipolar Disorder Otherwise Not Specified
Some people are diagnosed with Bipolar Disorder Otherwise Not Specified. This means that based on their symptoms, they don’t fit neatly into mania or one of the other BD subtypes. This diagnosis is more common in females and puts them at higher risk of clinical symptoms and episodes requiring intervention.
What Causes Bipolar Disorder?
Management and Treatment in Women
It can be challenging todiagnosea person with bipolar disorder accurately. Females may be misdiagnosed due to a lack of understanding about how the condition impacts them, or due to the presence of a co-occurring disorder.
Yet bipolar disorder is a mental health condition that requires lifelong management. A priority in treatment is stabilizing the person’s mood, typically through the use of medication and therapy.
Some studies suggest that females experience longer times until they receive treatment. They also show a less positive response to some drugs, including anticonvulsants like Depakote that are used with bipolar disorder.
Medication
Medications are available to help with symptom management:
Because some medications can increase the risk of birth defects, females should discuss with their healthcare provider the benefits and risks of taking medication during pregnancy and while nursing.Side effects also may be a concern.
Therapy
Therapy can be very beneficial for people with bipolar disorder. In therapy, a person will talk through their diagnosis and learn coping skills.
Cognitive behavioral therapycan aid with challenging unhealthy thoughts and behaviors, while family-focused therapy can help loved ones gain understanding and offer support.
Therapy, especially in combination with medication, can be an effective way to manage bipolar disorder. Therapy can also support people with adhering to a medication regimen.
Exercise
Exercise plays an important role in managing mood and a person’s circadian rhythm (the natural daily cycle). A review of studies on health interventions and bipolar disorder indicated that exercise can reduce stress and symptoms of depression.
When to Alert Your Care TeamIt’s important to have an open discussion with members of your care team if:You notice changing or worseningsymptoms.You are experiencing side effects of medication.You are grappling with suicidal thoughts or feelings. Sharing these thoughts with your care team leads to collaboration on a coping plan to keep you safe.
When to Alert Your Care Team
It’s important to have an open discussion with members of your care team if:You notice changing or worseningsymptoms.You are experiencing side effects of medication.You are grappling with suicidal thoughts or feelings. Sharing these thoughts with your care team leads to collaboration on a coping plan to keep you safe.
It’s important to have an open discussion with members of your care team if:
Why Does Bipolar Disorder Get Worse With Age?
Summary
Bipolar disorder is a mood disorder that can present differently in females. Hormonal changes in females can impact mood, and they have a higher risk of having other, co-occurring mental health conditions. Patterns of symptoms also may be different in females and males.
Timely diagnosis and treatment are key to managing the condition. Bipolar disorder can be treated with medication, therapy, or a combination of both.
Learning ways to cope with mood fluctuations also can help with well-being. Creating a daily routine of exercise, along with self-care habits of quality sleep and healthy eating, can benefit your mood.
16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Bipolar Disorder.Dell’Osso B, Cafaro R, Ketter TA.Has Bipolar Disorder become a predominantly female gender related condition? Analysis of recently published large sample studies.Int J Bipolar Disord. 2021 Jan 4;9(1):3. doi: 10.1186/s40345-020-00207-z.American Psychiatric Association.What is bipolar disorder?Irving J, Colling C, Shetty H, Pritchard M, Stewart R, Fusar-Poli P,et al.Gender differences in clinical presentation and illicit substance use during first episode psychosis: a natural language processing, electronic case register study.BMJ Open. 2021 Apr 20;11(4):e042949. doi:10.1136/bmjopen-2020-042949.Menculini G, Steardo L Jr, Sciarma T, D’Angelo M, Lanza L, Cinesi G,et al.Sex Differences in Bipolar Disorders: Impact on Psychopathological Features and Treatment Response.Front Psychiatry. 2022 Jun 10;13:926594. doi: 10.3389/fpsyt.2022.926594.Salazar de Pablo G, Cabras A, Pereira J, Castro Santos H, de Diego H, Catalan A,et al.Predicting bipolar disorder I/II in individuals at clinical high-risk: Results from a systematic review.J Affect Disord. 2023 Mar 15;325:778-786. doi:10.1016/j.jad.2023.01.045.Parial S.Bipolar disorder in women.Indian J Psychiatry. 2015;57(Suppl 2):S252-S263. doi:10.4103/0019-5545.161488Conklin D, Carpenter JS, Whitney MS, DeLozier S, Ogede DO, Bazella C,et al.Narrative Analyses: Cognitive Behavior Group Therapy for Women with Menopause and Bipolar or Major Depressive Disorders.Womens Health Rep (New Rochelle). 2021 Sep 22;2(1):430-442. doi: 10.1089/whr.2021.0025.Substance Abuse and Mental Health Services Administration.An Introduction to Bipolar Disorder and Co-Occurring Substance Use Disorders.Kuś A, Kjaergaard AD, Marouli E, Del Greco M F, Sterenborg RBTM, Chaker L,et al.Thyroid Function and Mood Disorders: A Mendelian Randomization Study.Thyroid. 2021 Aug;31(8):1171-1181. doi: 10.1089/thy.2020.0884.Duan J, Yang R, Lu W, Zhao L, Hu S, Hu C.Comorbid Bipolar Disorder and Migraine: From Mechanisms to Treatment.Front Psychiatry. 2021 Jan 11;11:560138. doi: 10.3389/fpsyt.2020.560138.Depression and Bipolar Support Alliance.Bipolar disorder statistics.Dome P, Rihmer Z, Gonda X.Suicide risk in bipolar disorder: a brief review.Medicina. 2019;55(8):403. doi:10.3390/medicina55080403National Institute of Mental Health.Bipolar disorder.Depression and Bipolar Support Alliance.Medications for mood disorders.Bauer IE, Gálvez JF, Hamilton JE, et al.Lifestyle interventions targeting dietary habits and exercise in bipolar disorder: a systematic review.J Psychiatr Res. 2016;74:1-7. doi:10.1016/j.jpsychires.2015.12.006
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Bipolar Disorder.Dell’Osso B, Cafaro R, Ketter TA.Has Bipolar Disorder become a predominantly female gender related condition? Analysis of recently published large sample studies.Int J Bipolar Disord. 2021 Jan 4;9(1):3. doi: 10.1186/s40345-020-00207-z.American Psychiatric Association.What is bipolar disorder?Irving J, Colling C, Shetty H, Pritchard M, Stewart R, Fusar-Poli P,et al.Gender differences in clinical presentation and illicit substance use during first episode psychosis: a natural language processing, electronic case register study.BMJ Open. 2021 Apr 20;11(4):e042949. doi:10.1136/bmjopen-2020-042949.Menculini G, Steardo L Jr, Sciarma T, D’Angelo M, Lanza L, Cinesi G,et al.Sex Differences in Bipolar Disorders: Impact on Psychopathological Features and Treatment Response.Front Psychiatry. 2022 Jun 10;13:926594. doi: 10.3389/fpsyt.2022.926594.Salazar de Pablo G, Cabras A, Pereira J, Castro Santos H, de Diego H, Catalan A,et al.Predicting bipolar disorder I/II in individuals at clinical high-risk: Results from a systematic review.J Affect Disord. 2023 Mar 15;325:778-786. doi:10.1016/j.jad.2023.01.045.Parial S.Bipolar disorder in women.Indian J Psychiatry. 2015;57(Suppl 2):S252-S263. doi:10.4103/0019-5545.161488Conklin D, Carpenter JS, Whitney MS, DeLozier S, Ogede DO, Bazella C,et al.Narrative Analyses: Cognitive Behavior Group Therapy for Women with Menopause and Bipolar or Major Depressive Disorders.Womens Health Rep (New Rochelle). 2021 Sep 22;2(1):430-442. doi: 10.1089/whr.2021.0025.Substance Abuse and Mental Health Services Administration.An Introduction to Bipolar Disorder and Co-Occurring Substance Use Disorders.Kuś A, Kjaergaard AD, Marouli E, Del Greco M F, Sterenborg RBTM, Chaker L,et al.Thyroid Function and Mood Disorders: A Mendelian Randomization Study.Thyroid. 2021 Aug;31(8):1171-1181. doi: 10.1089/thy.2020.0884.Duan J, Yang R, Lu W, Zhao L, Hu S, Hu C.Comorbid Bipolar Disorder and Migraine: From Mechanisms to Treatment.Front Psychiatry. 2021 Jan 11;11:560138. doi: 10.3389/fpsyt.2020.560138.Depression and Bipolar Support Alliance.Bipolar disorder statistics.Dome P, Rihmer Z, Gonda X.Suicide risk in bipolar disorder: a brief review.Medicina. 2019;55(8):403. doi:10.3390/medicina55080403National Institute of Mental Health.Bipolar disorder.Depression and Bipolar Support Alliance.Medications for mood disorders.Bauer IE, Gálvez JF, Hamilton JE, et al.Lifestyle interventions targeting dietary habits and exercise in bipolar disorder: a systematic review.J Psychiatr Res. 2016;74:1-7. doi:10.1016/j.jpsychires.2015.12.006
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
MedlinePlus.Bipolar Disorder.Dell’Osso B, Cafaro R, Ketter TA.Has Bipolar Disorder become a predominantly female gender related condition? Analysis of recently published large sample studies.Int J Bipolar Disord. 2021 Jan 4;9(1):3. doi: 10.1186/s40345-020-00207-z.American Psychiatric Association.What is bipolar disorder?Irving J, Colling C, Shetty H, Pritchard M, Stewart R, Fusar-Poli P,et al.Gender differences in clinical presentation and illicit substance use during first episode psychosis: a natural language processing, electronic case register study.BMJ Open. 2021 Apr 20;11(4):e042949. doi:10.1136/bmjopen-2020-042949.Menculini G, Steardo L Jr, Sciarma T, D’Angelo M, Lanza L, Cinesi G,et al.Sex Differences in Bipolar Disorders: Impact on Psychopathological Features and Treatment Response.Front Psychiatry. 2022 Jun 10;13:926594. doi: 10.3389/fpsyt.2022.926594.Salazar de Pablo G, Cabras A, Pereira J, Castro Santos H, de Diego H, Catalan A,et al.Predicting bipolar disorder I/II in individuals at clinical high-risk: Results from a systematic review.J Affect Disord. 2023 Mar 15;325:778-786. doi:10.1016/j.jad.2023.01.045.Parial S.Bipolar disorder in women.Indian J Psychiatry. 2015;57(Suppl 2):S252-S263. doi:10.4103/0019-5545.161488Conklin D, Carpenter JS, Whitney MS, DeLozier S, Ogede DO, Bazella C,et al.Narrative Analyses: Cognitive Behavior Group Therapy for Women with Menopause and Bipolar or Major Depressive Disorders.Womens Health Rep (New Rochelle). 2021 Sep 22;2(1):430-442. doi: 10.1089/whr.2021.0025.Substance Abuse and Mental Health Services Administration.An Introduction to Bipolar Disorder and Co-Occurring Substance Use Disorders.Kuś A, Kjaergaard AD, Marouli E, Del Greco M F, Sterenborg RBTM, Chaker L,et al.Thyroid Function and Mood Disorders: A Mendelian Randomization Study.Thyroid. 2021 Aug;31(8):1171-1181. doi: 10.1089/thy.2020.0884.Duan J, Yang R, Lu W, Zhao L, Hu S, Hu C.Comorbid Bipolar Disorder and Migraine: From Mechanisms to Treatment.Front Psychiatry. 2021 Jan 11;11:560138. doi: 10.3389/fpsyt.2020.560138.Depression and Bipolar Support Alliance.Bipolar disorder statistics.Dome P, Rihmer Z, Gonda X.Suicide risk in bipolar disorder: a brief review.Medicina. 2019;55(8):403. doi:10.3390/medicina55080403National Institute of Mental Health.Bipolar disorder.Depression and Bipolar Support Alliance.Medications for mood disorders.Bauer IE, Gálvez JF, Hamilton JE, et al.Lifestyle interventions targeting dietary habits and exercise in bipolar disorder: a systematic review.J Psychiatr Res. 2016;74:1-7. doi:10.1016/j.jpsychires.2015.12.006
MedlinePlus.Bipolar Disorder.
Dell’Osso B, Cafaro R, Ketter TA.Has Bipolar Disorder become a predominantly female gender related condition? Analysis of recently published large sample studies.Int J Bipolar Disord. 2021 Jan 4;9(1):3. doi: 10.1186/s40345-020-00207-z.
American Psychiatric Association.What is bipolar disorder?
Irving J, Colling C, Shetty H, Pritchard M, Stewart R, Fusar-Poli P,et al.Gender differences in clinical presentation and illicit substance use during first episode psychosis: a natural language processing, electronic case register study.BMJ Open. 2021 Apr 20;11(4):e042949. doi:10.1136/bmjopen-2020-042949.
Menculini G, Steardo L Jr, Sciarma T, D’Angelo M, Lanza L, Cinesi G,et al.Sex Differences in Bipolar Disorders: Impact on Psychopathological Features and Treatment Response.Front Psychiatry. 2022 Jun 10;13:926594. doi: 10.3389/fpsyt.2022.926594.
Salazar de Pablo G, Cabras A, Pereira J, Castro Santos H, de Diego H, Catalan A,et al.Predicting bipolar disorder I/II in individuals at clinical high-risk: Results from a systematic review.J Affect Disord. 2023 Mar 15;325:778-786. doi:10.1016/j.jad.2023.01.045.
Parial S.Bipolar disorder in women.Indian J Psychiatry. 2015;57(Suppl 2):S252-S263. doi:10.4103/0019-5545.161488
Conklin D, Carpenter JS, Whitney MS, DeLozier S, Ogede DO, Bazella C,et al.Narrative Analyses: Cognitive Behavior Group Therapy for Women with Menopause and Bipolar or Major Depressive Disorders.Womens Health Rep (New Rochelle). 2021 Sep 22;2(1):430-442. doi: 10.1089/whr.2021.0025.
Substance Abuse and Mental Health Services Administration.An Introduction to Bipolar Disorder and Co-Occurring Substance Use Disorders.
Kuś A, Kjaergaard AD, Marouli E, Del Greco M F, Sterenborg RBTM, Chaker L,et al.Thyroid Function and Mood Disorders: A Mendelian Randomization Study.Thyroid. 2021 Aug;31(8):1171-1181. doi: 10.1089/thy.2020.0884.
Duan J, Yang R, Lu W, Zhao L, Hu S, Hu C.Comorbid Bipolar Disorder and Migraine: From Mechanisms to Treatment.Front Psychiatry. 2021 Jan 11;11:560138. doi: 10.3389/fpsyt.2020.560138.
Depression and Bipolar Support Alliance.Bipolar disorder statistics.
Dome P, Rihmer Z, Gonda X.Suicide risk in bipolar disorder: a brief review.Medicina. 2019;55(8):403. doi:10.3390/medicina55080403
National Institute of Mental Health.Bipolar disorder.
Depression and Bipolar Support Alliance.Medications for mood disorders.
Bauer IE, Gálvez JF, Hamilton JE, et al.Lifestyle interventions targeting dietary habits and exercise in bipolar disorder: a systematic review.J Psychiatr Res. 2016;74:1-7. doi:10.1016/j.jpsychires.2015.12.006
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