The gender role of biology and gender affect how women feel and are diagnosed with bipolar disorder. A lot of people are misdiagnosed due to the mental illness’s typical manifestations–bouts of depression, interspersed with periods of a wildly increased mood, commonly referred to as mania. These are difficult to recognize or miss even for experts with training.

However, treatment and diagnosis are often more complex for women who are transgender, as the symptoms vary based on gender and sexual identity. In the same way, doctors aren’t able to spot heart disease in women since they are looking for the typical symptoms of the disease in males Mental health professionals might overlook the symptoms of bipolar disorder for women. This can result in misdiagnosis or no diagnosis at all.

The gender roles of women, their pregnancy, and symptom variations can influence the way bipolar disorder is treated and diagnosed. To find out more, Health spoke to Vivien Burt, MD, director of the Women’s Life Center at the Resnick UCLA Neuropsychiatric Hospital.

What Is Bipolar Disorder?

While every instance of bipolar disorder is within an equivalence that is divided into two primary diagnoses. Bipolar I disorders are marked by extreme manic and psychotic episodes which can lead to hospitalization. However, Bipolar II disorder features milder forms of mania, known as hypomania. It can be mistaken as a normal mood swing. Both cases of bipolar disorder can cause extreme fluctuations in energy and mood.

Bipolar Disorder Has Different Symptoms In Women

Bipolar disorder appears different in women and men, beginning the moment that the symptoms first begin to appear. Based on the Office on Women’s Health Women are typically diagnosed with bipolar disorder later than men and women are more frequently diagnosed as having bipolar II disorders than males. These changes may be caused by the incorrect diagnosis. But, research suggests that women may experience different symptoms of bipolar disorder.

According to 2021’s International Journal of Bipolar Disorders article women who suffer from the bipolar disorder tend to be more likely to experience depressive symptoms as well as rapid cycling with there are four or more episodes of depression or mania occurring over the course of a year. The authors also pointed out that women are more likely to suffer from mixed manic episodes (manic depression and manic symptoms that occur simultaneously).

“Nobody really knows why some people with bipolar disorder present with mixed mania, or why women are more likely to experience this condition than men. Bipolar symptoms in women may overlie a baseline demonstrative mood and temperament, and this may in part explain their increased prevalence of mixed mania,” Dr. Burt said. Also, women might be more susceptible to mixed mania as they are more likely to be more prone to feeling and expressing anxiety, even when suffering from depression.

“Also, women are ‘hormonally challenged’ throughout their childbearing years, from month-to-month, and from reproductive event to reproductive event, whether its pregnancy, postpartum, perimenopause, or menopause, and this too may be related to the gender-specific differences in presentation of bipolar disorder and other mood disorders in women,” Dr. Burt said.

Symptoms and Premenstrual Dysphoric Disorder

Many people can also mistake the signs of a depressive episode that is about to occur for the symptoms of premenstrual syndrome. Premenstrual disorder of the psyche (PMDD) is a condition in which people experience extreme physical and emotional changes prior to the start of their period and one of the symptoms is mood shifts.

It’s not uncommon for women to experience mood swings, and to believe that they may be experiencing mood changes due to premenstrual disorder (PMS) (also known as premenstrual dysphoric disorders doctor Dr. Burt said. “Properly evaluated, some of these women may have bipolar disorder or some other condition.”

It is also possible to have PMDD or bipolar disorders. The levels of hormones, such as estrogen, can affect symptoms of bipolar disorder. In 2021’s International Journal of Molecular Sciences article Researchers found that those with bipolar disorder as well as PMDD are more likely to suffer from more frequent and severe symptoms.

If you suspect you may have PMDD or PMS, begin keeping a calendar for each day of your symptoms and note which days you experience your period. This can help you figure out whether your symptoms only occur prior to the period or also occur during other times during the month.

Bipolar Disorder Drugs, Pregnancy, and Side Effects

Bipolar disorder treatment may be affected by your biological sexual partner. Bipolar disorder is treated primarily with medication, however, these medications have been associated with birth defects and other complications. For instance, the Food and Drug Administration (FDA) has warned that taking Valproate during pregnancy may affect children’s cognitive development and result in birth defects to the spine, brain, or spinal cord.

However that not treating bipolar disorder may be harmful to you as well as the unborn child. In the 2014 drug, healthcare as well as Patient Safety article, researchers found that the likelihood of relapse in bipolar disorder was higher in those who had stopped using their medication while pregnant. The severity of your symptoms will determine whether an untreated condition can hinder you from taking proper care of yourself and your infant.

Based on Dr. Burt, healthcare providers suggest taking mood stabilizers during your pregnancy, particularly when you suffer from serious bipolar I disorder. The aim is to ensure that patients are in good health and safe while choosing the most secure medication for the growing fetus. If you experience milder symptoms, then you may be able to stop taking medications for the first trimester or throughout your pregnancy. Consult your doctor regarding the best treatment options for your health and that of your child.