June 10th-16th is Men’s Health Week, celebrated the world over. The week is meant to heighten awareness of conditions that disproportionately affect men, and to encourage those affected to seek treatment for their physical and mental health issues.
While bipolar disorder strikes men and women about equally, there are several differences between the two genders. In previous posts, I’ve covered bipolar disorder in women, bipolar disorder in children, and the differences between children and adults when it comes to the mental illness. It’s high time I covered how bipolar disorder tends to manifest in men.
Symptoms of Bipolar Disorder and Overall Differences
Bipolar disorder, formerly known as manic-depressive disorder, is a severe mental illness where people with the condition cycle through two types of mood episodes. To fully explain bipolar disorder in men, we must first look at the two “poles” of the disease: mania and depression.
Symptoms of mania can include:
- racing thoughts
- elevated mood
- over-excitement
- a lack of a need to sleep
- irritability
- impulsive decisions
- delusions, occasionally.
Symptoms of depression can include:
- feeling sad or sluggish
- overeating
- insomnia or over-sleeping
- severe lack of energy
- trouble making decisions
- potential thoughts of suicide.
People with bipolar disorder can swing between these two states over periods of days, weeks, months, or even years. Rapid cycling occurs when four or more mood episodes happen over the course of a year. Men are only about 1/3 as likely as women to have rapid-cycling bipolar disorder.
There are also different forms of bipolar disorder. Bipolar disorder I involves depression, but also the presence of severe manic episodes, which sometimes require hospitalization. Bipolar disorder II sufferers deal with severe depressive episodes, but only have hypomania, a less intense form of mania.
Men are more likely to have bipolar I disorder than women. The tendency to have a manic episode rather than a depressive episode as the first onset of bipolar disorder is more prevalent in men than women. Conversely, women tend to have depressive episodes first. In addition, these first manic episodes in men are often severe, sometimes leading to prison.
People with bipolar disorder also suffer from mixed states, where they feel symptoms of depression during manic or hypomanic states, or symptoms of mania during depressive episodes. A 2006 study showed that 72% of women presented depressive symptoms during hypomanic episode, while only 42% of men did.
However, these overall differences are all tendencies. Men can have rapid-cycling bipolar disorder 2 with mixed states, and women can have standard-cycling bipolar I with the first onset that was manic.
Denial of a Problem
Unfortunately, many people deny that bipolar disorder and other mental illnesses exist. Men are more likely to be in denial that they have problems, and therefore don’t seek help as often as women.
Women are more likely to be prescribed antidepressants when being treated for bipolar disorder. This is possibly because women more often express their feelings to doctors. Socially, men are encouraged to stuff their emotions. As bipolar disorder is disease that primarily affects emotions, diagnosing bipolar disorder in men who deny there’s a problem can be more difficult.
Similarly, manic states cause men and women to feel euphoria, which can be expressed as extreme confidence. Men are expected to feel more confidence than women in society, so diagnosing a manic state becomes harder.
Violence and Aggression
Mania can include symptoms of irritability, which encourages angry outbursts. Bipolar rage is a real thing.
One of the ways bipolar disorder manifests in men, especially during manic episodes, is through violence and aggression. Violence during manic episodes is rare for bipolar disorder sufferers overall, but is more common in men than women.
This leads men to be imprisoned more often than women. Studies show that men with mental illnesses are 2-4 times more likely to be incarcerated than their representation in the population.
Substance Abuse
Substance abuse is a serious problem with men who have bipolar disorder. At least 72.8% of men with bipolar disorder struggled with some sort of substance abuse problem at some point in their lives, compared to 27.2% of women with the same mental illness.
Men with bipolar disorder are twice as likely than women with the condition to be currently addicted to illegal drugs and/or alcohol, according to a 2004 study published in the journal Bipolar Disorder.
No one knows why men and women with bipolar disorder differ so much when it comes to substance abuse issues. One argument is that men use drugs and alcohol to cope with bipolar mood episodes rather than traditional medication.
Final Thoughts
While bipolar disorder affects men and women at equal rates, there are several differences between the two genders when it comes to this mental illness. Men with bipolar disorder are more likely to have more severe manic episodes, less likely to seek help, have more violent outbursts than women, and often struggle with substance abuse.
Bipolar disorder is a serious problem, especially in men who self-medicate with drugs and alcohol. We must raise awareness of this issue, and encourage the men with bipolar disorder symptoms in our lives to seek treatment.
If you suspect you or a loved one has bipolar disorder, don’t delay. Call your doctor today, and ask for a referral to a competent psychiatrist. He or she can confirm a diagnosis of bipolar disorder and start prescribing medications to help you manage your mood episodes. You deserve help.
For a post on getting a psychiatric evaluation, click here. For a post on how to start seeing a therapist, click here.
I wish you well in your journey.
Related:
The Bipolar Parent 
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