Bipolar disorder, a mood disorder in which sufferers cycle between manic and depressive states, affects 2.6 percent of the adult population in the United States. While men and women are equally affected, the illness manifests differently across the sexes.
Compared with men, women with the disorder are more likely to experience depressive episodes, mixed states–in which manic and depressive symptoms occur at the same time–and rapid cycling. Rapid cycling is the occurrence of four or more mood episodes in an annual period. Around three times as many women as men experience rapid cycling. Women are also more likely to be diagnosed with bipolar II, which has depressive and hypomanic–which are less intense than manic–episodes. Research demonstrates that thyroid imbalances may play a part in these differences, which, again, are more common in women than men.
Bipolar disorder often develops later in women than men, who are often diagnosed around age 25. Women are often misdiagnosed with unipolar depression, and men are often misdiagnosed with schizophrenia. Anxiety is often comorbid with diagnoses of bipolar disorder in women rather than men, and eating disorders are more likely to appear during depressive episodes of women’s than men’s. Men are shown to have higher rates of substance abuse and gambling addiction than women.
Symptoms of bipolar disorder worsen during perimenopause, menopause, and after childbirth–all linked to fluctuating levels of estrogen and other hormones. Women with premenstrual dysphoric disorder (PMDD) have a greater risk of developing bipolar I. Fifty percent of women with bipolar disorder will experience a mood episode within four weeks after childbirth. About twenty-five percent will go through postpartum psychosis, and a further twenty-five percent will suffer from postpartum depression.
Women and men are very different in the ways in which their bipolar disorder manifests. The menstrual cycle and its hormones plays a part in the worsening of symptoms. Women’s comorbid disorders necessitate different treatments than men.