It is well-reported that unipolar depression, or depression as we know it, is more commonly documented in women. No statistic, however, tells us that bipolar disorder is more common in men or women. In fact, research can tell us that the mental disorder is no less prevalent in one sex than the other [1], but does manifest itself differently.

How bipolar is expressed in men and women

Bipolar disorder expresses itself different in men and women, both pathologically/biologically and socioculturally.

By socioculturally, we mean how society thinks about a subject and how that thinking might direct bipolar disorder diagnoses or, importantly, misdiagnoses in people. For example, we cannot generalize and say that one sex is more easily diagnosed than the other. However, gender stereotypes play a role in how we perceive people and their behavior [2].

In men, a diagnosis of bipolar disorder might be more straightforward. This is because society has an image of men and how they behave, but society also has an image of women and how women behave. So, for example, an overconfident man cycling through an episode of mania may or may not be easier to diagnose than a woman going through the same thing because society is more used to men behaving that way. A woman can be diagnosed with bipolar disorder too. However, a diagnosis may occur later in life, after a significant event, whether it is traumatic or following the birth of a child. Because of this, women with bipolar disorder may spend some of their life undiagnosed [1].

Below is a list of the six most prevalent gender differences between men and women with bipolar disorder:

1. Bipolar mania is more obvious in men

By pathological, we mean the way bipolar disorder expresses itself in a person. Bipolar mania - the extreme high-energy, euphoric state which can at times be aggressive or destructive - is more evident in males than it is in females. While the depressive symptoms of bipolar disorder is more clearly expressed by female patients, in whom bipolar episodes of mania are less detectable.

2. Men are diagnosed younger

The average age of onset of bipolar disorder is younger for men than it is for women. The mental health condition can be identified in men at 22, whereas on average, women are not diagnosed until 27 [2].

3. Men with bipolar disorder are more prone to substance abuse

Often, early identification in young men occurs because their manic episodes are intense and may be exacerbated by substance use disorder, which is less common in their female counterparts. Young men are also less likely to seek help for their mental health concerns than women, who are more open to discussing them. Although episodes occur less frequently in males than in young women, they tend to be much more extreme due to concurrent tendencies or addictions [1].

4. Women with bipolar disorder are more likely to have a secondary mental health disorder & are very often misdiagnosed

Women, on the other hand, cycle through their episodes much more rapidly, and they are generally more likely to have simultaneous psychological challenges, such as an anxiety disorder, PTSD or insomnia. There is a 25% chance of a woman with bipolar disorder being incorrectly misdiagnosed with manic depression, of which the typical and, in this case, inappropriate treatment method is an antidepressant medication. Treatment of this type can spark manic episodes in women and more frequent and extremely rapid cycling [1].

5. Women with bipolar disorder are more likely to have a secondary physical health condition

A major pathological difference between men and women who have bipolar disorder is that women are much more likely to have a secondary medical condition, i.e., thyroid disease, obesity, or a predisposition for migraines. Diseases with a hormonal element are more common for women with bipolar disorder than for men with the same diagnosis.

6. And for this reason, women with bipolar disorder are urged to be cautious about their mood swings and cycles

Bipolar disorder can become more extreme during the reproductive cycle, especially in the postpartum period following giving birth, including the six months after a baby is born. One report notes 24  40% of women experienced a severe relapse during the period following birth [2].

Both pre- and post-menstrual cycles also place demands on women with bipolar disorder because of the reduced estrogen level. Similarly, premenopausal and menopausal women are at risk of relapse or late onset bipolar disorder due to the change in their hormones [1].

Conclusion

Living with bipolar disorder can be challenging whether you are male or female, so having a positive outlook on treating it is the first big step to living with this mental health condition. Like all of us, those with bipolar disorder need love and support. Identifying a unique combination of therapy and medicine that work for you or your loved one is especially important.

Resources:

  1. Pevzner, H. (2020, December 10). Psycom. https://www.psycom.net/bipolar-gender-differences
  2. Nowak, L. (2018, October 11). Bipolar in Men vs. Bipolar in Women: Understanding Gender Differences in Bipolar Disorder. Bridges to Recovery Beverly Hills. https://www.bridgestorecovery.com/blog/bipolar-in-men-vs-bipolar-in-women-understanding-gender-differences-in-bipolar-disorder/