The Unique Stigma of Bipolar Disorder in Women

Bipolar disorder is a relatively common mental health disorder that can have devastating effects on those struggling with it. Unfortunately, stigma can be a major obstacle to getting treatment and reaching out for help. Bipolar disorder in women can be particularly detrimental, and stereotypes can be even more harmful. The first step to breaking down those obstacles and overcoming stigma is understanding the true nature of the disorder itself. 

What Is Bipolar Disorder?

Bipolar disorder is a mental health disorder that is characterized by abnormal shifts in a person’s mood, behavior, energy and thought patterns. These shifts can make it hard to carry out day-to-day tasks, maintain healthy relationships, or hold down a stable job. You may have heard of bipolar before; it used to be known as manic-depressive disorder or manic-depression, but these terms are no longer used.

The word “bipolar” literally means having two poles or two extremes. Bipolar disorder’s two extremes are mania and depression. People with bipolar disorder swing frequently between the two extremes, often without warning. This can give the person and their loved ones a sense of mental whiplash, which can be difficult to deal with. 

Mania

You can think of mania as the “up” side of bipolar disorder. That is not to say that it is pleasant or good, however. While many people with bipolar disorder may insist they feel great when manic, mania can lead to dangerous behavior and decision-making. Mania is a state of elation, extreme emotion, and hypersensitivity to all stimulation. It often presents as a combination of irritability, joy, and high energy. 

Symptoms of mania include:

• Feeling wired or jumpy
• Acting erratically
• Racing thoughts
• Speaking quickly about many different topics
• Increased appetite for pleasure (food, sex, drugs, drinking, etc.)
• Inflated ego and sense of importance
• High energy levels
• Decreased need for sleep
• Feeling irritable or touchy

There are also two types of mania: regular mania and hypomania. The main difference is that hypomania is less severe than mania. Mania can sometimes become so severe that delusions can form. Delusions are ideas and beliefs that are not based on logic and often come from an inflated sense of importance or extreme paranoia. Hypomania does not include cases of delusion, as that is severe enough to be categorized as mania. 

Depression

While mania is the “up” side of bipolar disorder, depression is the “down” side. It is, in many ways, the inverse of mania. You may have heard of depression before in reference to another mental health disorder, major depressive disorder. While similar, these two things are uniquely different. Depression, as a condition by itself, refers to a chronic, prolonged state of sadness, negative self-talk, and disinterest in life. Major depressive disorder can last anywhere from months to years and can even persist throughout a person’s life. 

Depression, in terms of bipolar disorder, refers to shorter episodes of those same symptoms. In cases of bipolar disorder, depressive episodes typically last days to weeks before shifting into an episode of mania. The key difference is that both mania and depression must be present to be classified as bipolar disorder. 

Symptoms of depression include:

• Feeling miserable, sad, or hopeless
• Sleep issues (feeling tired, not being able to sleep, or sleeping too much)
• Brain fog (trouble concentrating and articulating thoughts)
• Feeling unable to complete simple tasks
• Having thoughts of self-harm, death, or suicide
• Lack of interest in most activities, even activities you used to find pleasurable 
• Low self-esteem, self-hatred, or feeling worthless

Bipolar Type I, Bipolar Type II, and Cyclothymic Disorder

There are three subcategories of bipolar disorder: bipolar I, bipolar II, and cyclothymic disorder. Each of these conditions is unique, and understanding the differences can lead to more accurate diagnoses and more effective treatment. To better understand the three types, you can think of them as levels of severity, with bipolar I being the most severe and cyclothymic disorder being the least severe. 

Bipolar Type I

This disorder is a severe mood disorder characterized by manic episodes, which are periods of intense and elevated mood, often accompanied by impulsive behavior, excessive energy, and reduced need for sleep. These manic episodes alternate with depressive episodes, marked by profound sadness, low energy, and loss of interest in activities. Unlike bipolar type II, individuals with type I experience full-blown manic episodes, which can lead to impaired daily functioning and risky behaviors. Delusions are common in bipolar type I. An example of a delusion is believing that God is speaking to you through song lyrics on the radio. Type I is a lifelong condition that requires ongoing care and support.

Bipolar Type II

This disorder is a mood disorder characterized by recurrent depressive episodes alternating with hypomanic episodes, which are less severe than full-blown mania seen in bipolar type I. During hypomania, individuals may experience elevated mood, increased energy, and heightened creativity, but it doesn’t lead to the same level of impairment as mania. Depression in bipolar type II can be debilitating and include symptoms like sadness, fatigue, and reduced interest in activities. Unlike bipolar type I, full-blown mania is absent in type II, making it a less severe form of the disorder.

Cyclothymic Disorder

This disorder is a chronic mood disorder characterized by frequent but less severe mood swings than those in the other two types of bipolar disorder. Individuals with cyclothymia experience recurring periods of hypomania, marked by elevated mood and increased energy, and milder depressive episodes, with symptoms like sadness and low energy. These mood fluctuations are chronic and persist for at least two years in adults (one year in adolescents). While less disruptive than the other types of bipolar disorder, cyclothymia can still affect daily functioning and overall well-being. The episodes of hypomania and depression are usually shorter, perhaps only lasting a couple of days. 

Bipolar Disorder in Women: What Does It Look Like?

Women with bipolar disorder present uniquely in several ways, reflecting the complex interaction between biology, hormones, and psychosocial factors. Understanding these distinctions is vital for accurate diagnosis, effective treatment, and improved support for bipolar disorder in women.

Here are a few ways that bipolar disorder in women is unique.

Rapid Cycling

Women are more prone to rapid cycling bipolar disorder, characterized by frequent mood swings within a year. Typically, rapid cycling is defined as having four or more episodes of mania or depression in one year. This phenomenon can be harder to treat and manage, with shorter periods between episodes. It can be extremely stressful for the person struggling, leading to emotional instability and a higher risk of suicide attempts.

Comorbidities

Women with bipolar disorder often experience comorbid conditions such as eating disorders, anxiety disorders, and borderline personality disorder (BPD). These comorbidities complicate treatment and may require a more comprehensive approach.

Seasonal Patterns

Some research suggests that women with bipolar disorder may experience seasonal patterns in their mood episodes, with more depressive episodes during the fall and winter months. More frequent or intense episodes of mania may be observed in the warmer months. This pattern is less commonly observed in men with bipolar disorder.

Trauma and Gender-Specific Stressors

Women are more likely to report childhood trauma and interpersonal stressors as triggers for mood episodes. The impact of gender-specific stressors like discrimination, gender-based violence, and societal expectations can exacerbate bipolar symptoms in women. Sexual violence and abuse are particularly pervasive causes of mood disorders such as bipolar disorder in women. 

Treatment Response

Research suggests that women with bipolar disorder may respond differently to mood stabilizers and antidepressants than men. Hormonal changes during the menstrual cycle can affect medication efficacy and side effects. Unfortunately, the majority of past research on these medications was performed on male subjects. New research is currently being conducted and reviewed to facilitate gender-specific care. Individualized treatment plans that consider these factors are essential.

Psychosocial Factors

Women may face unique psychosocial challenges related to societal gender roles, caregiving responsibilities, and societal expectations. Stressors associated with these roles can contribute to the onset or exacerbation of bipolar symptoms in many cases. 

The Stigma Surrounding Bipolar Disorder in Women

Bipolar disorder in women and the stigmatization that comes with it is a complex and deeply ingrained issue that feeds on misconceptions, discrimination, and inadequate support for those affected. Despite significant advancements in mental health awareness, women with bipolar disorder continue to face unique challenges due to gender bias and societal expectations.

Women with bipolar disorder often confront the stereotype of being “emotional” or “irrational.” Mood swings, a hallmark of the condition, may be attributed to hormonal fluctuations or dismissed as typical female behavior, further delaying diagnosis and treatment. The stereotype this is based on goes back centuries and has affected medical care for women since modern medicine was invented. In the not-so-distant past, bipolar disorder in women, along with other mental health conditions, was diagnosed as “hysteria” or “female hysteria.” They were often put into mental institutions where they were abused, raped, and refused adequate treatment. 

While the situation has improved since then, the stereotype still causes a great deal of harm. It not only undermines the seriousness of the disorder but also prevents women from seeking help when they most need it.

Additionally, women with bipolar disorder face the dual stigma of both mental illness and gender bias. The pervasive belief that women are inherently more emotional can lead to the misperception that bipolar symptoms are merely heightened expressions of normal female behavior. This can result in reduced empathy and support from friends, family, and even healthcare providers. Avery Lane is dedicated to being a safe haven for women where their issues are listened to and believed. 

In some cases, stigma may manifest as skepticism about women’s ability to manage responsibilities such as motherhood or demanding careers while living with bipolar disorder. This discrimination can lead to isolation, self-doubt, and reluctance to disclose their condition or seek help.

The stigma surrounding bipolar disorder in women also intersects with other aspects of identity, such as race, sexual orientation, and socioeconomic status, amplifying the discrimination experienced by marginalized communities. These intersecting stigmas compound the challenges women face in accessing appropriate care and support.

To combat the stigma surrounding bipolar disorder in women, it is crucial to raise awareness about the condition’s unique impact on this demographic. Public education campaigns, mental health advocacy, and destigmatization efforts seek to emphasize that bipolar disorder is a medical condition that affects individuals irrespective of gender. Furthermore, healthcare professionals should receive training to recognize and address gender-specific biases in diagnosis and treatment. 

Ultimately, challenging the stigma surrounding bipolar disorder in women is essential to ensure that all individuals, regardless of gender, receive the understanding, support, and quality care they need to manage their condition and lead fulfilling lives. Dismantling these stereotypes and biases within our society is crucial in order to create a more inclusive and compassionate environment for women living with bipolar disorder.

Avery Lane Provides a Safe Space for the Treatment of Bipolar Disorder in Women

Our mental health and addiction facilities are staffed by professionals committed to cultivating a space of empathy and trust, free from the biases and stereotypes of the outside world. We want you to feel empowered here to pursue the treatment path that feels right to you and enriches your spirit. 

Medications are often a cornerstone of bipolar disorder treatment. Mood stabilizers like lithium and anticonvulsants such as valproate can help regulate mood swings. Additionally, atypical antipsychotic medications like olanzapine and aripiprazole may be prescribed to manage manic symptoms. For depressive episodes, antidepressants can be used with caution, often in combination with mood stabilizers, to avoid triggering manic episodes. Deciding to start medicinal intervention is a difficult and complex decision that should be talked through with your case management team. Your team is there to help you choose the best possible treatment path for you.

Psychotherapy, or talk therapy, is often a crucial component of bipolar disorder treatment. Cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT) can help individuals identify and manage triggers, develop coping strategies, and improve their overall mental well-being. In these therapies, you’ll interact one-on-one with a mental health professional and receive tailored advice. Psychoeducation is also important. This is education on the condition itself and other co-occurring or connected disorders. Psychoeducation empowers clients to understand their condition and take an active role in their treatment.

Women with bipolar disorder can benefit from adopting a healthy lifestyle. This includes getting regular exercise, maintaining a balanced diet, and prioritizing sleep. Avoiding alcohol and recreational drugs is essential, as substance abuse can exacerbate bipolar symptoms. If meeting these lifestyle goals is difficult for you, Avery Lane is here to help. Our mental health programs can include life skills courses where you’ll learn the skills you need to lead the life you want.

Support groups can offer a safe and empathetic space for individuals with bipolar disorder to share their experiences and learn from others facing similar challenges. In support groups or group therapy sessions, you’ll listen and provide support to other women with mental health issues. Connecting with others who understand the condition can reduce feelings of isolation and provide valuable emotional support. Avery Lane believes strongly in women supporting and empowering each other. Our programs provide a perfect opportunity for building a sense of community and understanding with other women. 

Some women find complementary therapies, such as mindfulness, meditation, yoga, and acupuncture, helpful in managing bipolar symptoms. While these approaches may not replace traditional treatments, they can be used as adjuncts to improve overall well-being. That’s why we offer a variety of holistic treatment options to complement your evidence-based treatment as you see fit. We believe that whatever enriches your life, brings you peace, and fulfills your goals is a valid form of healing, and we will always enable you to pursue it. 

At Avery Lane, we believe in believing women. But we also know that that isn’t the standard in larger society. If you’re a woman struggling with mental health issues, especially if you’ve been victimized by discrimination and stigma, this is the place for you to heal. Living with mental health disorders like bipolar disorder is hard enough without societal expectations and prejudices adding to your load. We want to help relieve that burden and give you the space and support you need to pursue a life of wellness. Your healing journey needs a safe, empathetic environment to start in. Avery Lane can be that place for you. Give us a call at (800) 270-2406.