1. Bipolar 2 Is More Common in Women Than Men
Bipolar 2 happens at different rates in men and women. “Bipolar 2 disorder, in which people have major depressive episodes and a milder and often briefer manic state, called hypomania, is more common in women,” says the psychiatrist Sherwood Brown, MD, PhD, who is the Lou and Ellen McGinley distinguished chair in psychiatric research and the Aradine S. Ard chair in brain science at UT Southwestern Medical Center in Dallas.
Bipolar 1 disorder is a subtype of the condition characterized by the experience of manic episodes. Some people with bipolar 1 have episodes of depression, but others don’t. Bipolar 2 is a subtype characterized by episodes of depression and hypomania (a less severe version of mania that typically doesn’t cause the same issues with daily functioning that mania does). The full-scale episodes of mania that happen in bipolar 1 don’t happen in bipolar 2.
2. In Bipolar 1, Rapid Cycling Is More Common in Women Than Men
Unlike bipolar 2 disorder, bipolar 1 appears to be equally common in women and men, says Dr. Brown. However, “women may be more likely than men to experience rapid changes in mood,” says Brown, who has performed clinical research related to bipolar disorder for more than 20 years.
This is what’s known as rapid cycling. This means that some people with bipolar disorder have at least four manic or depressive episodes in one year. (Other individuals may have only a few mood episodes in their lifetime.) Rapid cycling can happen with any type of bipolar disorder.
3. Men Tend to Develop Bipolar Disorder Earlier Than Women
Men are more likely than women to develop bipolar symptoms at a younger age. “Men also have an earlier age of onset of first-episode mania, also about a five-year difference, compared to women,” says Christina Lee, MD, a psychiatrist at Kaiser Permanente in Baltimore, who treats children and adults with mood disorders like bipolar disorder.
“More women than men experience what’s called late-onset bipolar,” Dr. Lee says. This is when people develop bipolar disorder in their forties or later, rather than in their late teens and twenties, when bipolar disorder usually begins, she says.
4. Substance Misuse Is More Common in Men With Bipolar Disorder Than Women
“Men, in general, are at a greater risk of developing a substance use disorder than women, and people with bipolar disorder are no exception,” Brown says.
But overall, substance use disorders are very common among people with bipolar disorder and affect over half of people with the condition, studies suggest. “That’s why it’s so important for people with bipolar disorder to be screened for substance use disorders,” says Brown.
5. Women With Bipolar Disorder Are More Likely to Be Misdiagnosed Than Men
Misdiagnosis is very common in people with bipolar disorder, affecting roughly 21 to 62 percent percent of people with the condition who receive an incorrect diagnosis of major depressive disorder, according to research. But misdiagnosis appears to affect women more often than men, says Lee.
Women are typically misdiagnosed with unipolar depression for 1.9 years longer than men, Lee says, citing prior research. Major depressive disorder (MDD) is one of the most common misdiagnoses among people with bipolar disorder, according to one study.
Misdiagnosis can be a significant roadblock to getting the right treatment and can lead to worsened bipolar symptoms. For instance, someone with bipolar disorder who’s misdiagnosed with MDD may be prescribed antidepressants, which can sometimes trigger manic episodes or rapid cycling among people with bipolar disorder.
6. For Many Women, Bipolar Disorder Worsens Before Their Period or During Pregnancy, Postpartum, or Menopause
Mood disorders like bipolar disorder have hormonal components and can affect how women experience this condition, compared with men, says Lee. That’s especially true during times like pregnancy, postpartum, menopause, or in the days or weeks leading up to your period.
Many women with bipolar disorder are diagnosed with it for the first time during pregnancy or soon after giving birth. “[The postpartum] period is not only associated with a higher risk of bipolar onset, but also relapse [meaning the return of a mood episode after a period of feeling well],” says Lee.
“Bipolar can also worsen during premenstruation and during both perimenopause and menopause,” she says. Research has shown that during periods of increased hormonal changes, including menopause, mood symptoms may become more severe among women.
The Takeaway
- While men and women experience bipolar disorder at about the same rates, they may experience the illness differently, due to factors related to biological sex.
- Men tend to have an earlier illness onset than women, as well as higher rates of substance use disorders.
- Conversely, women experience bipolar 2 more often than men, as well as worsened bouts of illness related to hormonal changes.
