Women and Bi-polar (manic-bepressive) Disorders

What are they?
Bi-polar disorders are a set of mood disorders that involve periods of depression alternating with periods of mania. Mania is much more than being "up" or "hyper". It can be an irritable mood as well as elevated mood. However, it must last at least a week and it must disrupt social or job functions or require hospitalization to be considered true mania. Mania can be accompanied by grandiosity, lack of sleep, and excessive activity. Hypomania can also be a feature of some sub-types. It is characterized by elevated mood lasting less than one week and is not disruptive to one's life. Bi-polar disorders occur in about 1% of the general population.

The Different Kinds of Bi-polar Disorders
The three major types of bi-polar disorders are differentiated by the degree of mania or depression and which of them predominates. Bi-polar I is marked by at least one full-blown manic episode combined with some or all of the additional symptoms listed above. Bi-polar II is when a woman's depressive episodes are full-blown, but she has hypomanic episodes as opposed to full-blown mania. Cyclothymia is the third type of bi-polar disorder and is identified by an alteration between hypomania and mild depression.

Differences in Women
Unlike depression alone, which is predominate in women, bi-polar disorders effect both genders equally. However, there are still gender differences in the course and treatment of the disease. Women are more likely to rapidly cycle between high and low moods. The reasons for this are unclear. It may due to women's higher rates of hypothyroidism. This in turn may be due to women's greater susceptibility to lithium-induced hypothyroidism (lithium is a common treatment for bi-polar disorders). Any woman on lithium who experiences a return of depressive symptoms on lithium should be tested for hypothyroidism, which can cause depression in and of itself. Rapid cycling may also be due to the use of antidepressants to control the disease. This in turn is used in women more often because women express the depressive aspects of the disease more. Women are also more likely to have Bi-polar II disorder.

Women with bi-polar disorders are at a high risk of relapse in the post-partum period. Treatment is a challenge, in this situation, as the use of medications during pregnancy and nursing is difficult. Several drugs used to treat bi-polar women can interfere with oral contraceptives, most notably carbamazapine. Spotting between periods is a sign that the drug is interfering with the pill. An oral contraceptive with a higher dose of estrogen or a different birth control method all together, is in order. This is crucial as carbamazapine, lithium and valproic acid can cause birth defects. Valproic Acid also causes menstrual irregularities, including halting menstruation, in the vast majority of women who take it.

Gender differences that are still being researched and are not yet proven include studying whether or not women's expression of the disease is altered by female hormonal states other than during the post-partum period. Pre-menstrual and menopausal states are factors that may increase vulnerability. There is some evidence that menopause triggers a shift from depression to a bi-polar mood disorder, particularly to the rapid cycling type.

Rate this article: (1=lowest, 5=highest) 1    2    3    4    5   

Copyright © 1999 GenneX Healthcare Technologies,Inc.


a listing of scientific articles and texts used.

ARCHIVE (complete)