Bipolar disorder is characterized by both episodes of depression and episodes of mania, or less intense manic episodes called hypomania. During a depressive episode, someone typically exhibits all the classic symptoms of depression, including sadness, hopelessness, lethargy, sleep disturbances, aches, poor concentration and memory, and thoughts of suicide or death. The manic episodes, on the other hand are characterized by little need for sleep, abundant energy, delusions of grandeur, paranoia, starting ambitious projects, and reckless behavior. These may be so intense that they require hospitalization, or they may be relatively mild, resembling an unusually good mood. Bipolar disorder is different from other depressive disorders in that men and women suffer from bipolar disorder equally. Women are more prone to developing other depressive disorders such as major depression. Even accounting for underdiagnosis in men, women are almost twice as likely to suffer from a depressive disorder other than bipolar. Despite this parity, there are number of differences in the way men and women experience bipolar disorder. Men are more likely to develop symptoms at a younger age, often in adolescence. Men typically experience more frequent manic episodes and these are usually more intense. Men are also more likely to be aggressive during manic episodes. Women, on the other hand, are more likely to experience more frequent and intense depressive episodes and less intense manic episodes, which frequently leads to their being misdiagnosed with depression. As many as 60 percent of people with bipolar disorder are misdiagnosed as depression since people are more likely to seek help during a depressive episode and are only hospitalized for a very severe manic episode. It takes an average of 10 years for someone initially misdiagnosed to get the correct diagnosis of bipolar disorder. Because women are prone to misdiagnosis, it’s especially important that women suffering from depression are aware of the symptoms of bipolar disorder. Men typically experience symptoms of bipolar disorder less often, but when they do, symptoms are more intense. Women experience more frequent symptoms and the symptoms are more likely to cycle quickly. As with unipolar depression, men are more likely than women to self-medicate with drugs and alcohol and less likely to seek professional help. Women are more likely to have co-occurring disorders such as anxiety, PTSD, and insomnia. Women are also more vulnerable to experiencing symptoms when the seasons change. Treatment for bipolar disorder tends to be personalized since the pattern of symptoms can vary so much from person to person. As a result, there is no clear difference in the way bipolar is treated in men and women. Since men tend to experience more intense manic episodes, they may need more powerful mood stabilizers, while women may more often need psychotherapy to manage anxiety or PTSD. It all depends on the individual, but therapy will typically involve some combination of antidepressants, mood stabilizers, and psychotherapy.
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