How Hormones Impact Bipolar Disorder

Bipolar disorder is a chronic mental health condition that severely impacts mood, causing disruptive cycles between periods of depression and mania. Women experience this condition in ways that are unique and hormones may play a key role in this. Getting an accurate diagnosis for any mood or mental health condition is essential, but medical care to address hormonal issues is also essential for the right treatment and a good outcome.

Women experience a unique pattern of hormonal changes throughout their lives, from puberty and menstruation to pregnancy and menopause.

Hormones are responsible for so many functions in the body, but they also impact mood. The different experiences that women have with bipolar disorder may be explained by different hormones and hormonal shifts.

Anyone struggling with mood disorder symptoms should have good medical care along with mental health care to recover from this difficult mental illness.

What Is Bipolar Disorder?


Bipolar disorder is a serious mental illness that causes changes in mood from depression to mania. Depressive episodes cause similar symptoms to major depression: loss of interest, sadness, shame and guilt, fatigue, and difficulty focusing. Mania, and the less severe hypomania, is a period of high energy, euphoria, irritability, impulsiveness, and poor decision making.

This condition can be extremely disruptive to normal life and causes dysfunction in relationships, at work and school, and other areas. Bipolar is chronic, but it can be treated and managed with medications and therapy. It often co-occurs with substance abuse or other mental illnesses, which also need to be diagnosed and addressed.

Women and Bipolar Disorder


Both men and women are diagnosed with bipolar disorder in similar numbers, but there are significant differences in how women experience this mental illness.

  • Women are more likely than men to have a later age of onset of the condition. The average age at which symptoms first appear is 25, but women develop bipolar disorder an average of three years later than men.
  • It is more common for women to have difficulty with treatment and recovery from bipolar disorder because of co-occurring physical or mental illnesses.
  • Particularly common co-occurring illnesses in women with bipolar disorder are anxiety disorders, migraines, thyroid conditions, and obesity.
  • Women generally have more depressive episodes than men.
  • Bipolar II, which involves less severe episodes of mania (hypomania), is more common in women.
  • Episodes of mixed mania, with symptoms of both mania and depression, occur more often in women.
  • Women are also more likely to experience rapid cycling, faster shifts between mania and depression.

Why there are so many differences between men and women with bipolar disorder is not fully understood. However, there is evidence that hormones may play a role. Women go through different hormonal shifts throughout their lives and this may contribute to different experiences.

The Role of Reproductive Hormones in Bipolar Disorder


Some studies have found that bipolar disorder symptoms get worse for women during certain phases of the reproductive cycle: postpartum, premenstrual, and during perimenopause and menopause. Because hormone levels shift significantly during each of these different periods, it may be that hormonal fluctuations worsen bipolar disorder and its symptoms.

The postpartum period may be a particularly difficult time for women predisposed to or already diagnosed with bipolar disorder. After giving birth, both estrogen and progesterone levels drop dramatically. This has been associated with a greater risk of depression. Other changes in hormones related to the thyroid occur at this time and can lead to fatigue and tiredness.

It may be these hormonal changes that make postpartum women so vulnerable to bipolar disorder, especially recurrences in those already diagnosed. Research has shown that as much as 36 percent of women with bipolar disorder experience a relapse within the six weeks after childbirth.

During perimenopause and menopause, women again go through a change in hormone levels with estrogen dropping significantly. Up to 20 percent of bipolar women experience increased symptoms, especially depression, during and after menopause.

More evidence that it is the change in hormones that triggers these symptoms comes from studies of hormone replacement therapy (HRT). Women who use HRT to manage symptoms of menopause are less likely to struggle with mood changes and mood disorder symptoms than those who have not used HRT.

The Thyroid and Bipolar Disorder


Disorders of the thyroid, a gland that produces hormones, are more common in women than men and in people with bipolar disorder. The thyroid sits at the base of the neck and produces the hormones known as T3, T4, and calcitonin. These hormones are involved in metabolism, which can impact weight, heart rate, body temperature, and muscle contraction.

A thyroid disorder causes an over- or underproduction of these hormones, which can cause a number of symptoms. Problems with the thyroid can also impact other hormones and hormone-related functions in women, including reproduction, menstruation, pregnancy, the postpartum period, and menopause.

It’s not understood exactly why this is the case, but thyroid conditions and bipolar disorder often co-occur. This connection may add further proof to the idea that hormones and bipolar disorder are related. Specifically, studies indicate that thyroid issues are more common in people with any mood disorder, and in people diagnosed with rapid cycling and mixed mania types of bipolar disorder in particular.

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Fluctuating Hormones Can Lead to a Misdiagnosis


Because there is such a complicated interaction between mental health, moods, and hormones, women can all too often be misdiagnosed when they are struggling with bipolar disorder. A correct diagnosis is so important because it informs treatment. Treating the wrong condition means symptoms will persist, and this can lead to a poor outcome and potentially serious complications.

There are several ways in which hormones can complicate a bipolar diagnosis in women. For instance, hyperthyroidism, an overactive thyroid, can cause symptoms similar to both menopause and mood disorders. The mood swings of bipolar disorder, especially those with less severe mania, may be misdiagnosed as a thyroid condition or menopause.

Studies also show that women are more likely than men to be misdiagnosed with major depression when they actually have bipolar disorder. A woman going through a difficult hormonal transition, such as postpartum or menopause, may be dismissed as having depression tied to these changes. They may be diagnosed with depression when they really have bipolar disorder.

Premenstrual syndrome, or PMS, is another situation that could lead to a misdiagnosis. PMS can be severe, or may develop into the more serious condition premenstrual dysphoric disorder, causing mood symptoms like anger, depression, irritability, and anxiety. Bipolar disorder with its similar mood shifts may be misdiagnosed as one of these hormone-related conditions.

Getting Treatment


Whether distressing shifts in mood are caused by hormones, bipolar disorder, or both, it is important to get checked out by your doctor. If you are not satisfied with a diagnosis, get a second opinion. If you do have bipolar disorder, there is hope. Treatment can be effective, and a short stay in a residential facility that focuses on helping women can give you the specialized care you need and the tools to help you manage this condition.

Working with experts in women’s health care is essential. There are so many differences in how men and women experience this condition. The role of hormones and biology in influencing the course of bipolar disorder cannot be discounted. Women-focused care will provide you with the medical and psychiatric care needed to address all your health issues.

Helix Treatment Center’s innovative gender-specific mental health treatment program is designed to help women gain the life skills and strength needed to manage the symptoms of bipolar disorder in a supportive and compassionate environment. We offer a tranquil space to restore emotional and behavioral health and stability in a safe, comfortable environment at our six-bed residence nestled in the beautiful Mt. Helix region of San Diego.

Contact us today to learn more about our program and how we can help you or your loved one start on the path to lasting wellness.