Bipolar Symptoms in Women & Why it Often Goes Unrecognized

Are you a woman trying to figure out if you have bipolar disorder? Due to cultural and biological factors, you may experience substandard diagnostic and prescription care. Whether it is because of historical/systemic bias or a lack of appreciation for the role of biological sex in bipolar manifestation, women with bipolar disorder may experience misdiagnosis or delayed treatment. In this article, we will explore why this is the case and why psychiatric care at Mace Behavioral Health may be the right fit for you. 

Example

Picture this: a woman in her early thirties is struggling with moodiness. She chalks it up to life’s difficulties, but decides to seek some help anyway. She mentions it to her primary care physician (PCP) during a routine checkup. They tell her that she is struggling with depression and prescribe her Sertraline 25 mg/day. 

She begins taking the Sertraline as prescribed, and within a few days, she is feeling better. She is surprised because the PCP had said it would take several weeks before she felt noticeable improvement.

But after a week, the people around her began to get concerned. She does not sleep much. She has been maxing out credit cards with online shopping and having indiscriminate sex. She gets so carried away that her family intervenes, and she finds herself in a hospital psych ward. 

The ward psychiatrist tells her that she is experiencing a manic episode. They are considering a diagnosis of bipolar 1. In her hospital bed, she wonders, “How did this misdiagnosis happen? Where did things go wrong?”

Discussion of Gender-Based Care for BP

Let’s consider how sensitivity to biological sex may have impacted this case, as well as gender assumptions within the medical field overall. Women are more likely to experience medical gaslighting in healthcare, and when reporting serious symptoms, they may be dismissed as “just stress.” It is demonstrated that healthcare research, including mental health research, is often centered on biological males. This results in skewed data that often doesn’t capture the medical experiences of biological women.

An attentive provider may have discovered that this woman had a bad episode of postpartum depression and psychosis after giving birth to her first child. Since women with bipolar disorders are especially likely to experience a mood or psychotic episode in postpartum, the provider would have noted this postpartum experience during diagnosis. 

An attentive provider would also know that women with bipolar disorder are often misdiagnosed with unipolar depression and/or anxiety, resulting in delayed treatment. While men often experience mania at the onset of bipolar symptoms—resulting in immediate consideration of bipolar 1—women typically experience depression as their first symptom, potentially resulting in a misdiagnosis of Major Depressive Disorder (MDD) or Generalized Anxiety Disorder (GAD). 

Lastly, an attentive provider would be aware that treating bipolar 1 with an antidepressant may result in episodes of mania. With this awareness in mind, the provider should have educated this client about the potential for mania and closely monitor them for signs of mania to intervene quickly before negative symptoms exacerbate. 

Conclusion

Working with an attentive provider is essential to ensure that women are treated with dignity and receive the quality and non-stigmatizing care they deserve. At Mace Behavioral Health (MBH), we seek to provide gender-aware services that you can trust. Our founder and CEO, Ellis Mace MSN CRNP PMHNP-BC, understands firsthand the challenges faced by women in our medical care system. 

MBH makes every effort, therefore, to meet the unique needs of women. We listen closely to hear your whole story, we believe your reports of symptoms, and we seek to empower you to make your own best medical decisions. In these and many other ways, we at Mace Behavioral Health work to provide exemplary psychiatric care for our clients. Schedule an appointment today to begin your holistic, non-stigmatizing journey towards thriving mental health.

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Clarity changes what’s possible, but only if you act on it.

If you’re ready for a more thorough, thoughtful approach to your mental health care, you can book an appointment HERE.