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Bipolar disorder is a serious mental health condition that causes strong changes in mood, energy, and daily life. These changes, called manic or depressive episodes, are not just normal ups and downs. They can be disruptive, confusing, and hard to predict.¹

For women, bipolar disorder can feel more complicated. Hormonal changes during the menstrual cycle, pregnancy, or menopause may make symptoms feel more severe, though these changes do not cause the disorder itself.¹ Understanding how bipolar disorder shows up in women is an important step toward getting the right help.

What is bipolar disorder?

Bipolar disorder, sometimes called manic-depressive illness, includes periods of mania or hypomania (times of high energy, fast thoughts, or impulsive behavior) and periods of depression (times of deep sadness, emptiness, or loss of interest).

There are two main types:

• Bipolar I disorder: Includes at least one full manic episode, often with depressive episodes as well.
• Bipolar II disorder: Involves hypomanic episodes, which are less intense than full mania, and frequent depressive episodes. Bipolar II is more common in women.¹

Both types can greatly affect your life, but both can be managed with treatment.

Symptoms of mania or hypomania in women

During a manic or hypomanic episode, you may notice:

• Feeling overly happy, “high,” or unusually irritable
• Talking quickly or jumping from one idea to another
• Needing little or no sleep
• Feeling restless or “on edge”
• Starting many projects without finishing them
• Having unrealistic confidence or believing you have special powers
• Acting on risky impulses, like overspending or unsafe sexual behavior

For women, hypomanic episodes are often more common than full manic episodes, especially with bipolar II disorder.¹

Symptoms of depressive episodes in women

Depressive episodes bring the opposite mood shift and may include:

• Persistent sadness, emptiness, or hopelessness for at least two weeks
• Losing interest in activities you used to enjoy
• Sleeping or eating much more or much less than usual
• Feeling slowed down or exhausted
• Trouble concentrating or making decisions
• Thoughts of death or suicide¹

Women often have more depressive episodes than men. Because of this, bipolar disorder in women is sometimes misdiagnosed as depression alone.¹

How does bipolar disorder affect women differently?

Research shows some important differences:

• Bipolar II disorder is more common in women. Women are more likely to have hypomania with repeated depressive episodes.¹
• Rapid cycling is more common. Women may shift between highs and lows more often.¹
• Other conditions may occur together. Women are more likely to also have thyroid problems, migraines, weight gain from medication, or alcohol use issues.¹
• Reproductive health plays a role. Hormonal changes in pregnancy, postpartum, and menopause can influence how severe symptoms are or how well medications work.¹

How does bipolar disorder affect relationships?

During manic or hypomanic episodes, your thoughts may race, and you may act impulsively. This can make you seem overly talkative, confident, or irritable, which may be hard for partners or family.³

During depressive episodes, sadness and fatigue may cause you to pull away. Loved ones may not always understand the shifts, which can strain relationships. Including family or partners in treatment can improve support and communication.

What happens if bipolar disorder is left untreated?

Without treatment, bipolar disorder often worsens. It can also affect your work, school, finances, and relationships.

With the right treatment, many people manage symptoms and live fulfilling lives. Getting diagnosed early and staying in treatment makes recovery more likely.

How is bipolar disorder diagnosed and treated in women?

Diagnosis usually includes:

• A full history of your symptoms and episodes
• Talking with family or friends who notice your behavior
• Medical tests to rule out other causes

Treatment may involve:

• Medication: Mood stabilizers, lithium, antipsychotics, antidepressants, or anti-anxiety medications. Women may have different side effects, like weight gain, or need different doses.¹
• Therapy: Talk therapy can help you recognize early warning signs and learn coping skills.

If you are pregnant or planning pregnancy, medication management should be carefully reviewed with your provider to balance safety for you and your baby.

Bipolar disorder across a woman’s life span

• Teen years and young adulthood: Bipolar disorder often begins during this time.¹ Symptoms may be mistaken for normal mood swings.
• Pregnancy and postpartum: Women with bipolar disorder have a higher risk of postpartum depression and postpartum psychosis, which is a medical emergency.¹
• Menopause: Hormonal shifts can make symptoms worse, and treatment may need to be adjusted.

Help is available at Columbia Mental Health

Noticing the signs and symptoms of bipolar disorder in women is the first step. If you see patterns of extreme highs and lows, do not ignore them. Bipolar disorder is treatable, and stability is possible.

At Columbia Mental Health, we provide therapy, medication management, and comprehensive care to help women manage bipolar disorder at every stage of life. Our providers understand the unique ways this condition shows up in women and can guide you toward effective treatment.

For new clients, please click here to schedule an appointment. For existing clients, please click here and find your office location to contact your office directly.

Source:

1. Office on Women’s Health. Bipolar Disorder. Accessed 08.25.2025.