Women With Bipolar Disorder
Research shows that women tend to experience more periods of depression than men. Women are more likely to develop bipolar II disorder -- meaning they never develop severe mania, but instead have milder episodes of hypomania that alternate with depression.
Women are also at higher risk for rapid cycling, which means having four or more episodes in one year. Varying levels of sex hormones and activity of the thyroid gland in the neck -- together with the tendency to be prescribed antidepressants -- may contribute to rapid cycling, researchers believe.
Bipolar Medications and Reproduction
Mood-stabilizing medications have been linked with women's reproductive problems -- specifically polycystic ovarian syndrome, a problem related to female hormones. This condition puts women at risk for infertility, diabetes, and possibly heart disease and cancer of the uterus. However, the condition is treatable with medications.
Before and during pregnancy, women should not take lithium and other bipolar medications, says Michael Aronson, MD, a clinical psychiatrist and consultant for WebMD. "The interesting thing is, sometimes pregnancy by itself will stabilize someone with bipolar disorder. At other times, it can destabilize them. The best alternative for someone who is pregnant, who is having problems with depression or mania and cannot be placed on an adequate dose of medication, is using ECT [electroconvulsive therapy]. It's very effective and it's safe."
Women planning to become pregnant should talk with their psychiatrist about their plans. They should never stop taking their medications before talking with their doctor.
Bipolar Medications and Menopause
The hormone fluctuations of perimenopause and menopause can cause mood disorders in any woman -- not just those with bipolar disorder. However, for those already having troubles with major depression, bipolar disorder, or anxiety disorders there usually is an increase in symptoms during this time. Especially during perimenopause, women may be especially vulnerable to depressive symptoms because of declining estrogen levels.
During menopause, hormone therapy may help. A change in antidepressant or mood stabilizing drug also may be the answer. With either individual or group therapy, women can gain support and insight into life transitions that may be adding greater stress to their lives, making their depression worse.
WebMD Medical Reference provided in collaboration with the Cleveland Clinic
SOURCES: WebMD Medical Reference with The Cleveland Clinic: "Bipolar Disorder (Manic Depressive Disorder)." WebMD Assess Plus: Bipolar Disorder Assessment. National Institute for Mental Health: "Step-BD Womens Studies." Massachusetts General Hospital Bipolar Clinic & Research Program. MedicineNet.com: "Bipolar Disorder (Mania)." WebMD Medical Reference with The Cleveland Clinic: "Effects of Untreated Depression." American Psychiatric Association: "Practice Guideline for the Treatment of Patients With Bipolar Disorder."
Edited by David H. Fram, MD on September 01, 2006
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