Understanding Gender Differences in Bipolar Disorder: Bipolar in Women & Men

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Because of the way mental illness develops, as well as sociocultural factors, bipolar disorder in men and women can show up differently. It’s worth looking at some of these differences in order to better understand the common barriers to recovery and the best directions for individualized treatment.

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When Scott was an adolescent, he was punished for his acting out. He got into fights, took his mom’s car without asking, and drank alcohol (often to excess). Then, there were periods when he would withdraw and more or less disappear. His parents attributed his low moods to the punishment that followed his other troubling behaviors. These same misunderstandings followed him into young adulthood when the punishment for his outbursts and impulsivity became more severe with arrests, destroyed relationships, and difficulty keeping a job.

It wasn’t until many years later than Scott finally saw a doctor about his depression. Before long, the psychiatrist was able to determine that Scott’s life was complicated by much more than just depression. The behaviors that he was so often punished for were actually provoked by manic episodes that would have benefited from appropriate treatment long ago. Scott had weathered the ups and downs of bipolar disorder for much of his life, but he was shamed and judged when he needed to be cared for and empowered.

While the prevalence of bipolar in men versus bipolar in women is relatively equal, there are some differences in how the disorder shows up, how the cycling occurs, and the relationship to treatment. But, whether male or female, people with bipolar disorder need greater compassion and understanding as they navigate the complicated, difficult-to-control terrain of their lives. Hence, it’s important to promote treatment across the board because their lives really can get better with dedicated care.

What Are Some of the Unique Characteristics of Bipolar in Men Compared with Bipolar in Women?

As bipolar disorder manifests for men and women, differences exist both on the pathological level and on the sociocultural level. In a general sense, the following patterns have been observed regarding gender and bipolar disorder:

In men: In women:
  • Onset is typically earlier in life than it is for females.
  • Manic episodes are generally more common and more intense than they are for women.
  • During manic episodes, they may be more prone to aggressive behaviors.
  • Symptoms may occur less often than for women, but symptoms are also typically more severe overall.
  • Generally, they are more likely to have co-occurring substance use disorders.
  • They may be less likely to get help for mental health concerns.
  • Onset typically occurs later than it does for males.
  • Depressive episodes are generally more common than they are for men.
  • They are more likely to be misdiagnosed with depressive disorder.
  • They are more prone to cycling through bipolar symptoms rapidly.
  • Generally, they are more likely to have anxiety, PTSD, insomnia, and other co-occurring challenges.
  • They are more likely to experience seasonal symptom changes.

Unfortunately, stigma surrounds mental illness in general, but men and women may experience societal pressures differently. They may face some different barriers to help and treatment—both personal and sociocultural. For men, the expectation and pressure to be tough and invulnerable may be some of the biggest barriers to treatment—and to reclaiming a balanced and fulfilling life even with bipolar disorder. For women, it may be a more powerful barrier that misdiagnosis is so possible and so common because their symptoms can often echo those of other disorders and because hormones can play such an integral role in bipolar disorder in women.

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Is Bipolar Disorder Treatment Different for Men and Women?

In truth, the best bipolar treatment is different for each individual. Ideally, a treatment plan takes into account the person’s history, symptoms, triggers, home and daily environment, available support, and personal goals and challenges. Those variables may be unique to each client.

Considering that there tend to be recognizable patterns of bipolar episodes that differ in men and women, this may inform the particulars of their clinical supervision. For example, because men tend to experience more frequent and severe episodes of mania, clinicians may place more emphasis on preparing male clients for the challenges related to mania. But, of course, this wouldn’t make the depressive episodes any less serious. In fact, because men tend to be less likely to seek treatment, it is especially important that close attention is also paid to the lows that typically follow the highs.

On the other hand, women may experience more frequent depressive episodes and more rapid cycling of mania and depression. So, psychiatrists and therapists will aim to prepare female clients to cope with these personal challenges. They may also put in place treatment strategies to weather seasonal changes, as well as hormonal and phase-of-life changes that can affect bipolar women more intensely than men.

When left untreated, bipolar disorder leaves both men and women vulnerable—to their own uncontrollable cycling and often unpredictable behaviors, to society’s misunderstanding, to a possible lack of supportive resources, to others who might take advantage. And the list goes on. But it doesn’t have to. Expert treatment programs for bipolar disorder continue to improve in ways that continue to improve the lives of men and women in recovery.

Bridges to Recovery is a residential treatment center for bipolar disorder and other mental health disorders. Contact us to learn more about our renowned Los Angeles programs and how we can help you or your loved one start the journey toward healing.

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