Is There A Connection Between Bipolar Disorder And Menopause? 

If you have bipolar disorder, menopause may affect the severity of your symptoms and overall quality of life. Very rarely, menopause may cause the onset of bipolar disorder symptoms. Perimenopause is the transitional phase before menopause. During perimenopause, reproductive function begins to stop gradually. It’s a time that features significant hormone shifts and symptoms like mood changes, hot flashes, sleep disturbances, and libido changes. Bipolar disorder is a mental health disorder with several subtypes. It features extreme changes in mood and energy, with periods of elevated, agitated mood known as mania or hypomania, and periods of low mood and energy meeting the criteria for major depressive episodes. It’s generally diagnosed when people are in their 20s or 30s. For some people with bipolar disorder, perimenopause may make their symptoms more intense or more frequent. Very rarely, it might increase the chances of developing bipolar disorder in individuals who may be predisposed to mood disorders. Menopause is not considered a formal cause of bipolar disorder. In very rare cases, perimenopause may increase the chances of developing bipolar disorder among people already predisposed to the condition. A medical literature review from 2021 explains that rapidly declining hormones, inflammatory processes, sleep disturbances, and lifestyle habits during the menopausal transition may all affect the likelihood of worsening symptoms in people who already have a mental health condition. A large 2024 study including more than 128,000 female participants from the United Kingdom explored the onset of certain mental health conditions during perimenopause. Researchers found that a very small number of individuals (0.88%) reported their first psychiatric disorder during perimenopause, with mania having the largest likelihood of onset. Researchers also found an increased risk of major depressive disorder during perimenopause as well. The symptoms of bipolar disorder are the same during perimenopause and menopause as they are during any other time in life, though their severity and frequency may change. They’re outlined in The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR), a clinical guidebook used in the diagnosis of mental health conditions. Mania: Periods of high energy and agitation that can include: decreased need for sleep irritability racing thoughts rapid speech restlessness increased activity feelings of invincibility or high self-worth harmful behaviors and risk-taking Major depression: A period of extremely low mood and energy lasting for at least 2 weeks and featuring at least four of the following symptoms nearly all day, every day: sense of worthlessness or guilt difficulty concentrating sleeping too much or too little appetite changes restlessness or slowed movement and speech fatigue suicide ideation Bipolar I disorder features at least one manic episode, and a depressive or hypomanic (less severe mania symptoms) episode is also possible. Bipolar II disorder features major depressive episodes and at least one hypomanic or manic episode. Cyclothymia disorder is considered a “milder” version of bipolar disorder with many mood changes, but mood episodes aren’t severe enough to meet the clinical definition of mania or major depression. Hormone fluctuations, stress, and other physiological changes during perimenopause are known to cause mood changes. Because bipolar disorder is a mood disorder, perimenopause may affect the severity and frequency of your bipolar disorder symptoms. In a narrative review from 2022, researchers indicate bipolar disorder symptoms may increase in severity or frequency during menopause, particularly for people living with bipolar II disorder. Bipolar disorder is a stand-alone mental health diagnosis. While medically managing menopause (like with hormone therapy) can help improve mood symptoms overall, these treatments won’t cure or reverse bipolar disorder. Bipolar disorder is treated using a combination of medications, psychotherapy, and lifestyle strategies. Medications to help regulate mood and energy in bipolar disorder include: mood stabilizers antipsychotics antidepressants Psychotherapy, also known as talk therapy, can help you identify and change unhelpful thought and behavior patterns that can affect the quality of life with bipolar disorder. Psychotherapy also helps you establish daily routines and supportive environments and helps you develop coping strategies. Improving your sleep habits, focusing on a balanced diet and exercise, and eliminating substance use also support your mental well-being with bipolar disorder. Menopause is a time of many physiological changes known to contribute to changes in mood. For some people with a mood disorder like bipolar disorder, these physiological changes worsen their bipolar disorder symptoms. In rare cases, menopause may cause the onset of bipolar disorder symptoms. As you go through menopause, work closely with your doctor or therapist to manage your bipolar disorder. They can provide treatments to help relieve symptoms and offer support and resources during this transition.


‘Did I Waste 15 Years Of My Life?’ Investigating My Bipolar Diagnosis 

This story is from The Pulse, a weekly health and science podcast. Subscribe on Apple Podcasts, Spotify, or wherever you get your podcasts. Find our full episode on diagnosing bipolar disorder here.  In 1999, Abigail Kafka was having a tough time adjusting to college.  She was unhappy, and her personal life wasn’t going well.  During this stressful period, she was admitted to a psychiatric hospital.  Shortly after that, she received a diagnosis that seemed to explain all her troubles: bipolar disorder. For the next 15 years, Abigail received treatment including psychiatric medications for bipolar disorder.  Her condition did not improve, and she was designated disabled by the State of California.  But around 10 years ago, Abigail made some radical changes in her life.  And the result caused her to question everything she thought she knew about her past and her condition. It’s estimated that 5 to 10 million Americans have bipolar disorder.  But what do we really know about it?  Join Abigail along with reporter and producer Justin Kramon as they explore this common and life-altering mental health condition.  Sound design by Boen Wang.  Listen to the story above.   They investigate Abigail’s past, what led to an explosion of bipolar diagnoses in the 1990s, the debate among experts on the topic of overdiagnosis, and the current research on bipolar disorder with help from doctors: Claudia Baldassano, Associate Professor of Clinical Psychiatry and the Director of Bipolar Outpatient Resident Teaching Clinic at the University of Pennsylvania School of Medicine. Kristin Raj, Clinical Associate Professor of Psychiatry and Behavioral Sciences and Chief of the Bipolar Disorders Clinic at Stanford University School of Medicine. Mark Zimmerman, Professor of Psychiatry and Human Behavior at The Warren Alpert Medical School of Brown University and Director of the Adult Partial Hospital Program and outpatient psychiatry at Rhode Island and The Miriam hospitals.  Abigail Kafka is a writer living in Berlin who is working on a memoir. WHYY is your source for fact-based, in-depth journalism and information. As a nonprofit organization, we rely on financial support from readers like you. Please give today.


How To Ask For Help During A Manic Episode 

“[My mother and grandmother] have been traumatized by my previous behavior that they’re not a good indicator of mania […] But my wife, she’s been well trained. Not only has she been well trained on mania, on bipolar disorder, but she’s been well trained on Gabe’s mania. Gabe’s bipolar disorder. Gabe’s episodes. So when she says something, I drop everything — literally drop everything — and say, ‘OK, what are we going to do?’ And I have a couple of other people in my life I can do that with.” — Gabe Howard, “Inside Bipolar” podcast host