Women and bipolar disorder

It's kind of a duh that girls are effected differently by mental illness than boys. We have wide fluctuations in hormones throughout the month, which effects our mental health. "...a girl’s energy, judgment, demeanor and appearance can vary dramatically throughout the month depending on which biochemical, hormone, or neural circuit has seized the reins."

"Some CABF parents report that their daughters have a sharp increase in irritability, depression, impaired concentration, sleeplessness, panic attacks, self-injury or anxiety prior to their first menstrual period, and experience these symptoms before each subsequent period.... Psychiatrists in the emerging specialty of reproductive psychiatry study the interaction between mood and hormonal changes at all stages of a woman's life. They find that premenstrual dysphoric disorder (PMDD) (a severe form of premenstrual syndrome, or PMS) may be associated with a serotonin deficiency during the luteal phase (second half) of the monthly cycle."

Which is why a lot of us get a little more nutty around our periods. I know I get super irritable, depressed, and panicky around my period. I've heard that birth control pills help with PMDD as they regulate the progesterone and estrogen in your cycle. But I wonder if SSRI (Selective serotonin reuptake inhibitors - a type of medication used in mental illness) works for PMDD. It would seem that replacing that serotonin would make the symptoms more bearable. Of course, in bipolar you can't just use an SSRI. You have to have a stabilizer as well (SSRI's are only anti-depressants, which can trigger mania).

There's another big kicker with women and mental illness: we get pregnant. It's a huge choice for a woman whether or not to continue to use medications during pregnancy, because the docs aren't sure what a lot of them do to the fetus. According to this great article, mania may be pregnancy induced:

"Some studies suggest that pregnancy may lessen symptoms: “In one study, 800f patients with affective illness (predominantly bipolar) experienced an improvement or a diminution of symptoms of their mood disorder during pregnancy” (Altshuler et al. 1998). At the same time, these studies are contradicted by other studies. For instance, in a study involving women with bipolar type I disorder, “…women reported manic mood changes, in each case occurring during pregnancy” (Blehar et al., 1998). Manic episodes and cycling seemed to occur exclusively during pregnancy."

So there's a lot to look out for for us ladies. We have to be careful to watch ourselves closely, and remember to look where we are in our illness and where we are in our cycle. It's something I'm going to be tracking more regularly. I do think I have a pattern of up and down during the month, which I always attributed to pure rapid-cycling. It may be menstrual cycle induced cycling.