Bipolar Disorder Symptoms in Women
By the Ridge Way clinical team · Bipolar disorder · 4 min read · Published October 30, 2026
On this page
- What Are the Symptoms of Bipolar Disorder?
- How Is Bipolar Disorder Different in Women?
- Why Bipolar Disorder Can First Look Like Depression
- Does Bipolar Disorder Change With Periods, Pregnancy or Menopause?
- Bipolar Disorder After Childbirth
- How Is Bipolar Disorder Treated in Women?
- When to Get an Evaluation
- Questions Patients Ask Us
Part of our Bipolar Disorder articles. For evaluation and medication management, see bipolar disorder care at Ridge Way.
Key Takeaways
- The core symptoms are the same for everyone, highs of mania or hypomania and lows of depression.
- Some studies have found more bipolar II, rapid cycling and depressive episodes among women, but findings vary and do not predict one person’s course.
- Some women notice changes around periods, pregnancy, childbirth or perimenopause, and the weeks after childbirth carry a higher risk of an episode.
- If you are pregnant or planning a pregnancy, review your medicines with a prescriber before making any change.
Bipolar disorder symptoms in women are the same core symptoms anyone can have, highs called mania or hypomania and lows of depression. Some studies have found more depressive episodes, bipolar II and rapid cycling among women, although findings vary. Here is what to watch for, including around periods, childbirth and perimenopause.
What Are the Symptoms of Bipolar Disorder?
Quick answer: Episodes of mania or hypomania, when mood is unusually high or irritable, and episodes of depression.
The National Institute of Mental Health (NIMH) describes mania as feeling very up, elated, or extremely irritable, with racing thoughts and less need for sleep. Hypomania is milder. Depression brings sadness or anxiety, lost interest in almost everything, and sometimes thoughts of death or suicide. MedlinePlus adds that some episodes are mixed, with high and low symptoms together.
Bipolar I involves manic episodes lasting at least seven days, or symptoms severe enough to need hospital care. Bipolar II involves depression and hypomania. See bipolar 1 vs bipolar 2 for the difference.
How Is Bipolar Disorder Different in Women?
Quick answer: Some studies have found more bipolar II, rapid cycling and depressive episodes among women, but findings vary across studies and do not predict one person’s course.
A 2017 paper in the Indian Journal of Psychological Medicine reports that bipolar II may be more common in women and that depression is often the first episode. It also describes rapid cycling, which NIMH defines as four or more episodes in a year. Anxiety disorders and thyroid problems often come along too, and NIMH notes that thyroid disease can cause mood symptoms of its own.
Why Bipolar Disorder Can First Look Like Depression
When the highs are mild, a person may only seek help during the lows. NIMH notes that misdiagnosis can happen because some bipolar symptoms look like other illnesses.
This changes treatment. NIMH and a recent review in Current Opinion in Psychiatry both say an antidepressant alone is generally not used in bipolar disorder, because it can raise the risk of mania. If you have been treated for depression and also had stretches of unusual energy or little need for sleep, tell a clinician. Read more in bipolar depression vs depression.
Does Bipolar Disorder Change With Periods, Pregnancy or Menopause?
Quick answer: Some women notice symptom changes around the menstrual cycle, pregnancy, childbirth or perimenopause. Research suggests these can be times of increased vulnerability, but experiences vary.
Life stages and what to watch
Menstrual cycle
Some women with bipolar disorder report symptoms that worsen before a period.
Pregnancy
Review medicines with a prescriber before any change. Some carry pregnancy risks. Do not stop medication without first talking with a prescriber.
After childbirth
A high-risk period for recurrence, particularly in the first weeks. Watch for depression, mania or psychosis, and make sleep support part of the care plan.
Perimenopause
Research suggests more vulnerability to depression in these years. Research on mania in this stage is still limited.
A 2025 study found that women with bipolar disorder and a history of premenstrual symptoms or postpartum depression were more likely to have depression in perimenopause. See PMDD vs PMS for more.
Bipolar Disorder After Childbirth
A recent review in Current Opinion in Psychiatry reports that childbirth raises relapse risk for women with bipolar disorder, that sleep loss around delivery raises it further, and that most postpartum episodes of mania or psychosis begin within four weeks of delivery. For low mood after birth, see our guide to postpartum depression.
Postpartum psychosis is a psychiatric emergency. Signs include seeing or hearing things others do not, disorganized thinking, or thoughts of harming yourself or the baby. Call 911 right away. For thoughts of suicide, call or text 988.
How Is Bipolar Disorder Treated in Women?
Quick answer: Treatment may include a mood stabilizer, an atypical antipsychotic, psychotherapy or a combination, with the medication plan reviewed around pregnancy and other reproductive stages.
NIMH notes that the most common medications are mood stabilizers and atypical antipsychotics. Bipolar disorder usually requires ongoing treatment, including periods when mood is stable. The Current Opinion in Psychiatry review stresses planning before pregnancy. Talk with a prescriber before starting or stopping any medicine.
Psychotherapy can help with routines, sleep and early warning signs. Ridge Way provides psychiatric evaluation and medication management. We do not provide therapy. If therapy is part of your plan, we can refer you to an outside provider. Our bipolar disorder care page explains how we work.
When to Get an Evaluation
Consider an evaluation for depression that keeps returning, stretches of unusual energy, mood that shifts sharply with your cycle, or a hard time after a birth. Our women’s mental health page covers care across life stages.
Ridge Way provides psychiatric care across Georgia, by telehealth and at our Sugar Hill office. You can start with our free depression screening. When you are ready, request an appointment and we will usually call you back within one business day.
For what treatment can involve, read how mood stabilizers are used.
Ridge Way is not an emergency service. If someone is in immediate danger, call 911. For a mental health or suicide crisis, call or text 988, any time, or call the Georgia Crisis and Access Line at 1-800-715-4225. See our crisis resources.
Questions Patients Ask Us
What are the first signs of bipolar disorder in women?
A depressive episode may be the first recognized sign. Hypomanic periods can be missed if they feel productive, which is why an evaluation asks about both lows and stretches of unusual energy or little need for sleep.
Terms Defined in This Post
- Rapid cycling
- Four or more mood episodes within one year.
- Perimenopause
- The years of hormonal change before menopause.
References
- National Institute of Mental Health. Bipolar Disorder. Accessed October 2026.
- MedlinePlus, U.S. National Library of Medicine. Bipolar Disorder. Accessed October 2026.
- Naguy A. Bipolar in Women. Any Gender-based Difference? Indian Journal of Psychological Medicine. 2017;39(3):381-382. Accessed October 2026.
- Kurimay T, Pelikán A, Tory V. State-of-the-art treatment of postpartum bipolar disorder. Current Opinion in Psychiatry. 2026;39(1):32-41. Accessed October 2026.
- Gordon-Smith K, Perry A, Di Florio A, Craddock N, Jones I, Jones L. Associations between lifetime reproductive events among postmenopausal women with bipolar disorder. Archives of Women’s Mental Health. 2025;28(3):573-581. Accessed October 2026.
Medical disclaimer: This article is for informational purposes only and does not replace medical advice, diagnosis or treatment. It cannot account for your history, what else you take, or what is actually going on. Ridge Way Mental Health Services does not provide therapy or counseling. If you are having thoughts of harming yourself, call or text 988, or call 911 if you are in immediate danger.
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