Bipolar I disorder is a mental health condition that lasts throughout a person’s life but responds well to medical treatments and therapy. It is distinguished from the related bipolar II disorder by the presence of at least one full manic episode, often requiring hospitalization. Manic episodes are sometimes interspersed with episodes of depression. A manic episode is defined by high energy, high impulsivity, and strong emotional states. A depressive episode is the opposite, and a person in this state typically has little energy or motivation, and their emotions often become numbed. Bipolar I disorder is fairly common, as it affects about 1-2% of the adult population, with DSM‑5 lifetime prevalence estimates of around 2.1% (Blanco, Carlos, et al. “Epidemiology of DSM-5 Bipolar I Disorder: Results from the National Epidemiologic Survey on Alcohol and Related Conditions—III.” Journal of Psychiatric Research, vol. 84, 2016, pp. 310-17). Although it was historically considered to affect men and women equally, more recent large-scale studies suggest a female predominance, with 57-65% of diagnosed cases being women (Dell’Osso, Bernardo, et al. “Has Bipolar Disorder Become a Predominantly Female Gender Related Condition? Analysis of Recently Published Large Sample Studies.” International Journal of Bipolar Disorders, vol. 9, 2021). In women, the clinical presentation of bipolar I often differs from that in men. Women more frequently experience depressive onset, mixed mania, and rapid‑cycling courses, and they also have higher rates of comorbidities such as anxiety disorders, thyroid disease, migraine, and obesity (Dell’Osso). Additionally, life‑cycle factors like pregnancy, postpartum, and menopause can strongly influence symptom onset and recurrence, complicating treatment and recovery (Vega, Patricia, et al. “Bipolar Disorder Differences Between Genders: Special Considerations for Women.” Women’s Health, vol. 7, no. 6, 2011, pp. 663-74).

Stigma remains a major barrier for people with bipolar I, particularly for those seeking treatment. Women in particular may face greater diagnostic delays and misdiagnosis (e.g., as unipolar depression), which can lead to less effective treatment (Dell’Osso). In many cultural contexts, mood instability in women is sometimes dismissed or pathologized, contributing to internalized stigma and a tendency to refrain from seeking help. Women are told their feelings are “normal,” related to PMS, or just part of growing up. Additionally, gender expectations around emotional expression and motherhood can exacerbate feelings of shame, as women with bipolar may struggle meeting these expectations, reducing willingness to seek care or adhere to medication schedules. Further research is needed to improve the likelihood of adherence to treatment, as well as to find out more about the effects of various medications on fetal development to better address mood disorders in pregnant women.

Adapting to life with bipolar is difficult for most if not all people with the disorder. Adapting to bipolar brings mixed feelings: Accepting the diagnosis can be painful, but treatment can mean experiencing fulfillment and success in one’s life again. The level of success that people have in adapting and managing their disorder depends heavily on their knowledge of the disorder and how to manage it effectively. Managing bipolar while in a manic or depressive state is described by many as nearly impossible, as it requires a level of foresight and self-reflection that is often not present in those moments. Self-acceptance, as well as acceptance from loved ones and the world at large, make a major difference in how well a person lives with bipolar disorder, as social supports and a sense of belonging are crucial for anyone’s wellbeing (Eikelenboom-Valk, Johanna H., et al. “The Lived Experience of Patients With Bipolar Disorder With Adapting Their Lifestyle to Their Condition.” Archives of Psychiatric Nursing, vol. 53, 2024, pp. 78-84).