We've long known that gender affects how people experience bipolar disorder, impacting everything from what symptoms they experience to the specific point in life when the disorder first appears. But new research from Penn State has revealed that bipolar disorder is different for men and women on a biological level — which has big implications for the future of treatment.
Bipolar I and bipolar II disorder are both mental health issues that cause sufferers to experience extreme shifts in mood, from elevated highs to profound lows (though bipolar II disorder sufferers tend to experience less of an elevated mood than bipolar I sufferers). The disorder is equally common among women and men; but while the basics of the disorder are similar among sufferers, a vast body of research has found that gender impacts how these illnesses exhibit themselves. For example, in 2005, scientists found that women with bipolar disorders were more likely to experience bipolar II, rapid cycling and "mixed episodes" (which is when mood extremes happen extremely rapidly or even at the same time) than men. Research has also shown that giving birth can trigger an episode for many women, that bipolar disorder tends to show up later in life among women, and one 2010 study found that male bipolar disorder sufferers were more likely to also have problems with marijuana, alcohol, and gambling, while female sufferers were more likely to encounter problems with insomnia and disordered eating.
But while women are taken into account in some bipolar disorder research (unlike many other illnesses, where research skips over women's experiences), this research doesn't always make its way down to doctor's offices and school health clinics. Men's experiences are still often treated as the default, which can shape how we talk about bipolar disorder — or treat it.
This Research May Change The Way We Treat Bipolar Disorder
The new Penn State research might be able to help women get more accurate diagnoses — and better treatment.
Though traditional thinking about mental health disorders painted them as purely issues of brain chemistry, science has realized that they can have complex effects throughout the body, and bipolar disorders are a prime example. The Penn State study emphasized this, as it found that men and women with bipolar disorder often have two particular and unique immune responses in the body.
It's a bit complicated, but here's the basic idea: Bipolar disorder seems to be related to some abnormality in the immune system, because a lot of people with bipolar disorder have autoimmune issues and their immune "markers" are different from those of healthy people. Two of those markers, zinc and neopterin blood levels, tend to show up as abnormally elevated in people with bipolar disorder — and there's a gender difference in how that plays out.
When bipolar women had high zinc levels in their blood, their depression was more severe, while men with high levels of neopterin had more severe mania (nothing was linked to men with higher zinc levels or women with higher neopterin ). This might provide a biological explanation for why men and women's bipolar disorders experiences can be so different: Their immune systems are going awry in different ways. And that has big implications for treatment.
This new information is, scientists hope, going to lead to much more personalized treatment. "What we are aiming for," lead researcher Erika Saunders commented in a statement, "is to have a blood marker that we can use in the clinic that will help us predict when someone is developing a bipolar episode, and conversely when a treatment is working." Diagnosis and treatment are becoming much more personalized — and that's good news for women. Though we don't yet know how this research will figure into future medications, knowing more about how the disorder specifically manifests itself inside women's bodies will make it easier for women to get accurate, effective treatment — and easier for mental health professionals to stop treating men's experiences as the default.