Bipolar Disorder and Girls

Bipolar disorder is one of the most perplexing of all mental health conditions. One of the reasons for this is that symptoms vary between individuals; there may episodes of intense elation, irritability, despair and depression-alternating with normal mood.

This mental illness poses unique challenges for girls, who are more likely than boys to have mixed states of mood (mania along with depression, for example) and who are also more likely to experience rapid cycling of moods. Bipolar disorder in girls is also more likely to be resistant to standard treatments, thus more difficult to treat.

While gender differences in bipolar disorder are not entirely understood, it's thought that female hormones play a part. Girls with bipolar disorder often have increased symptoms during times of fluctuating hormone levels, such as just prior to menstruation or during pregnancy.

Some gender-specific symptoms of bipolar disorder in girls are:

Menstrual irregularities and premenstrual symptoms - Girls with bipolar disorder often have longer than normal menstrual cycles, and sometimes absence of periods. Menstruation may bring heavy bleeding and severe cramps, while premenstrual symptoms may include an increase in irritability, depression sleeplessness, panic attacks, self-injury or anxiety.

Self-injurious behavior - Girls may cut, scratch or pierce their skin repeatedly with objects such as razors or household knives and hide the behavior with long sleeves or sports wristbands.

Impulsive sexual behavior - Girls with bipolar disorder may act and dress provocatively and exhibit early and impulsive sexual behavior. This puts them at risk for rape, STDs, and unplanned pregnancy. If pregnancy results in childbirth, there may be increased symptoms of bipolar disease as well as potential for postpartum psychosis and depression.

Substance abuse and addiction -Those girls with bipolar disorder are seven times more likely to abuse substances than those without the disorder. And drugs and alcohol can cause psychiatric symptoms in those with bipolar disorder.

Medications used to treat bipolar disorder can also cause hormonal irregularities in girls, which can lead to symptoms such as weight gain, acne, polycystic ovarian syndrome, and elevated prolactin levels (a hormone produced by the pituitary gland that stimulates breast development and milk production).

Parents of girls with bipolar disorder should educate themselves about the risks associated with this mental illness and help to create a safe and protective environment. For some children, residential treatment is the best environment in which to be educated in a safe and structured setting. Here, professional staff can teach coping mechanisms for impulse control and management of overwhelming feelings, allowing the girl to avoid being trapped in a lifelong cycle of substance abuse, relapse and hospitalization.