Gender: Bipolar II

Research is mixed regarding diagnosis of BPDII having gender variances.  External factors such as social acceptability may lead more women to seek help.  Additionally, childbirth may be a trigger for hypomanic episodes in 10%-20% of women in the early postpartum period (American Psychiatric Association, 2022).  While the diagnosis of BPDII appear to be equal between genders, the presentation of this clinical issue disproportionately affects the functionality in woman including both cognitively and socioeconomically through the inability for occupational stability and higher rates of comorbidity due to depression, panic attacks, and alcohol use disorder.  Rapid cycling is believed to be the predicting factor for functioning deficits.  Scott, et al. (2015) found the rate to be 43% higher in females.  This is true from adolescent development throughout the lifespan and perimenopause transition.  Aside from being more susceptible to postpartum there are temperament and personality differentials to consider within culturally and socially acceptable constructs for men and women. Fletcher, et al. (2012) found BPDII to be less introverted and more likely to use denial and blame in response styles.  “Denied anger prevents girls from both protecting and knowing themselves: two key components of mental health” (Van Daalen-Smith, 2008, pp. 121-122).  Balancing the problematic cultural expectation for women to be reserved and agreeable or face functional deficits associated with the stigma of a mental health label are systematic failures on a global scale.  As women acquire their sense of self through cultural interactions as all individuals do there are important implications (Cervone & Pervin, 2023). As clinicians do their part to foster in social change having a culturally competent treatment plan in consideration for women, personality, and temperament differentials are essential.  Empathetically targeting person-centered treatment for women with BPDII appreciating the cultural expectational stressors has the ability to mitigate the impact of maladaptive functioning development across the lifespan.

References

American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision. Washington, DC: American Psychiatric Association.

Cervone, D., & Pervin, L. (2023). Personality theory and research (Fifteenth ed.). Hoboken, NJ: Wiley. Retrieved from ISBN 9781119891673

Fletcher, K., Parker, G., Barrett, M., Synnott, H., & McCraw, S. (2012). Temperament and personality in bipolar II disorder. Journal of Affective Disorders, 136(3), 304-309. Retrieved from https://doi.org/10.1016/j.jad.2011.11.033

Scott, J., Grunze, H., Meyer, T. D., Nendick, J., Watkins, H., & Ferrier, N. (2015). A bipolar II cohort (ABC): The association of functional disability with gender and rapid cycling. Journal of Affective Disorders, 185, 204-208. Retrieved from https://doi.org/10.1016/j.jad.2015.06.050

Van Daalen-Smith, C. (2008). Living as a chameleon: Girls, anger, and mental health. The Journal of School Nursing, 3, 116-123. Retrieved from https://doi.org/10.1177/1059840543214321

 

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