Bipolar Disorder in Men: Symptoms, Treatment, & Getting Help

What Is Bipolar Disorder?

Bipolar disorder is a mental health condition characterized by extreme mood swings that go beyond the normal ups and downs of life. There are two main types: Bipolar I and Bipolar II. In Bipolar I, individuals experience manic episodes, where they feel overly excited, impulsive, and have high energy, often followed by depressive episodes with profound sadness and low energy.

In Bipolar II, the manic episodes are less severe, known as hypomania, but the depressive episodes are similar. These mood swings can disrupt daily life and relationships. Proper diagnosis and treatment, often involving therapy and medication, can help individuals with bipolar disorder lead more stable and fulfilling lives, managing these mood swings effectively.

Manic symptoms of bipolar disorder include:¹

• Elevated mood
• Increased energy
• Racing thoughts
• Reduced need for sleep
• Impulsivity
• Irritability

Depressive symptoms of bipolar disorder include:¹

• Persistent sadness
• Fatigue
• Difficulty concentrating
• Changes in appetite and weight
• Loss of interest in activities
• Suicidal thoughts or behaviors

Is Bipolar More Common in Men Than Women?

While the overall rates of bipolar in men and women are relatively similar, research has indicated that men may be slightly more likely to experience bipolar I disorder. In contrast, women tend to have higher rates of bipolar II disorder.² These differences may reflect variations in symptom presentation, but it’s essential to remember that the overall impact of bipolar disorder on individuals’ lives remains significant, regardless of gender.

How Bipolar Disorder Is Different In Men Vs. Women

Bipolar disorder can affect men and women in distinctly different ways. Men typically develop bipolar disorder at an earlier age than women. In contrast, women’s symptoms tend to worsen around their menstrual cycle, postpartum, pregnancy, and menopause.³ One study found that men have a higher likelihood of comorbidity with substance abuse.⁴ Other studies have found that women are more likely to experience rapid cycling bipolar episodes.⁵

Differences in bipolar disorder in men versus women include:

Onset

The age of onset for bipolar disorder differs between men and women. Generally, men tend to develop the condition at an earlier age compared to women. Symptoms of bipolar disorder often emerge during late adolescence or early adulthood in men, while women may experience their first episodes slightly later. One study shows that men experience symptoms of bipolar disorder approximately 3.2 years earlier than women.⁶

Episodes

In bipolar disorder, men and women can experience differences in the frequency and nature of mood episodes. Men often have a higher likelihood of having more frequent manic episodes, characterized by elevated mood, increased energy, and impulsivity. In contrast, women may encounter more frequent depressive, mixed mania, and rapid cycling episodes.⁷

Presentation

In men, bipolar II disorder may present with more frequent hypomanic episodes, which are milder than full-blown mania but still involve increased energy and impulsivity. In contrast, women with bipolar II disorder may experience more intense depressive episodes marked by persistent sadness and low energy.⁷

Comorbidity

The co-occurrence of other mental health conditions alongside bipolar disorder can differ between men and women. Men with bipolar disorder often have a higher prevalence of addiction, such as alcohol or drug abuse, possibly as a way to self-medicate their symptoms. On the other hand, women with bipolar disorder may be more likely to experience co-occurring bipolar and anxiety or eating disorders.⁷

Treatment Response

Research suggests that bipolar disorder goes undiagnosed longer and is more difficult to diagnose in women, greatly impacting their course of treatment.⁸ Research also indicates that the connection between substance abuse and bipolar disorder in men can make treatment more challenging. Due to these specific issues in both genders, having an individualized approach and treatment plan is even more important in approaching this disorder.

Hormonal Influences

Hormonal influences can play a role in how bipolar disorder manifests differently in men and women. For women, hormonal fluctuations related to the menstrual cycle, pregnancy, or menopause can sometimes trigger mood swings or exacerbate bipolar symptoms. These hormonal changes may not affect men in the same way. In one study, it was found that higher levels of testosterone (common in males) were associated with a higher likelihood of manic episodes.⁹

Bipolar Symptoms in Men

Men with bipolar disorder may exhibit more externalizing behaviors during manic phases, such as increased risk-taking, aggressive outbursts, and impulsive actions. Men are also more likely to engage in substance abuse during manic episodes as a way to cope with their symptoms. Additionally, there may be heightened irritability and anger during manic phases, which can contribute to conflicts in their relationships and social interactions.

During depressive episodes, men with bipolar depression may display more irritability and outwardly directed anger, whereas women may exhibit more internalized sadness. In addition, while both men and women with bipolar disorder can experience suicidal thoughts, men have a higher likelihood of committing suicide. In contrast, women have a higher likelihood of suicide attempts.¹⁰

What Causes Bipolar in Men?

The exact causes and risk factors for bipolar in men are not fully known, but it’s thought to result from a mix of genetic and environmental factors. If someone has a family history of bipolar disorder, they might be more likely to develop it themselves, suggesting bipolar has a genetic link. Researchers are looking into specific genes related to brain function and chemical balance in the brain to understand this better.

Environmental factors, like going through very stressful situations, experiencing trauma, using substances, or having hormonal imbalances, can also play a role in triggering bipolar disorder. For men, how these genetic and environmental factors interact can lead to the development of the disorder. However, there is ongoing research to grasp better the exact causes and risks related to bipolar disorder, especially when it comes to men.

Diagnosis Challenges of Bipolar in Men

Diagnosing bipolar disorder in men can be challenging because men are less likely to recognize and report emotion-related symptoms, as societal expectations often discourage men from seeking help for mental health. Instead, symptoms like anger or impulsivity might be mistaken for other issues, leading to a bipolar misdiagnosis. Additionally, men may be more prone to externalizing behaviors, such as substance abuse, further complicating the diagnostic process.

Unique Ways Bipolar Impacts Men

Bipolar disorder uniquely impacts men in various aspects of their lives, including work, their relationships, societal stigma, and self-esteem. These challenges impact the recovery process for men with bipolar disorder, emphasizing the need for personalized treatment and support to help them lead fulfilling lives despite the complexities posed by the condition.

Here are some unique ways bipolar disorder impacts men:

Work

Men with bipolar disorder can encounter mood swings that can affect their ability to maintain consistent employment and positive work relationships. Open communication with employers about their diagnosis and potential accommodations can be useful in navigating these challenges. Establishing a daily routine, managing stress, and taking prescribed medications can help maintain employment and improve workplace relationships.

Relationships

Bipolar disorder can have a significant impact on personal relationships for men. Mood swings, impulsivity, and irritability during manic phases can cause someone with bipolar disorder to strain romantic relationships. In depressive episodes, withdrawal and persistent sadness can distance men from their partners and families, making communication challenging.

To navigate these challenges, open and honest communication is important. Men with bipolar disorder and their loved ones should work together to understand the condition and develop coping strategies. Seeking couples therapy or family therapy can also provide a supportive environment for addressing relationship issues and strengthening bonds. Building a network of support and empathy can help men with bipolar disorder maintain healthier and more fulfilling relationships.

Self-esteem

Bipolar disorder can profoundly affect self-esteem and self-worth in men. The unpredictable mood swings, difficulty in relationships, job instability, and higher potential for experiencing rejection sensitivity dysphoria can lead to feelings of hopelessness and inadequacy.¹¹ Men may struggle with self-doubt and question their abilities to cope with the challenges posed by the condition.

Societal Expectations

Societal expectations of masculinity and conforming to traditional views of strength and emotional independence can discourage men from seeking help or discussing their mental health struggles openly. This difficulty in acknowledging vulnerability can lead to delayed diagnosis and treatment, making the condition more challenging to manage. Moreover, attempting to meet these societal expectations can create added stress and anxiety, which can trigger or intensify mood swings in individuals with bipolar disorder.

Treatment for Bipolar in Men

Bipolar disorder treatment typically involves a combination of approaches tailored to the individual’s specific needs. While there isn’t a one-size-fits-all solution, certain aspects of treatment can be particularly beneficial for men with bipolar disorder. A comprehensive treatment plan often includes medication to stabilize mood swings, psychotherapy, lifestyle adjustments, and support from friends and family.

Treatment options for bipolar disorder include:

• Cognitive behavioral therapy (CBT): CBT for bipolar disorder is a type of psychotherapy that focuses on identifying and changing negative thought patterns and behaviors associated with the condition. It aims to help individuals with bipolar disorder better understand their mood swings, develop coping strategies, and prevent relapses.
• Medications: Medication options for bipolar disorder are prescribed to stabilize mood swings and manage the symptoms associated with this condition. Some medication options include mood stabilizers, antipsychotics, antidepressants, and anti-anxiety medications.
• Lifestyle Changes: Maintaining a regular daily routine, including consistent sleep patterns and meal schedules, can aid in mood stability. Avoiding alcohol and recreational drugs is important, as substance abuse can worsen symptoms.
• Electroconvulsive therapy (ECT): In severe cases or when medications and psychotherapy are ineffective, ECT may be considered. It involves controlled electrical stimulation to the brain to induce a brief seizure, often resulting in symptom improvement.¹²
• Group therapy and support groups: Joining support groups or therapy groups specifically for men with bipolar disorder can provide a sense of community, reduce isolation, and offer valuable insights from others who share similar experiences. Group therapy and support groups are available online and in person, making them easily accessible to everyone.

Resources for Men With Bipolar

There are various resources and support options available to help men with bipolar disorder. National organizations like the National Alliance on Mental Illness (NAMI) and the Depression and Bipolar Support Alliance (DBSA) offer valuable information, support groups, and online forums specifically designed for individuals with bipolar disorder, including men.

Additionally, mental health apps and tools like Bearable and Daylio can help men monitor their moods, track symptoms, and gain insights into their condition. These resources provide a convenient way for men to actively manage their bipolar disorder, stay connected with others who understand their experiences and access valuable information to support their journey toward better mental health.

Breaking the Stigma of Bipolar in Men

Traditional views of masculinity have prevented men from seeking help for their mental health for a long time. To break the stigma around mental health and bipolar disorder, we must encourage open dialogue and psychoeducation. Empowering men to prioritize their mental well-being is important, as it allows them to manage bipolar symptoms better, improve their relationships, and lead fulfilling lives.

How to Ask for Support as a Man With Bipolar

For men dealing with bipolar disorder, seeking help begins with self-acceptance. Remember that reaching out is a sign of strength, not weakness, and it will guide your path ahead. Next, find trusted friends or family members with whom you can discuss your diagnosis safely. While being open and vulnerable may be challenging, it is an important part of your journey.

While there’s no one-size-fits-all approach to seeking support, consulting a mental health specialist can be invaluable. They can offer a precise diagnosis and create a treatment plan tailored to your unique needs. Keep in mind that not all mental health professionals are alike, so it’s important to find a therapist who specializes in bipolar disorder and with whom you have a meaningful connection.

How to Support a Man With Bipolar

Supporting a man with bipolar disorder begins with educating yourself about the condition and offering a non-judgmental space for open communication. Recognize that bipolar disorder doesn’t define him, and encourage him to engage in activities he enjoys. Lastly, be aware of your boundaries and seek support for yourself, as supporting a loved one with bipolar disorder can be emotionally challenging.

Here are some ways to support a man with bipolar disorder:

Encourage Routine

Help him establish and maintain a regular daily routine, including consistent sleep patterns and meal schedules. Routine can help stabilize mood swings and provide stability and predictability. If possible, align his routine with your own so that living a healthy lifestyle for his bipolar disorder is woven into your life as a couple.

Help With Medication Management

Assist him in adhering to his medication regimen by offering to set up phone reminders, accompanying him to appointments, and encouraging follow-through. Effective medication management can help him achieve better mood stability and overall mental health, aiming to increase confidence and reduce irritability, risk-taking, and anger outbursts.

Practice Open Communication

Open communication is essential for men with bipolar disorder because it empowers them to break free from societal expectations of emotional restraint and fosters an environment where they can freely share their emotions and challenges, ultimately promoting better mental health and overall well-being. Create a safe space for open dialogue about his feelings and experiences. Encourage him to express himself without judgment.

Help Monitor Triggers

Together, identify potential triggers for mood swings and work on strategies to manage or avoid them. While some situations could trigger anyone with bipolar disorder, some areas may be particularly triggering to men (i.e., feeling inadequate, not providing). Tracking and understanding these triggers is important to work through them and cope effectively.

Support Self-Care

Supporting self-care, including regular exercise and a balanced diet for bipolar, is particularly important for men with bipolar disorder due to the potential for these practices to alleviate mood symptoms and enhance emotional well-being. Engaging in physical activity can help release endorphins, which can help to regulate testosterone and cortisol in the body.

Plan for Crisis

Developing a crisis plan is especially important for men with bipolar disorder because they tend to be at a higher risk of experiencing severe mood episodes, impulsivity, and, in some cases, a higher likelihood of acting on suicidal thoughts. Due to societal expectations of emotional stoicism, men may be less likely to seek help during crises, making developing a crisis plan essential.

Stay Educated

Continuously educate yourself about bipolar disorder to better understand his condition and be an informed source of support. Educating yourself on Bipolar Disorder, specifically how it impacts men, can help you remain empathetic and understanding of what he is experiencing. It can also allow space to reduce the stigma surrounding his mental health and encourage open communication.

Respect Independence

Giving space for a man to make decisions about his treatment fosters a sense of empowerment and control over his life. This can be especially significant for men facing societal expectations of self-reliance and autonomy. In addition, it sends the message that seeking help and managing bipolar disorder is a responsible and self-determined choice.

When to Seek Professional Support

Men with bipolar disorder should consider seeking professional help at the first onset of symptoms if their symptoms worsen and for continued medication management. An online therapist directory or online therapy platform can be helpful to find mental health professionals who specialize in bipolar disorder. These platforms provide a convenient way to connect with therapists, including those who offer online therapy sessions.

Online psychiatrist options can be beneficial for individuals seeking bipolar medication management, offering remote access to qualified psychiatrists who can assess and adjust medication regimens as needed.