Bipolar disorder is a treatable mental health condition, but it is not always easy to recognise. In women, particularly those living with bipolar II disorder, symptoms can sometimes be misunderstood or attributed to depression, anxiety, hormonal changes or the pressures of everyday life. This can mean that diagnosis is delayed and women do not always receive the support they need.
At The Somerville Clinic, we believe that understanding your mental health is an important step towards feeling empowered, finding the right treatment and developing the tools to support your wellbeing.
Understanding bipolar disorder and bipolar II
Bipolar disorder involves changes in mood, energy and activity that are more pronounced than the ordinary ups and downs of everyday life. These changes can affect sleep, concentration, relationships, work and overall functioning.
There are two commonly recognised forms:
Bipolar I disorder involves episodes of mania, which may be severe and significantly affect daily life. Depressive episodes may also occur.
Bipolar II disorder involves episodes of depression and hypomania. Hypomania is a period of unusually elevated or irritable mood, increased energy or activity, and changes in behaviour. It is less severe than mania, but can still have a significant impact.
Bipolar II disorder is sometimes missed because women may seek help primarily for depression. Periods of hypomania may be experienced as feeling unusually productive, energetic or confident, rather than as a symptom that warrants clinical attention. Some women may not recognise these changes as part of a wider pattern, particularly if they have experienced them for many years.
It is important to remember that bipolar II is not simply a milder form of bipolar disorder. Its depressive episodes can be particularly distressing and disabling, and an accurate diagnosis matters.
Why diagnosis can be challenging for women
Women with bipolar disorder may experience complex interactions between mood, hormones, reproductive health and life circumstances. Symptoms can change around menstruation, pregnancy, the postnatal period and perimenopause.
There can also be overlap with other mental health experiences, including anxiety, ADHD, trauma and difficulties with sleep. This can make it harder to identify the underlying pattern, particularly when someone presents during a depressive episode.
A careful assessment considers the whole picture: previous episodes of depression, periods of increased energy or activity, changes in sleep, family history, medication experiences and the impact of hormonal and life transitions.
There is no single blood test or questionnaire that can diagnose bipolar disorder. Diagnosis relies on a detailed clinical assessment, including an understanding of how mood and energy have changed over time.
Treatment and ongoing support
With the right treatment and support, women with bipolar disorder can lead fulfilling lives and develop greater confidence in managing their mental health.
Treatment is individualised and may include:
Medication: Mood stabilisers and other psychiatric medication can help reduce mood episodes and support longer-term stability. Medication choices need careful consideration, particularly during pregnancy, breastfeeding and other reproductive transitions. Medication should always be reviewed with a qualified prescriber.
Psychological therapies: Approaches such as cognitive behavioural therapy (CBT), psychoeducation and other tailored psychological interventions can help women understand their mood patterns, recognise early warning signs and develop coping strategies.
Sleep and routine: Protecting sleep, maintaining regular routines and recognising the impact of stress can be important parts of managing bipolar disorder.
Understanding hormonal influences: Recognising changes associated with the menstrual cycle, pregnancy, the postnatal period and menopause can help inform a more thoughtful and responsive treatment plan.
Supportive relationships: Involving trusted family members or friends, where appropriate, can help women feel less isolated and provide additional support in recognising changes in mood.
Empowering women to understand and manage their mental health
A diagnosis should never define a woman. Instead, it can offer an explanation for experiences that may have felt confusing, frightening or difficult to manage.
We believe women should be supported to understand their own mental health, recognise their individual patterns and feel confident in seeking help when they need it. This includes having the opportunity to ask questions, understand treatment options and develop a plan that reflects their personal circumstances and priorities.
Keeping a record of mood, sleep, energy and menstrual or hormonal changes can be a useful starting point for some women. Recognising early warning signs and agreeing a plan with a healthcare professional can also help women feel more prepared and supported.
How The Somerville Clinic can help
At The Somerville Clinic, we take a compassionate, holistic and individualised approach to women's mental health. We recognise that bipolar disorder does not exist in isolation from a woman's physical health, hormonal wellbeing, relationships and wider life experiences.
We aim to provide thoughtful assessment, clear explanations and evidence-informed treatment recommendations, helping women access the support that is right for them.
You deserve to feel understood, listened to and involved in decisions about your care. With the right diagnosis, treatment and ongoing support, it is possible to build a greater understanding of your mental health and feel more empowered in managing it.
If you are concerned about changes in your mood, energy or sleep, or wonder whether previous episodes of depression may be part of a wider pattern, seeking a specialist assessment can be an important first step.
