Women with histories of major depression are vulnerable during the transition to menopause and are at increased risk for relapse; however, we have less information on how this transition affects women with bipolar disorder.
At the American Psychiatric Association’s 2014 Annual Meeting, researchers presented data from an observational study of 56 women between the ages of 40 and 60 years with bipolar disorder (BD).
Women in the late menopausal transition (MT) period and early postmenopause had significantly higher depression and mood elevation scores than women in the early stages of the menopausal transition.
The findings are a bit surprising. Although clinically we do often see destabilization during the menopausal transition, I would have expected to see the highest levels of destabilization during the early part of the transition, when levels of estrogen fluctuate more dramatically. The findings of the present study may suggest that estrogen — even when its levels are fluctuating — has a mood stabilizing effect or may enhance the effects of traditional mood stabilizers.
Future studies will help us to better understand the impact of the menopausal transition on the course of bipolar disorder. The study highlights the importance of monitoring women as they transition into the menopause. This constitutes a period of increased vulnerability, where even women who were previously stable on a medication regimen may be vulnerable to relapse.
Ruta Nonacs, MD PhD
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This is not so much a reply as a question. I am going to try and keep this short. I am 52 years old, have not had a period in over a year. I was unable to have children due to an ectopic pregnancy at 20 caused by PID. My periods have always been painful and the PMS severe. That is the medical stuff.
Now the emotional/mental stuff. I had been the primary caretaker for both of my parents. My mother passed in 2011 and my father 362 days later. My Uncle passed a month before my mother and my aunt 4 months before my father. My husband and I separated for a short time after all this. Then my dog had to be put down, and I lost my job. 10 months ago, I was diagnosed with bi polar disorder. I was initially on Lamictal and Risperdone, then was put on Lithium as well, along with Xanax as needed. I was a zombie. I took myself off the risperdone because I gained an enormous amount of weight. The Psychiatrist at my insistence took me off the Litium as well.
I feel good. For the first time in a while. But I am wondering could the bi polar symptoms have actually been caused by the Hormonal imbalance that menopause causes? Can all the stressors that occurred prior to the diagnosis affect my “mental” health and not just my “emotional” health? I know you are going to say to see my Doctor, but the Psychiatrist doesn’t really seem interested in all of that. Just prescribing medication and sending me on my way. I
These are all very good questions. We know that genetics play an important role, but that there are also physiologic and environmental stressors. Hormonal shifts, such as those occur during the postpartum period or during the menopausal transition, can trigger the new onset of a mood disorder or can exacerbate a pre-existing one.
Im in desperate need of some knowledge on this situation. Im 43 yrs old and it seems just in the past year i have been having a lot of difficulty maintaining my moods. Im also Bipolar and have been on a pretty heavy cocktail for 15 years to maintain it. Lithium, remrom, tegertal, xanax, prozac. my doctor said i was having Perimenopause? symptoms. Im finding it very hard usually the week before i am to start, controlling my emotions. very angry, people walking on egg shells around me, no urge to do anything, like my body just hurts.but as soon as i start, im good again. i feel like im on a roller coaster again and its affecting my bipolar. my anxiety is through the roof. Emotionally, my life is wonderful and i have a lot of support but i dont know how long they can take me like this, or me take me like this. im going nuts. any suggestions
Hi
When you say you’re bipolar what exactly happens to have this diagnosis – im just trying to understand as ive been diagnosed with bipolar – i was on venlafaxine and had been under extreme stress which sent me psychotic, was taken off venlafaxine and given zopiclone – after a few days i was fine but then went high and was put on quetiapine, i then crashed into depression a year ago and i cannot shake it – im on lithium, venlafaxine, mirtazapine, pregabalin – the only thing that makes me feel normal is diazepam.
My early 50’s relative is in menopause and also has a history of depression. Her father was bipolar as was a grandparent. She is very ‘unsettled’ and almost anything not her way causes an outburst. She is a single parent of two teens which in itself is ‘challenging. She has many fine traits but her behavior is astonishing to anyone who gets close. Suggestions, please, Our relationship is often tense and she is not in contact for months and of course I worry and I care.