Understanding Depression and Anxiety in Women with Bipolar Disorder: Insights and Support

In this blog, we’ll explore how Depression and Anxiety manifest in women with Bipolar disorder, discuss treatment options, and share some strategies that have helped me along the way. If you’re just starting your journey, check out my previous article on How to Start Managing Bipolar Disorder: A Comprehensive Guide.

Understanding Bipolar Disorder

Bipolar disorder is a mood disorder marked by extreme highs (Mania) and lows (Depression). There are different types: Bipolar I, where Mania is more severe, and Bipolar II, where depressive episodes tend to dominate. For women, these mood swings can be even more intense due to hormonal changes like menstruation or pregnancy.

I’ve found that recognizing my mood patterns helps me prepare for what's coming. It doesn’t solve the problem, but it gives me a little more control over the chaos. It’s about understanding how my brain works and finding ways to work with it, rather than against it.

The Impact of Depression in Women with Bipolar Disorder

Depression with Bipolar disorder is more than just feeling sad. It’s an all-encompassing weight that drains your energy, your motivation, and sometimes even your will to live. I’ve gone through periods of uncontrollable crying, days spent in bed, and times where I couldn’t even muster the strength to shower.

For me, depressive episodes are often triggered by major life events, like losing a loved one, or even something as simple as seasonal changes. The worst part is the isolation—feeling like no one understands. But once I started reaching out for help, things slowly began to change.

Anxiety Disorders Coexisting with Bipolar Disorder

Anxiety can show up in a variety of ways. I was diagnosed with Generalized Anxiety disorder (GAD) when I was 16 years-old, but my Anxiety started long before that. As a kid, I worried about everything—school, family, money. The racing thoughts were so loud that I would physically shake my head to try to quiet them down. It wasn’t until much later that I realized this was my Anxiety taking control.

My Anxiety often fuels my Depression, and sometimes it’s hard to tell where one ends and the other begins. Self-medicating with substances like marijuana was a mistake I made in my 20s, thinking it would help. Instead, it propelled me into my first manic-psychotic episode, leading to my diagnosis of Bipolar I disorder. Learning to manage my Anxiety has been a crucial step in managing my overall mental health.

Treatment Options for Depression and Anxiety in Bipolar Disorder

Medication can be helpful, but it’s not always straightforward. I take anti-anxiety medication as needed, but antidepressants have never worked for me. In fact, they’ve made me feel worse—suicidal even. My psychiatrist says I’m “treatment-resistant” to antidepressants, which happens with some people who have Major Depressive disorder. Finding the right medication cocktail is essential, but it can take time.

Therapy is another critical piece. Cognitive Behavioral Therapy (CBT) has helped me change negative thought patterns, while Dialectical Behavioral Therapy (DBT) incorporates mindfulness practices to help manage emotions. Peer support groups have also been a safe space for me to share my struggles and connect with others who understand.

Lifestyle Changes and Coping Strategies

Managing Bipolar disorder isn’t just about medication and therapy—it’s about how you live your life. For me, self-care means prioritizing my physical and mental health. Eating well, getting enough sleep, and exercising regularly have become non-negotiable parts of my routine.

Mindfulness has also played a huge role in reducing my anxiety. Breathing exercises, yoga, and meditation help me stay grounded when my mind starts to race. It’s taken time, but I’ve learned that building a strong support network and finding community resources has been life-changing.

Advocacy and Resources

Advocating for myself didn’t come naturally. In the beginning, I was shuffled around in the mental health system, too scared to speak up. I didn’t feel like anyone would listen to the “Bipolar girl.” But once I started educating myself about my condition, I gained the confidence to speak up and demand the care I deserved.

As women, we often struggle to voice our needs. But finding your voice is key to navigating the healthcare system and getting the support you need. Don’t be afraid to ask for help, and when you can’t, rely on your support team to advocate for you. There are more resources available today than ever before—spaces where we can move beyond the stigma and have real conversations about mental health.

Final Thoughts

Depression and Anxiety are tough enough on their own, but when combined with Bipolar disorder, they can feel impossible to manage. Understanding the connection between these conditions is the first step in regaining control. With the right treatment plan, lifestyle changes, and support system, you can find balance in your life.

If you or someone you know is struggling with Depression, Anxiety, or Bipolar disorder, don’t hesitate to reach out for help. Together, we can foster resilience and create a path toward mental wellness. Let’s keep having conversations that take us beyond the stigma of mental illness. For more insights on managing bipolar disorder, check out my pillar post How to Start Managing Bipolar Disorder: A Comprehensive Guide.

Starting Next Week

Understanding Bipolar Disorder in Women

Bipolar disorder is marked by intense mood swings—highs (Mania or Hypomania) and lows (Depression). It can feel like an emotional rollercoaster that never stops. While both men and women experience it, women often face unique challenges, especially when trauma is involved.

For me, trauma shaped how Bipolar disorder showed up in my life. Childhood sexual abuse and later gender-based violence (GBV) left scars that made my Bipolar episodes more severe. I didn’t understand how connected these things were until much later.

The Intersection of Trauma and Bipolar Disorder

Trauma changes everything. For women with Bipolar disorder, it can make the symptoms worse, and often, the trauma comes long before the diagnosis. Whether it’s sexual abuse, domestic violence, or other forms of trauma, the effects can linger for years.

I was 14 years-old when I was sexually assaulted. It sent me into a deep depression that felt like it would never end. I became anxious, dissociated, and eventually turned to substances to numb the pain. It wasn’t until my grandmother’s death—another trauma—that I had my first manic-psychotic episode. That’s when the connection between trauma and my Bipolar disorder became painfully clear.

Coping Strategies and Resilience

Facing trauma is hard work, but it’s necessary. One of the most helpful tools for me was therapy. Cognitive Behavioural Therapy (CBT) helped me confront my fears and negative feelings about myself and men. It wasn’t easy, but it made a world of difference. CBT practices like exposure therapy helped me confront my subconscious fears  toward men that I carried with me for many years. I began to practice radical acceptance which does not mean I approved of my trauma but rather it’s an acknowledgement that my trauma happened but cannot be changed.  

I also learned the power of breathing exercises and tapping (EFT) to release tension. When things got too overwhelming, I would tap specific points on my body and take deep breaths. It helped calm me down. And when that wasn’t enough, I reached out to my support team or called a crisis line. Sometimes, just voicing what you’re feeling makes it feel a little smaller.

Seeking Professional Help

If you’re dealing with trauma and Bipolar disorder, getting professional help is crucial. Trauma-informed care makes all the difference. It’s about understanding how trauma has shaped you and working with professionals who know how to treat both your trauma and Bipolar disorder.

I’ve found support through Durham Mental Health Services (DMHS), COPE Mental Health Program, and Ontario Shores-Durham Community Clinic. It’s not always easy to find the right care, but it’s worth the effort. Keep going, even when it feels hard.

Stories of Empowerment and Recovery

Recovery isn’t a straight line, but it’s possible. Forgiveness, for both myself and those who hurt me, was a big part of my healing. I had to learn to stop letting the past control my present. That was a turning point. I stopped being the victim and became the victor over my past trauma.

Many women have stories like mine—of trauma, Bipolar disorder, and ultimately, resilience. Their strength and courage show that while the journey is tough, it’s not impossible. With the right tools, support, and mindset, healing can happen.

Final Thoughts

Living with trauma and Bipolar disorder is tough, especially for women who face unique challenges. My unaddressed trauma shaped my identity and how I viewed the world. It took time but facing my trauma with the help of my healthcare and support team was the best decision I have made for myself in my Bipolar recovery. Through sharing our stories, we can help others find strength, understanding, and hope. If you’re struggling, remember that seeking help is a sign of strength, not weakness. There’s a path forward, and you don’t have to walk it alone. Let's continue to have conversions that take us beyond the stigma of trauma to a place of self-acceptance, self-love and forgiveness.

In this post, I aim to share my journey, illustrating the extremes of a manic episode and the profound effects it had on my life. My hope is that by sharing my story, others might find understanding, connection, and perhaps the courage to seek help.

Understanding Manic Episodes

A manic episode can be described as an extreme and uncontrollable elevation of mood, often accompanied by feelings of excitement or euphoria. For me, the initial surge of energy felt like a spark igniting a fire. I was flooded with ideas, racing thoughts, and an inflated sense of self-esteem. I felt invincible, believing I could accomplish anything. However, as thrilling as it was, I was unaware of the shadows lurking just beneath the surface.

The symptoms of mania are multifaceted. They can manifest as:

• Rapid speech: I found myself talking a mile a minute, unable to slow down or catch my breath.

• Disorganized thoughts: My mind raced, bouncing from one idea to another, making it nearly impossible to focus on anything.

• Delusions of grandeur: I believed I had extraordinary abilities and a purpose that I was destined to fulfill.

• Impulsivity: Financial decisions became reckless, and relationships strained under my new-found bravado.

• Paranoia: I felt as though everyone was watching me, judging my every move.

As my episode progressed, these symptoms intensified, leading to hallucinations and even violent outbursts. It’s a stark reminder that, if left untreated, Mania can escalate into Manic-psychosis, where the boundaries of reality blur dangerously.

Men vs. Women: A Distinct Divide

Research shows that the onset of Mania typically occurs earlier for men, often in adolescence or around 4-5 years before women. Men may experience more intense and frequent manic episodes, while women often grapple with depressive episodes more frequently. For men, aggressive behaviors can surface during Mania, whereas women may experience rapid-cycling or seasonal episodes, leading to a different emotional landscape.

For me, this gendered experience of Bipolar disorder added layers to my understanding of my condition. I often felt caught between the heightened emotions of Mania and the stark reality of Depression, wondering how my experience compared to that of my male counterparts. After experiencing 13 episodes in my lifetime I can classify my Mania as rapid-cycling or seasonal episodes followed directly by severe depressive episodes.

The Triggering Events: A Perfect Storm

My manic episode was precipitated by a series of stressors that I couldn’t have anticipated. On my 22nd birthday, my grandmother passed away, a loss that shattered my emotional foundation. Just eight months later, I lost my other grandmother, compounding my grief and leaving me feeling adrift.

In an attempt to cope, I turned to substances like marijuana, seeking relief from the overwhelming sorrow. But rather than finding solace, I only intensified the storm brewing inside me. I struggled to focus on my final year in university, plagued by insomnia and a deteriorating relationship with my then-boyfriend. It was a perfect storm of emotional upheaval and loss that I didn’t see coming.

What the Episode Looked Like

As I spiraled into my first manic episode, I experienced a barrage of symptoms that became increasingly difficult to manage. Rapid speech turned into disorganized thoughts, and my once coherent conversations devolved into chaotic rants filled with delusions of grandeur. I believed I could change the world, that I had a mission that no one else could comprehend.

In the throes of Mania, my emotions felt like a pendulum swinging wildly. I laughed uncontrollably one moment, only to erupt into tears or anger the next. I remember feeling detached from reality, caught in a dissociative state where nothing felt tangible or grounded. My parents, concerned for my well-being, noticed the drastic changes in my behavior and knew they needed to intervene.

How My Parents Got Involved

My mother was just five minutes away from leaving for her 12-hour nursing shift when my boyfriend at the time reached out to her, desperately conveying how out of control I had become. That call prompted a frantic drive of four hours to Ottawa, where I was living at the time. I was hallucinating, lost in a world that felt all too real yet completely fabricated.

During the drive home, I tried several times to jump out of the moving vehicle, a clear indication of my disorientation and desperation. My mother, a nurse, assessed the gravity of the situation and recognized that I was experiencing a serious psychotic episode. She made the decision to take me to Scarborough General Hospital for psychiatric treatment.

The Hospital Experience

Arriving at the hospital was surreal. I was so far removed from reality that I couldn’t comprehend the seriousness of my condition. The staff deemed me a danger to myself and others, and I was restrained to a bed to prevent any further outbursts or attempts to escape. It was a terrifying experience to be chained to a bed, sedated into a haze of confusion due to the intense psychosis and my prolonged lack of sleep—I hadn’t slept for 52 hours.

When I finally regained consciousness, I found myself in an isolation room, disoriented and frightened. It was here that a psychiatrist diagnosed me with Bipolar I disorder, attributing my episode to substance use. He explained that I was essentially allergic to marijuana, and its use had triggered this manic episode.

Post-Episode: The Depths of Depression

After my manic episode, the reality of Bipolar disorder set in. I faced an extreme and prolonged Depression that left me feeling hollow and isolated. Sleep became my only refuge, and I would often stay in bed for hours, neglecting personal hygiene and losing interest in everything I once loved. I experienced a significant loss of appetite, leading to dramatic weight changes as I transitioned from manic energy to profound lethargy.

Social activities became daunting, and I withdrew from friends and family, fearing their judgment. Suicidal ideations crept in, an ever-present reminder of the darkness that enveloped me. This cycle of Mania followed by crushing Depression left me grappling with the reality of my condition.

The Stigma of Support

Navigating the stigma surrounding mental health proved to be one of the most challenging aspects of my experience. While I knew I was sick and needed help, the thought of entering the mental health system filled me with dread. I didn’t want to be labeled as someone with a mental disability, fearing the societal repercussions.

In the job market, having a mental health condition can feel like a scarlet letter, making it harder to find employment. Insurance applications often discriminate against those with invisible disabilities. When I was well, I felt invisible; but when I became unwell, it was as if my struggles were on display for all to see.

Many people choose to suffer in silence rather than risk the vulnerability that comes with seeking help. The fear of being treated as a second-class citizen in society can be paralyzing, and it often leads individuals to avoid the support they desperately need.

Managing Symptoms and Stressors

I learned that managing my symptoms equated to managing my stress. Self-awareness became crucial; I had to recognize what stressed me out and have the courage to walk away from toxic relationships or situations, whether they involved family, friendships, or even jobs.

I took small steps toward understanding my triggers and incorporating healthy coping mechanisms. Mindfulness practices, journaling, and regular exercise helped ground me. Surrounding myself with understanding friends who offered support without judgment was essential in my journey toward stability.

The Journey Toward Acceptance

Over time, I learned to accept my condition as part of my identity, rather than allowing it to define me. Seeking therapy and engaging in medication management became vital components of my routine. I learned to communicate openly with my loved ones about my struggles and sought to educate them about my condition.

Embracing my journey and sharing my experiences became therapeutic. I realized that breaking the stigma surrounding mental health starts with conversation. I found strength in vulnerability, and it empowered me to advocate for myself and others navigating similar paths.

Final Thoughts

Reflecting on my first manic episode, I realize it was a wake-up call—a moment that reshaped my understanding of myself and my mental health. The experience was both harrowing and enlightening, revealing the importance of community, understanding, and acceptance.

If you find yourself grappling with similar experiences, remember that you are not alone. It takes courage to seek help, to share your story, and to confront the stigma surrounding mental health. Together, we can foster a community of support and understanding, ensuring that no one has to navigate these turbulent waters alone.

For many women, fear and anxiety are the most common by-products of trauma. The pressures we face in society—to excel in our careers, maintain flawless relationships, and uphold family dynamics—create a breeding ground for fear of failure and fear of judgment. When compounded with Bipolar disorder, these feelings become amplified. We often find ourselves grappling with the idea that we are somehow "less than" because our minds operate differently, leading to an intense stigma rooted in fear.

Understanding Fear in the Context of Bipolar Disorder

Unaddressed trauma creates a permanent space for fear in our minds, dictating our actions, behaviors, and decision-making processes. When I first began to understand my Bipolar disorder, my biggest fear was rejection. Would people accept me if they knew I had a serious mental illness? Would my family still love me after the chaos of a manic episode? Would my friends still want me around when things got heavy? The constant questions loomed large in my mind, fueled by a society that often portrays those of us with mental health conditions as dangerous, volatile, or unpredictable.

In the beginning, my fear felt suffocating. I worried about losing my job due to burnout and exhaustion. I feared hospitalization and the potential side effects of medication, especially the dread of tardive dyskinesia. Each thought spiraled into an overwhelming anxiety that often left me paralyzed, struggling to engage with the world around me.

Breaking Down the Stigma and Finding Self-Acceptance

To combat these fears, I quickly learned the importance of self-love and self-acceptance. Surrounding myself with supportive, patient, and understanding individuals became crucial. I needed to find my tribe—people who could appreciate me for who I am, even during the challenging moments of my journey. As I began to embrace this support system, I found a community that reinforced my strength rather than my fears.

One of the most liberating realizations I had was that my fears, while valid, did not define me. I started practicing mindfulness and meditation to ground myself during overwhelming moments. These practices helped me clear my mind and refocus my thoughts. I learned to breathe through the anxiety and remind myself, “This too shall pass.” This sentiment became a comforting mantra, allowing me to navigate the peaks and valleys of my mental health journey.

Spirituality and Affirmations as Anchors

In my quest for stability, I turned to spirituality, which played a vital role in helping me manage my fear. One of my favorite quotes, “The only way out is through,” attributed to Robert Frost, reminds me that there is no going back with Bipolar disorder—only forward, regardless of the fears that may arise. I also posted daily affirmations on my bedroom wall: “For God did not give me a spirit of fear, but of power, love, and a sound mind.” This affirmation serves as a reminder that I am capable and deserving of a fulfilling life.

While I try to manage my anxiety naturally, there are times when the weight of my fears becomes too much to bear. When my coping mechanisms fail, I turn to my PRN medication, using it only as needed. I’ve learned to see medication as a tool, not a crutch—a means to help me reclaim control over my life when fear threatens to overwhelm me.

The Power of Talk Therapy

I am a firm believer in talk therapy. Speaking with a counselor or therapist can provide a sounding board to help dispel fears and anxieties. Voicing my concerns out loud often diminishes their power, allowing me to confront the fears that once felt insurmountable. In these sessions, I learned to explore the roots of my anxiety, gaining insights that have been instrumental in my journey toward healing.

As a public speaker, I also face my fears head-on by sharing my story. Speaking my truth can be both terrifying and empowering. Each time I take the stage, I confront the fear of judgment and rejection, reminding myself that my voice matters. Through advocacy, I strive to educate others about mental health, helping to dismantle the stigma that often isolates us.

Facing Fears in Advocacy and Daily Life

Advocating for myself and my mental health is another way I face my fears. Whether I’m discussing medication management with my psychiatrist or navigating a hospital setting, I refuse to let fear dictate my journey. I remind myself that my ultimate goal is a fulfilling life and a successful future. I deserve to be heard, seen, and treated with dignity, regardless of my mental health status.

However, fear can still be pervasive. I often grapple with the fear of not returning to baseline after an episode. The anxiety of wondering whether I’ll ever have children—naturally or through adoption—sometimes weighs heavily on my heart. I fear that my genetics might be passed on, leaving a legacy of mental illness for future generations. The fear of never finding a healthy, supportive romantic relationship lingers, as does the anxiety of ending up isolated and alone.

Transforming Fear into Empowerment

Despite these fears, I am committed to transforming them into empowerment. Each fear I face teaches me something valuable about myself and the world. I’ve learned that while fear can be paralyzing, it can also be a powerful motivator for change. By confronting my anxieties, I am gradually reclaiming my narrative and embracing my identity as a woman living with Bipolar disorder.

It’s essential to recognize that fear is a shared experience. Many women, especially those navigating mental health challenges, carry similar burdens. By sharing our stories and supporting one another, we can dismantle the stigma that surrounds mental illness and empower ourselves to live authentically.

For a deeper understanding of how to manage Bipolar disorder and navigate the accompanying fears, check out my comprehensive guide, How to Start Managing Bipolar Disorder: A Comprehensive Guide.

Final Thoughts

Embrace the Journey

Navigating fear as a woman living with Anxiety and Bipolar disorder is a complex journey. It requires self-love, acceptance, and a commitment to facing our fears head-on. By cultivating supportive relationships, practicing mindfulness, and advocating for ourselves, we can create a fulfilling life despite the challenges we face.

Remember, fear does not have to dictate our actions. As we embrace the mantra “Feel the fear and do it anyway,” we open ourselves up to new possibilities, resilience, and hope. Our stories matter, and by sharing them, we empower not only ourselves but also those around us who may be navigating similar paths.