Carrie Fisher and Bipolar Disorder: Bipolar Disorder in Women
by Lisa DiFalco
One of the talented artists who candidly shared her struggle with mental illness has passed away. In recent news, Carrie Fisher, the actress and author, died a few days after experiencing a heart attack. Aside from her many talents, Fisher should be appreciated by the mental health community for being a pioneer in openly using humor and unflinching personal detail to broach the topic of bipolar disorder. She was only one of a few of the public figures at the time brave enough to share their personal plights and struggles with mental illness. Bipolar disorder is a condition that currently impacts the lives of approximately 2.6 percent of adults in the United States. The condition affects women and men differently and treatment options may need to consider such differences. Obesity, weight struggles, drug and alcohol abuse and more may be part of the reality for many that are attempting to deal with the condition’s symptoms. Recent news and findings highlight bipolar disorder and the impact of the condition on women. Find out more about Carrie Fisher’s contribution to the dialog surrounding bipolar disorder and how bipolar disorder affects women.
Using Adversity to Bring Awareness
Fisher was diagnosed as having bipolar disorder at 24 and took 5 years to fully accept the diagnosis. The period in which she spoke about her condition was also during a time when there was a burgeoning interest in the condition. Fisher answered questions about the disorder with characteristic aplomb. As of last year at the Indiana Comic-Con, she said:
“It is a kind of virus of the brain that makes you go very fast or very sad. Or both. Those are fun days. So judgment isn’t, like, one of my big good things. But I have a good voice. I can write well. I’m not a good bicycle rider. So, just like anybody else, only louder and faster and sleeps more…Oh manic depression…oh how I love you.”
The National Institute of Mental Health’s definition of bipolar disorder is:
“A brain disorder that causes unusual shifts in mood, energy, activity levels and the ability to carry out day-to-day tasks.”
In addition to her acting, Fisher authored Postcards From the Edge in 1987, her first best-seller, four additional novels, three memoirs including Wishful Drinking, several plays and screenplays. The Princess Diarist was published two months ago. Her honesty helped peel back the secrecy and shame that often had surrounded discussions of mental illness. As Judith Schlesinger, a psychologist and author, said:
“She was so important to the public because she was telling the truth about bipolar disorder, not putting on airs or pontificating, just sharing who she is in an honest-to-the-bone way.”
She was outspoken in a time when the condition was just starting to be understood. She openly discussed her struggles with addiction and her bouts of creativity. Carrie Fisher put a face on the condition that others might relate to and never backed down from sharing her personal journey. She died days after experiencing a heart attack at the age of 60.
How Bipolar Disorder Affects Women
Even though there are a list of symptoms to characterize the “ups” and “downs” of the condition, bipolar disorder affects women differently than it does men. There are thoughts that the female menstrual cycle and pregnancy may be factors for the differences. Such differences may also be related to hypothyroidism or abnormal thyroid levels. What has been discovered about bipolar disorder in women?
Women are more likely than men to have:
- Mixed episodes, with simultaneous highs and lows within the same episode or in rapid sequence;
- Rapid cycling between the states of “high” and “low.”
- Depressive episodes; and
- Bipolar II disorder.
It is found that bipolar disorder develops later in women, even though the average age of appearance of the condition in men and women is 25. When considering bipolar disorder types, women have an increased chance of having bipolar II disorder with the feature of hypomania. Hypomania is expressed with the symptoms of elation and hyperactivity.
Rapid cycling has been found to be three times more likely to occur in women than in men. Rapid cycling is “the occurrence of four or more mood episodes within twelve months, alternating between hypomania and depression.”
Other findings about bipolar disorder in women include:
- Depression is the main feature of bipolar disorder in women and manic episodes appear to be more common in men;
- Women are often misdiagnosed with depression and men can be misdiagnosed with schizophrenia; and
- Women have a higher chance of eating disorders, insomnia, appetite changes and weight changes during a depressive phase than men.
Reproductive life events can greatly influence both the course of the condition and its treatment. These life events include:
- Breastfeeding; and
Hormonal changes may trigger symptoms to worsen during a specific reproductive cycle phase, in the premenstrual cycle and during both perimenopause and menopause. Women may experience more frequent depressive episodes during perimenopausal and postmenopausal periods. Women who are sensitive to hormonal changes can have more frequent relapses, more severe symptoms and may have less of a response to treatment.
Bipolar disorder is a mental health condition that must be sensitively treated by healthcare professionals, mental health professionals and case managers. As symptoms may express differently in men and women, the treatment needs to be modified to address the specific needs of the individual under care. As Carrie Fisher brought to light, the struggle is very real, and treatment solutions must consider the unique needs of the many loving and confused individuals stuck on this emotional rollercoaster.