While bipolar disorder impacts an equal number of women and men, there are distinct differences between men and women in terms of the symptomatology of the disorder. Some of these differences relate to the onset and course of the symptoms while others relate to severity and the nature of symptoms experienced. An understanding of the bipolar symptoms that affect men is vital to the success of treatment strategies and the prevention of future complications.
Key considerations concerning symptomatology of bipolar disorder in men relate to the onset of the disorder and the timing of the symptoms. In general, symptoms of bipolar disorder tend to emerge earlier in life in men than they do in females. When the disorder initially emerges in men, it is more likely to manifest itself in the form of a manic episode rather than depression. Also, men with bipolar disorder tend to experience more manic episodes throughout the course of their illness than women.
The severity of manic symptoms is often more pronounced in men with the disorder. Consequently, men are more likely than women to be hospitalized or arrested as a result of their destructive behavior. Partly because of the greater prevalence of manic episodes, men with bipolar disorder are more likely than women to engage in damaging behaviors such as shouting and fighting. Perhaps most detrimental is the tendency for men to refrain from voluntarily seeking treatment. Many men refuse to admit that they have the disorder in the first place, while others sense the presence of a problem and try to self-medicate with drugs or alcohol. The habit of self-medicating with drugs or alcohol explains the higher comorbidity of substance abuse disorders among men. And more important, this resistance to treatment and self-destructive behavior puts men with bipolar disorder at a higher risk for suicide as compared to women.
In addition to being at an increased risk for suicide, men with bipolar disorder tend to have longer cycles of depression and mania compared to women. Specifically, men tend to have fewer than four episodes of mania and depression within a calendar year. This element of symptomatology is significant because the relative absence of rapid cycling can result in relatively lengthy periods of time without symptoms. These symptom-free periods can falsely lead men to refuse treatment because they think that they no longer suffer from the disorder.
Fortunately for men, they are less likely than women to experience comorbidity of other psychiatric disorders or medical conditions. This decreased likelihood of comorbidity in men increases the likelihood of successful treatment of bipolar disorder. However, when comorbidity does exist in men with bipolar disorder, the diagnosis is more apt to be a substance abuse disorder. By recognizing the symptoms and complications that tend to affect men with bipolar disorder, friends and family members of affected men can provide valuable monitoring and support.
