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Living with Bipolar Disorder: Women’s Issues & Needs

by Cassendre Xavier


As a persun living with bipolar disorder (BPD) since the early 90s. Bipolar 2, to be exact, and this is one of the more common types of BPD. Being someone who reads a lot and loves to learn (“bibliotherapy” has always been a major part of my life!), I thought I’d learned almost all there was to learn about my condition. I don’t mean in the clinical sense, but in the laypersun’s sense: medication, the importance of regular psychotherapy, diet, exercise, and so forth.

Recently I learned even more, from yet another highly informative and therapeutic book, The Bipolar Disorder Survival Guide (2nd edition): What Your and Your Family Need to Know, by David J. Miklowitz. The updated second edition of this bestselling guide has the latest facts on medications and therapy, an expanded discussion of parenting issues for bipolar adults, and a new chapter, "For Women Only."

In that chapter I learned that there are some significant issues women with BPD often deal with that men don’t.

This reminds me of how I first heard, years ago, that women’s symptoms of heart disease, heart failure, and heart attacks are often very different from the ways those symptoms manifest in men. For instance, we’d long been taught that a heart attack looks like someone having severe chest pain, and maybe pain shooting down “his” left arm.

Now, thanks in no small part to the groundbreaking work done at Mt. Sinai on women’s heart disease (largely funded by Barbra Streisand, who helped bring this issue to the masses, and continues to write about it on her website), we know our symptoms can be very different. (Visit the Barbra Streisand Women’s Heart Center at Mt. Sinai Hospital.)

A heart attack in a woman can appear as a severe indigestion, nausea, or even a backache, among other symptoms. 

Many times medical studies are done on men, not women, and it can take years, even decades, to find out women don’t respond the same as men do, which also means the drugs and treatments developed for those conditions may not be as effective for women, and that some of our (women’s) needs, are not being addressed sufficiently, if at all.

Perhaps due to our hormones as well as the myriad of ways women and men are very different, it turns out BPD is similar to heart disease in that we experience it sometimes differently than men do.

In the chapter “For Women Only”, Miklowitz, the author, wrote quite a bit, and what interested me the most were the following symptoms that tend to be more common in women with BPD: compulsive overeating, extreme mood swings, and irregular menstrual cycle.

I have all three!

I have been a compulsive overeater for as long as I can remember, even being “caught” overeating by relatives, when I was between 4 and 8 years old (I remember where my family lived at the time, and that’s the age I was there). One of our relatives (an uncle on my mother’s side) was visiting us from Haiti and was home during the day. I apparently had been eating a lot of soft white bread with yellow French’s mustard because one day when I got home from school, to our apartment in Flatbush, Brooklyn, my uncle took out the loaf of bread and showed me how little there was left, in number! Apparently, he had counted the slices beforehand and counted them after. I was mortified! That was the first of many incidents I would recount in my 27+ years of attending an anonymous 12 Step program for people with compulsive eating behaviors (which I would later leave to pursue or create a different method or system to heal my eating issues).

Regarding moodiness: Anyone who’s ever around me can attest to this! I thought it was just my personality, or having a Cancer rising (and we know Cancer is the sign of the crab and Cancerians are known to be moody!). Maybe, but mostly it’s that I’m a persun with a raging case of the old bipolars!

And finally: Irregular menstrual cycle. Where do I begin? My period has been irregular my entire life. Onset of my cycle was at age 13, and instead of bleeding once a month for 4 or 5 days like the clockwork regularity of my mother and sister, I menstruated once a year for 33 days straight!

It wasn’t until my mother realized she was still buying me maxi pads weeks into my period, that she took me to a gynecologist (at 16), and I was prescribed The (contraceptive) Pill, which would regulate my cycle. (I went off of them a couple of years later and just lived with an irregular cycle.)

Years later, I would find that going all or high raw vegan would regulate my cycle, but I was not ever able to maintain that strict form of eating for more than a few weeks at a time. So, off to The Land of Infrequent Periods again, which interestingly enough, I did not enjoy, as millions of women would envy. I love having my period and I felt unhappy to not have it for so much of the year.

Enter the good news! My period has been very regular for the last three years or so!

Guess why? Is it raw food? Nope! Am I on The Pill again? Negative!

It’a...(drumroll please!)  mood stabilizer!

Yes, ladies and gentlefolk, once I began taking a mood stabilizer (for the first time - my insurance covered for the first time - prior to glorious Obamacare I had only been on antidepressants, which as you can imagine, doesn’t always help and actually sometimes harms a persun with BPD who may be in a manic state), my cycle regulated.

First I was on carbamazepine, a drug mainly used as an anticonvulsant, and then I switched to lamotrigine (brand name: Lamictal), another mood stabilizer which is very effective for many people with BPD. Lamotrigine has been working well for me, or well enough, given that it isn’t my first choice to use a pharmaceutical drug with its side effects and low-level toxicity, but I do recognize that it’s been helping me in various ways, and the thing I love the most is that my cycle has been regular.

I now can even plan around it, expect, and prepare for it. Case in point I noticed it was getting to be literally that time of the month and that it was time to stock up on my pads and such (to the men reading this, I say “You’re welcome!” as I’m sure you wish to thank me profusely for providing such intimate and attractive details!). 

Something so common to most women’s experience is rare to me and a major treat. It makes me very happy to have my period, and I have a special appreciation because I am 47 years on earth! I hope I am one of those wimmin who just keep menstruating until an advanced age. I saw on the news recently that a woman in Spain, a medical expert, just gave birth (again) at age 62. I’m not interested in menstruating just to give birth, but because I just enjoy the entire experience.

I used to think my cycle was irregular because I was living in a stressful environment, and my mother told me that stress affects the hormones, and “hormones affect everything!”

After reading “For Women Only” I know that it’s very common for women with BPD to have irregular menstrual cycles. And I am very happy to have found something that brings me back something about myself, and my being a woman, that I love very much.

I thank you for sharing this journey with me, and I invite you to learn more about your illness, and ways you might be experiencing it differently than someone of a different demographic.

I’ll close by saying that one other very interesting subject in the chapter “For Women Only” was about pregnancy. Many women used to just be advised by their doctors to not give birth. Now, we know we can have children, and manage our medication during pregnancy, and so forth. 

Whatever we want to do as people living with BPD, is most likely possible, with the right help and support.

I wish you the best on that journey!

Related Reading: 

Living with Bipolar Disorder: Hope & Inspiration Wisdom Magazine article by Cassendre Xavier  (January 2016)
Living with Bipolar Disorder: 3 Tips for Accepting Lifetime Medication Wisdom Magazine article by Cassendre Xavier  (September 2016)
Loving Someone with Bipolar Disorder: Understanding and Helping Your Partner 2nd Edition book by Julie A. Fast and John D. Preston PsyD ABPP (Jan 2, 2012) 
Bipolar Happens! Straight Talk on Managing Bipolar Disorder A website from bestselling author and bipolar expert, Julie A. Fast http://www.bipolarhappens.com

Bonus: Cassendre singing (on YouTube) her semi-original song and Willie Nelson parody/tribute: On the Rag Again! 

Cassendre Xavier has been writing for Wisdom Magazine's online edition since May 2009. Cassendre was diagnosed with Bipolar II and Posttraumatic Stress Disorder (PTSD) in the early 1990s, and has been learning to live well with both, since. From 1996-1999, Cassendre founded and facilitated Sisters Healing Together, a peer support group for women survivors of incest with a special focus on compulsive overeating, at the William Way LGBT Community Center in Philadelphia. Cassendre is the creator of the popular Affirmations for Survivors guided meditation audio series (“Self-Love” and “Spirituality” were released in 2007; “Sexuality” and “Life Skills” are forthcoming). For more information, please visit  http://cassEndrExavier.com

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