Women’s Mental Health and the Latent Stage in Bipolar Disorder

Bipolar disorder (BD) frequently emerges in women during critical reproductive periods. Pregnancy and childbirth can trigger mood episodes, with a significant proportion of women experiencing depression during the perinatal period. Among those screened positive for perinatal depression, nearly one-quarter may have a BD diagnosis. However, BD remains underdiagnosed or misdiagnosed in this population. Psychiatric disorders with onset in the perinatal period may be a predictor of latent BD; thus, updated guidelines recommend screening for BD during this period to ensure timely and appropriate treatment. The accurate diagnosis of perinatal BD is crucial, as it influences treatment decisions and maternal and child outcomes. The bidirectional relationship between premenstrual dysphoric disorder (PMDD) and BD suggests that women with PMDD are at higher risk for BD, warranting closer monitoring and tailored interventions. The menopause transition, marked by significant hormonal changes, can precipitate new-onset BD or unmask latent BD in women with a history of Major Depressive Disorder (MDD). This chapter delves into BD in these important life stages, exploring the factors associated with the diagnostic conversion and new onset of BD in women and the implications for treatment.