Bipolar and Hormones

My daughter has bipolar type 2 but is managing without medication. We have noticed that her deepest depressions occur with her monthly cycle. Is there a test she can have on her hormone levels which may help to ease the symptoms?

Ben's Answer:

While I don't have much knowledge about this type of testing, there are certainly tests that can be done on hormone levels. An endocrinologist or OB/GYN - or most any doctor would probably be willing to do this kind of testing. The question however, is if they find some kind of imbalance, how will they treat it, or will they treat it at all?

The typical medical treatments for PMS are hormones or antidepressants, both of which can have negative side effects. Antidepressants carry a high degree of risk for a person with Bipolar disorder and often contribute to the roller coaster, chronic course of ongoing depressions, as well as raising the risk of triggering hypomania or even escalating a person in to a full blown manic episode.

I've seen acupuncturists who treat women's hormonal issues with a high degree of effectiveness. I've also seen that some women are able to reduce their PMS symptoms with supplements - Evening Primrose Oil being one that has a good reputation and no side effects. Chaste Tree Berry is another popular remedy. Calcium, Magnesium, and Vitamin E are other supplements that show some effectiveness in reducing PMS.

Here's a decent article (on WebMD of all places!) that actually admits that herbs and supplements might have some benefit:

Relief for PMS

PMS is often a huge trigger for mood episodes in those with a history of bipolar disorder, and it is well worth it to thoroughly explore options in getting more balanced hormonally in order to stabilize the mood. Blood sugar imbalances are also a common trigger for mood swings, so a steady, healthy, low sugar diet can also be helpful in many cases.

Best Wishes,
Ben Schwarcz, MFT