--- title: What happens when someone has both bipolar disorder and PMDD? description: Women with both conditions experience more severe bipolar disorder with more mood episodes and more depression. Treatment is challenging because standard PMDD url: https://niyora.com/research/papers/comorbid-premenstrual-dysphoric-disorder-and-bipolar-disorder-a-review-2021/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - What happens when someone has both bipolar disorder and PMDD? Survey study, 2021 # What happens when someone has both bipolar disorder and PMDD? Women with both conditions experience more severe bipolar disorder with more mood episodes and more depression. Treatment is challenging because standard PMDD medication can trigger mania in people with bipolar disorder. Moderate study design Women with bipolar disorder, particularly those with comorbid PMDD ## What they did Researchers reviewed the scientific literature on bipolar disorder, PMDD, and how these conditions interact when both occur in the same woman. They examined how they present clinically, illness severity, brain differences, and treatment challenges. ## What they found Women with both bipolar disorder and PMDD tend to have more rapid mood changes, mixed mood states, more depressive episodes, more bipolar type II, earlier bipolar onset, more other psychiatric conditions, and more total mood episodes. Standard PMDD treatment with SSRIs can trigger mania. ## What it means for you When bipolar disorder and PMDD occur together, the condition is more complex and harder to treat. Standard PMDD medications may not be safe for women with bipolar disorder. This review summarizes current knowledge but does not test a new treatment. earlier onset of bipolar with comorbid PMDD rapid cycling mood changes more common in bipolar females risky SSRIs for PMDD in bipolar disorder ## About the study Original title Comorbid Premenstrual Dysphoric Disorder and Bipolar Disorder: A Review Authors Slyepchenko A, Minuzzi L, Frey BN Journal Frontiers in psychiatry Year 2021 Study design Survey study What was tested None—literature review Open access Yes Read the paper [doi.org/10.3389/fpsyt.2021.719241](https://doi.org/10.3389/fpsyt.2021.719241) Original abstract Bipolar disorder (BD) differs in its clinical presentation in females compared to males. A number of clinical characteristics have been associated with BD in females: more rapid cycling and mixed features; higher number of depressive episodes; and a higher prevalence of BD type II. There is a strong link between BD and risk for postpartum mood episodes, and a substantial percentage of females with BD experience premenstrual mood worsening of varying degrees of severity. Females with premenstrual dysphoric disorder (PMDD)-the most severe form of premenstrual disturbances-comorbid with BD appear to have a more complex course of illness, including increased psychiatric comorbidities, earlier onset of BD, and greater number of mood episodes. Importantly, there may be a link between puberty and the onset of BD in females with comorbid PMDD and BD, marked by a shortened gap between the onset of BD and menarche. In terms of neurobiology, comorbid BD and PMDD may have unique structural and functional neural correlates. Treatment of BD comorbid with PMDD poses challenges, as the first line treatment of PMDD in the general population is selective serotonin reuptake inhibitors, which produce risk of treatment-emergent manic symptoms. Here, we review current literature concerning the clinical presentation, illness burden, and unique neurobiology of BD comorbid with PMDD. We additionally discuss obstacles faced in symptom tracking, and management of these comorbid disorders. Reproduced under CC-BY. ## Topics [Premenstrual syndrome (PMS)](https://niyora.com/research/topics/condition-pms/)[Premenstrual dysphoric disorder (PMDD)](https://niyora.com/research/topics/condition-pmdd/)[Low mood and depression](https://niyora.com/research/topics/symptom-depression-mood/)[SSRIs and antidepressants](https://niyora.com/research/topics/treatment-ssri/)[Bipolar disorder](https://niyora.com/research/topics/comorbidity-bipolar/)[Adolescents and young people](https://niyora.com/research/topics/life-area-adolescents/) Research tells you what helps on average. Niyora helps on the day it hits. Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor. ## Related studies Study, 2026 Do anxiety and depression get worse before your period if you already have a mental health condition? Survey study, 2026 What is the true rate of PMDD, and does it worsen mental health conditions? Guideline, 2014 What antidepressant should doctors use to treat depression and premenstrual dysphoric disorder? Review, 2026 What should doctors know about PMS and PMDD in teenagers? Review, 2025 How does the menstrual cycle affect psychiatric symptoms like depression and anxiety? Case report, 2024 Can lithium help treat PMDD when other medications are not an option? Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗