Bipolar disorder does not favor a sex, but women have unique complications as a result of bipolar disorder; moreover, different ethnic communities handle it differently on a social level.

Brigham and Women's Hospital published a new study in The New England Journal of Medicine indicates that lithium administered to women during pregnancy does not correlate as strongly with the risk of infants being born with heart defects as it was originally believed. "Women that have bipolar disorder—it's a very severe illness," said the medical director of the Center for Women's Behavioral Health at Women & Infants Hospital, Dr.Neha Hudepohl.

"Women tend to get significantly worse if they stop their medication and what this means for our patients is if they do we need to stay on the medication, lithium, to maintain their mood stabilization, which is crucial in pregnancy, that this is reassuring for them."

Bipolar affective disorder, also commonly referred to as manic depression, is a mental dysfunction typified by spells of depression and elevated mood, and the stark contrast of these polar-opposite, emotional states is what primarily characterizes the disorder.Bipolar disorder is relatively pervasive throughout the global population, and all peoples are equally affected by it.

African-American women, however, occupy a disadvantageous social sphere in which they are less likely to be treated properly or at all for manic depression, and unfortunately, there is a vast quantity of other significant risks to living with bipolar disorder, which go unaddressed for many African-American women or afflict groups that include African-American women.

It is estimated that over two million Americans are afflicted with manic depression.With the proper treatment, it is possible for these victims to control the drastic mood swings the disorder imposes upon them so that they can live healthy lives.Studies support the notion that the rate of manic-depressive illness is consistent among all of America's racial demographics, but it is equally true (and studies support) that African Americans, in general, are measurably less likely to be diagnosed at all.Consequently, more Blacks than others live with bipolar disorder and do not receive treatment.

The new study published in The New England Journal of Medicine involved 1,325,563 pregnancies, and all pregnant participants were Medicaid enrollees who delivered live-born babies between 2000 and 2010.Race was not a factor in the population study.The research team looked at the cardiac malformation risk in infants who received lithium exposure during the first trimester.They compared those observations with infants exposed to a different mood stabilizer even more commonly used: lamotrigine.

Mental Health America reports a wide variety of factors that contribute to African Americans with bipolar disorder not being diagnosed and not being treated.One cultural influence is that the Black community still maintains a certain level of mistrust toward health professionals.It stems from several facets of the problematic history of Blacks in America, but Mental Health America attributes it primarily to a history of Whites institutionalizing Blacks at an inordinate rate.Of course, this also compounds with numerous other mistreatments throughout African-American history.

More broadly, Blacks have cultural barriers that keep them from regularly seeing physicians and other healthcare professionals.Part of what socially constructs these barriers, in fact, is that, according to Mental Health America once again, Black communities have tendencies during periods of emotional distress to substitute family and religion for mental health professionals specifically.Similarly, African Americans tend to speak much more openly about physical problems than mental ones, even to the extent of the former superseding the other in conversation.

Perhaps most notably, though, there are economic restrictions that keep the Black community from embracing the healthcare industry.Historically, healthcare has been relatively expensive, and many Blacks cannot afford regular visits to see their physicians, much less to visit specialists of any kind.

Karen Brock, author of Living with Bipolar Disorder: A Handbook for Patients and Their Families, explains the relevance of folic acid deficiency to bipolar disorder, beginning with a definition of folic acid (folate) deficiency.It is a rare deficiency since folic acid is a common occurrence in most fruits, vegetables, and animal products, but it often results from a list of problems that Brock provides: chronic alcoholism, malnutrition, hyperthyroidism (and related drugs), decreased or increased metabolism, and B12 deficiency.

A symptomatic connection can be drawn from folate deficiency to manic-depressive illness when scrutinizing the symptoms: sleeplessness, forgetfulness, and irritability.In fact, the deficiency is often correlated to the neural tube defects of newborns, and a wealth of evidence supports the relatively new idea that diabetes-associated birth defects and a raised risk of autism are also products of folic acid deficiency.

The significance of folate deficiency is observed relative to folate supplementation's extensively researched potential to reduce stroke risk, though not the risk of cardiac events.Of course, other evidence taints this by suggesting that folate may hold a correlation to cancer.Regardless, Brock explains that the elderly are the most likely to over-supplement while women of childbearing age and especially Black women are the groups most liable to under-supplement.

The irony comes from the fact that the elderly are already the most at risk for cancer, yet they over-supplement what is likely to exacerbate that risk.Black women, on the other hand, are usually the most in need of certain folate levels, but they are most prone to under-supplement.