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All Journal Sinergi International Journal of Psychology Psychosocia : Journal of Applied Psychology and Social Psychology
Sakdyah, Halimatus
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Education Health Professions Medicine & Pharmacology Social Sciences

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Hormonal Influence on Mood Dysregulation: A Case of Bipolar Disorder with Endometriosis Sakdyah, Halimatus; Septina, Egy Atthahirah; Pramesta, Linda Ramadhanty; Ikhsan, Muhammad; Shafira , Alsa; Nurhayati , Endi; Algristian, Hafid
Sinergi International Journal of Psychology Vol. 3 No. 4 (2025): November 2025
Publisher : Yayasan Sinergi Kawula Muda

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61194/psychology.v3i4.829

Abstract

Bipolar disorder often coexists with gynecological conditions such as endometriosis, presenting clinical challenges due to overlapping hormonal and neuropsychiatric influences. The impact of hormonal therapy on mood stability in women with affective disorders remains underexplored. We report the case of a 30-year-old woman with bipolar II disorder, stable for nearly two years on lamotrigine, who developed mood destabilization after initiating hormonal treatment for stage III endometriosis. Sequential regimens—dienogest, norethisterone, and ethinylestradiol–levonorgestrel—were temporally associated with new or worsening mixed affective symptoms, including agitation, insomnia, irritability, and emotional lability, despite adherence to mood stabilizers. Her Hamilton Depression Rating Scale score increased from 9 to 21 within three months, with laboratory evaluation showing elevated estradiol and suppressed luteinizing hormone, supporting a hormone-related mechanism. A structured literature review (PubMed, Scopus, Google Scholar, 2000–2024) identified limited but consistent evidence that synthetic progestins may exacerbate psychiatric symptoms in mood-vulnerable populations through neuroendocrine and neurotransmitter modulation. This case underscores the importance of recognizing hormonally induced mood dysregulation in women with pre-existing psychiatric disorders and highlights the need for proactive management strategies. We recommend pre-treatment psychiatric screening, structured and longitudinal mood monitoring throughout hormonal therapy, and close interdisciplinary collaboration between gynecology and psychiatry to optimize outcomes. Integrated care approaches may reduce the risk of mood destabilization, enhance safety, and improve quality of life for women facing the dual burden of bipolar disorder and endometriosis.
Hallucinations in Bipolar Disorder: A Spectrum Between Psychotic Features and Affective Intensification Pramesta, Linda Ramadhanty; Sakdyah, Halimatus; Egy Atthahirah Septina; Ikhsan, Muhammad; Shafira, Alsa; Winaryani; Algristian, Hafid
Psychosocia : Journal of Applied Psychology and Social Psychology Vol. 3 No. 1 (2025): January 2025
Publisher : Indonesian Scientific Publication

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61978/psychosocia.v3i1.757

Abstract

Hallucinations, while traditionally associated with schizophrenia spectrum disorders, are increasingly recognized in individuals with bipolar disorder, particularly in rapid cycling forms. Such manifestations complicate diagnosis and, if overlooked, may lead to poorer prognoses. This case report describes the clinical course and management of a 30-year-old female with bipolar I disorder, rapid cycling subtype (≥6 episodes/year), presenting with impulsivity, emotional instability, and mild auditory hallucinations. Her history included childhood emotional and physical abuse. Assessments involved DSM-5 structured interviews, the Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HAM-D), and Difficulties in Emotion Regulation Scale (DERS). Findings indicated pronounced affective lability, trauma-related personality traits overlapping with borderline personality disorder, and partial resistance to prior pharmacological treatment. During inpatient care, she was treated with valproate and low-dose quetiapine, complemented by psychoeducation and trauma-focused psychotherapy, producing notable improvement despite residual mood instability. This case underscores the interaction between trauma, affective dysregulation, and psychotic-like features in rapid cycling bipolar disorder (RCBD). Hallucinations here may reflect affective intensification rather than primary psychosis, stressing the need for careful differential diagnosis and trauma screening. The implications advocate routine trauma-informed assessments in bipolar disorder and highlight the efficacy of multimodal strategies combining pharmacological stabilization with targeted psychotherapy. Integrating trauma-focused care with mood management can enhance long-term outcomes in RCBD, particularly where conventional treatment shows partial resistance.
Co-Authors Algristian, Hafid Egy Atthahirah Septina Muhammad Ikhsan Nurhayati , Endi Pramesta, Linda Ramadhanty Septina, Egy Atthahirah Shafira , Alsa Shafira, Alsa Winaryani