Perimenopause is the precursor to menopause.....some women get symptoms, some barely feel a thing. I was 31 when my symptoms started. Interesting about the Bipolar dx. How old is she?

here is a link for symptoms......

http://www.project-aware.org/Experience/symptoms.shtml

Derealisation and depersonalization are also often experienced by women and in severe cases, psychosis-like symptoms and dissociation.......hope that helps.....Thyroid disfunction can also cause problems......there are stats to support that people with hypothyroidism are often misdx bipolar. Does she have a family history of Bipolar?