Bipolar disorder & pregnancy

Bipolar sufferers will usually have their first episode in their late teens or early twenties. For some women though, giving birth will trigger their first bipolar episode. 

A person with bipolar disorder will experience extreme highs (mania) and lows (depression), which can continue for weeks and, in some cases, months. It is an uncommon disorder and there is usually a family history. The depressive symptoms of bipolar are the same as for depression.

Some of the symptoms of mania include:

• an excessively happy mood – being high as a kite
• sometimes an irritable mood rather than happy mood, or irritable mood mixed with an excessively happy mood
• having lots of energy, moving quickly as though driven by an internal motor
• speaking very quickly, trying to keep up with your racing thoughts
• less need to sleep; feeling energetic on little or no sleep
• feeling overly confident in your looks, abilities and talents
• feeling that you are invincible and engaging in increased risk taking, such as dangerous driving
• increased libido that can sometimes lead to inappropriate behaviour
• having lots of plans and acting on them in a hasty and disorganised fashion
• increased spending, often on things you do not need or do not want and resulting in debt
• behaving rashly and in ways that are out of character, such as quitting work or leaving a relationship in an abrupt and irrational manner
• increased alcohol and drug use
• in extreme cases there may be psychotic symptoms and a loss of touch with reality.

Bipolar disorder has a lot to do with brain chemistry and there is a strong genetic link. Relapse is often linked to sleep deprivation particularly with a manic episode. The main treatment for bipolar disorder is medication.

For women who have been diagnosed with bipolar before they are pregnant it is a good idea to plan your pregnancy with the help of a doctor. Some medications used for bipolar can’t be taken during pregnancy and changes to your medication must be balanced with the risk of relapse. You should never stop taking your medication abruptly.  Your treatment must be a collaborative process between you, your partner and your treating GP or psychiatrist.

You are at greatest risk of a bipolar relapse in the first month after delivery. It’s a good idea to have extra monitoring from your GP or psychiatrist at this time. For some women who have had recurrent episodes, you may choose to start or increase medication as soon as you deliver.

---