Pregnancy and Bipolar Disorder an Article by Gemma Hales

Gemma sent me this wonderful article she wrote about Pregnancy and Bipolar and I want to share it with you all. Thanks Gemma for such great info!!
Understanding Bipolar in Pregnancy

Did you know that historically doctors would advise women who suffered from bipolar disorder simply to not get pregnant? Yep, really. Not only was this idea impractical (studies show that in 2011 almost half of the 6.1 pregnancies in the US were unplanned and this can happen regardless of a woman’s mental health status) but completely heartbreaking for bipolar women who desperately want to be mothers and are more than capable of doing so. Thankfully this advice is now seen as outdated and focus is given to specialist, individual care rather than complete avoidance of pregnancy. But that doesn’t mean that it’s all plain sailing. Pregnancy can be challenging for any woman but for those with bipolar disorder there are a lot more tricky choices and special considerations to be made. Understanding bipolar disorder and the ways in which it can affect pregnancy is the first step in making an educated decision about how to effectively manage the two conditions together. Here are some things to think about.

What are the risks?

The biggest dilemma of becoming pregnant when you are being treated for bipolar is whether or not to continue with the medication. Unfortunately most types of medication used to treat bipolar carry some risk of birth defect and other complications such as cardiovascular problems, cleft palate and overall development. But stopping the medication can lead to a significantly higher risk of relapse for the mother during pregnancy and beyond. Most doctors would advise that if you discover you are pregnant while taking bipolar medication you do not stop taking it until you have consulted a doctor. It is also worth remembering that bipolar can first present itself during pregnancy, particularly if there is a family history of it so even if you are not aware of having had the condition previously, you should still be alert for any symptoms.

What should I do if I want to plan a pregnancy?

Most women are advised to take folate when attempting to conceive. This helps reduce the risk of birth defects and malformations and is particularly important in those taking medication for bipolar. If you are thinking of planning a pregnancy it is important to have a full consultation with a doctor who can assess your individual case and advise the best course of action. Generally it is best to plan a conception while not on any form of medication – the first trimester of pregnancy is a crucial and vulnerable time where abnormalities may be more likely to develop than further on in the pregnancy. Having said that, the case will need to be assessed on the needs of the mother, the severity of her symptoms and the likelihood of a relapse.

How do I cope during pregnancy?

Coping during pregnancy means balancing the needs of the mother alongside the wellbeing of the developing foetus and finding some ground whereupon they are both as safe as well cared for as possible. To do this, very regular consultations with psychiatrists and obstetricians alike. Understand that the risk of a manic or depressive episode is considerably higher during pregnancy and so it is extremely important to try to pre-empt the symptoms in order to get help quickly if necessary. Try keeping a mood diary to help flag up any warning signs and if you are really struggling speak to your doctor or psychiatrist about the safest type of medication during pregnancy – there are some (such as lithium) that are considered safer than others. For any woman, taking care of herself is the first step in taking care of her unborn child. Bear this in mind and be kind to yourself. Living an overall healthy lifestyle with a good, nutritious diet alongside gentle exercise and regular sleeping patterns may also help you feel better.

What about afterwards?

Unfortunately the troubles don’t always end after pregnancy. Sadly studies show that bipolar women are almost 100 times more likely to suffer from postpartum psychosis than other women. Dealing with such a terrifying and debilitating condition alongside caring for a newborn baby can be extremely challenging and for some women who suffer from this, the best option is a stay in a residential hospital where they are able to be cared for while having their baby with them. Otherwise, regular consultations with your medical team and review/introduction back onto your medication can help improve symptoms although it may restrict you from breastfeeding.  

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