Treating Bipolar Disorder After Childbirth

depressed-mother-holding-infant-SSPregnant and postpartum women with bipolar disorder more frequently have significant mental health and early mothering challenges than other perinatal women undergoing psychiatric treatment, according to a study in the Journal of Affective Disorders. The findings indicate the importance of properly identifying the disorder and developing specific treatments for women during and after pregnancy, the lead author said.

“Similar to what you find with bipolar disorder in the nonperinatal population, the overall level of clinical severity and functional impairment really stands out as being of concern,” said Cynthia Battle, associate professor (research) of psychiatry and human behavior in the Alpert Medical School of Brown University.

“It’s a highly vulnerable time for these women,” said Battle, who is also a psychologist at Butler Hospital and Women & Infants Hospital. “They have increased functional demands at this time.”

Pregnancy often disrupts sleep and parenting a newborn can involve getting up several times a night for months, for example. Such sleep problems can potentially trigger new mood episodes among women with bipolar disorder, Battle said. Also, some women go off their medicines while pregnant out of concern for the health of the fetus, leaving their condition untreated.

Last fall a study led by Dr. Verinder Sharma, a psychiatrist from the Schulich School of Medicine & Dentistry, found that the occurrence of conversion from depression to bipolar disorder in postpartum women was 11-18 times higher than reported in non-postpartum women.

“If you look at the literature on postpartum mental illness, there’s lots of emphasis on postpartum depression; not much attention is paid to bipolar disorder,” Sharma said.

Both studies stress the importance of watching carefully for symptoms of mania that distinguish bipolar disorder from depression because most women seek treatment for their depressive symptoms only, unaware of any history of mania or family history of mania. “Asking those kinds of questions to help clarify whether this is unipolar depression vs. bipolar is going to be important to guide treatment,” Battle said.

This research intrigues me because it was after giving birth to my second child that I was diagnosed as bipolar. The first 30 years of my life I struggled from major depressive disorder with some anxiety and obsessive-compulsive stuff thrown in. I wish I had known to look out for symptoms of mania or hypomania because I had to fall hard in order to figure out the bliss wasn’t all fun and games.

Having been hospitalized twice in those postpartum years, I can appreciate why bipolar disorder is especially challenging for new moms, and even more so when they don’t know what their illness is, and are existing from manic high to manic high, crashing hard in between.

Upon diagnosis, Battle said, the next question is “How can we best support women in making reasonable treatment decisions when faced with bipolar disorder during pregnancy?”

One option could be guiding patients to switch to medications that are safer during pregnancy or breastfeeding, so that they don’t go off medications altogether. Connecting them to effective psychosocial therapies is also important.

Battle said she is part of a team working to develop a specialized psychosocial intervention for perinatal women with bipolar disorder.

In addition to Battle, other authors are Lauren Weinstock and Margaret Howard.

Source: Brown University

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12 thoughts on “Treating Bipolar Disorder After Childbirth

  1. I, too, was diagnosed bipolar after the birth of my third child and three bouts of postpartum depression. Good information…now we need to know coping strategies for managing BP while mothering!

  2. Most interesting Therese, as always I can identify w you. My depression ( suffered n diagnosed during hospitalization in my early twenties) morphed to bipolar after my 4 child ( which is when I entered treatment for my alcoholism Thanks be to God husband n family) after 10 years I finally have the balance I need for maintaining good mental health for today.

  3. Thank you so much, Therese, for writing about these subjects. I was diagnosed with postpartum bipolar disorder (PPBD) 6 weeks after the birth of my second child. I was thirty-seven years old and the trio of total sleep deprivation during labor, childbirth hormones, and a genetic predisposition to bipolar disorder ( My father had bipolar one) created the “perfect storm” so to speak for postpartum mania, hypergraphia (compulsive writing) to set in. Then came the suicidal depression, multiple hospitalizations, meds and ECT. Thank God I’ve come a long way since my diagnosis in 2007 and I was selected by the International Bipolar Foundation (IBPF) as their first 2014 “Story of Hope and Recovery”. I blog for the IBPF and I am doing very well. As a freelance writer for almost two decades I’m writing my first book geared to mothers with PPBD called “Birth of a New Brain – Healing from Postpartum Bipolar Disorder”. My story was featured on Postpartum Progress’ acclaimed website; not many people are aware of this postpartum mood disorder compared to postpartum depression, etc., hence I felt my book could help other women. If only I had been screened for mental illness during my pregnancy, things could have been very different. For more information about my experience please visit my personal blog “Birth of a New Brain”: http://www.proudlybipolar.wordpress.com and thanks for letting me write my novella here! 😉 p.s. I loved your book “Beyond Blue” and I read it soon after its publication. It was of great comfort to me.

  4. Reblogged this on Birth of a New Brain and commented:
    I read Therese’s book “Beyond Blue” soon after its publication when I was very down, and it was of great comfort to me. I highly recommend it if you want a good book about depression and anxiety that stands out from the mountain of similar-themed books. In Therese’s blog post she addresses postpartum bipolar issues and remarks that she’s intrigued by them for personal reasons….just like yours truly! Therese also cites a significant medical study I am very familiar with by psychiatrist Dr. Verinde Sharma. I sprinted to the “good”computer downstairs to comment on her site and wrote a lengthy one despite being distracted by two little girls freaking out about Webkinz and our rambunctious puppy – I hope what I wrote doesn’t scare her and that she publishes it. Anyway, check this out! Thanks for reading and I’ll be back later in the week. :) Dyane

  5. There are a few types of bipolar disorder. Every kind is characterized by the length, recurrence and pattern of scenes of insanity and depression. A natural method to overcome bipolar disorder is The Trivedi Effect®, and it provides a long-lasting relief. To know more about how to overcome bipolar disorder using the natural method

    1. In my almost 45 years of being around bipolar disorder (first with my Dad, and then with me),and as being a member of the International Society of Bipolar Disorders and working for the International Bipolar Foundation and DBSA (Depression & Bipolar Support Alliance), I’ve never heard about the Trivedi Effect.

      No offense, but I would trust using this obscure, medically unsubstantiated method for successful bipolar disorder treatment as far as I could throw a Hummer!

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