Bipolar Disorder & Pregnancy

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My little sister had a baby boy on August 27, 2012. Watching him grow the last few months has been amazing, and it has stimulated a lot of thinking because I (tentatively) plan on becoming a mother. 

I’ve always wanted to be a mother, ever since I was a young child. Family has been an extremely important part of my life, and it’s almost as if I couldn’t imagine not having a kid of my own. In high school, before I had any idea of what real life is like, I wanted to have a kid as soon as possible. Luckily, I didn’t act on that–what a disaster that would have been.

I have learned a lot since graduating from high school and one of the things I have learned is that my illness is a major undertaking, 365 days a year, seven days a week. I have not been very stable since being diagnosed five years ago. Granted, I’ve had a lot more success in the past year, but I am nowhere where I’d like to be. I just can’t have a kid right now; it’s not practical.

I realize that my health is pretty fragile at this point; no time to bring a baby into this world. I don’t know how I would strategize medication, and I’m a little scared to even try. If I’m on less medication, how will I make sure I can work every day and be healthy enough to grow a healthy baby? I also worry about what I’m going to be like as a mother. I can be really emotionally unstable at times and I don’t want my child to be surrounded by yelling or have a mother that’s too tired and depressed to nurture them properly. 

My mother has major depression and spent a lot of the time when we were growing up in her room, napping. The pain of not being able to have an open, honest, tender relationship with my mother, largely due to her illness, has stuck with me. Some people would probably tell me not to have a child and sometimes I don’t blame them, because I know what it’s like to be a child without a present mother. It affects your entire life going forward whether you want it to or not. I’d like to think that the love for my child would supersede all of the pain I was feeling inside at a given moment, but maybe my mother thought the same thing.

Sometimes I think I’m putting too much pressure on myself and that it will all work itself out. Sometimes I also think that this is not going to work at all. Maybe a pregnancy might not be possible, or maybe it’s just too difficult. I try to separate myself from this issue and not get too emotionally involved to protect myself. It can be too hard to think about.

I’ve asked my therapist and psychiatrist about bipolar pregnancy briefly, and they say it is nothing I can’t do. That gives me confidence, but it is often overshadowed by doubt.

Like I said, my current strategy with pregnancy and childbearing is to just not think about it. I have at the very least a few years to get serious about planning for a child. But with my sister having a son now, people are asking me when I am going to have a baby. This is outrageous to me in many ways–I’m 24 years old. Let’s slow down. In addition, these people don’t know that I live with bipolar disorder every day and have enough issues with keeping the stress at bay as it is. I am looking to grow emotionally in 2013, but with my condition, I don’t think that having a baby should be taken lightly or be a snap decision. I’ve seen a lot of girls my age take the plunge and have a child, and it’s a life changer. And most of them don’t have any kind of chronic illness. 

What the Research Shows

In an article on bipolar pregnancy by the National Alliance on Mental Illness, the organization notes that pregnancy and delivery often increase the symptoms of bipolar disorder–just what I’m worried about happening. In fact, according to the article, pregnant women or new mothers with bipolar have a sevenfold higher risk of hospital admission, and a twofold higher risk for a recurrent episode, compared with those who have never delivered a child or who are not pregnant. Studies also make it clear that discontinuing medication during pregnancy have increased risks of a recurrent episode. 

NAMI wants women with bipolar to know that they must carefully plan. Planning should start well before conception. 

Luckily for me, the article states that Lithium and the first-generation antipsychotics like Haldol and Thorazine consistently show minimal risks to the fetus. Some anticonvulsants like Depakote and Tegretol, however, have proven harmful to fetuses, possibly causing birth defects. 

Studies also show that one mood stabilizer is better for the fetus than the use of multiple mood stabilizing medications.

Lithium

The use of Lithium during pregnancy can be life saving for the mother. While taking Lithium both during pregnancy and without child, it is important for a woman to stay hydrated to prevent Lithium toxicity. Careful monitoring of Lithium levels must be done throughout pregnancy, but if you take Lithium like me, you’re no stranger to getting your blood drawn.

The only thing I don’t think I want to do is breast feed. I know it’s great for the baby, but in my opinion, not when you‘re on Lithium. If the mother is on Lithium and breast feeds, the baby’s blood needs to be monitored for Lithium levels. That just seems like too much to me. I rather go the formula route, personally.

Zyprexa

Zyprexa is part of the second-generation antipsychotics, which also includes Seroquel and Risperdal. Few studies have been done on pregnancy and second-generation antipsychotics, especially Seroquel and Risperdal. However, studies in Zyprexa show, so far, that it does not cause birth defects. I like that news, but feel a little concerned with using multiple medications during pregnancy. 

One of the downsides to Zyprexa without being pregnant is weight gain, so you can imagine what health risks might be involved with Zyprexa during pregnancy. Gestational diabetes, weight gain, and high blood pressure can occur with use of olanzapine

What I‘m Seeing “Out There” 

Different websites will give you varying  information. A WebMD article lists Lithium as possibly causing heart defects, and is not recommended during the first three months of pregnancy. If you’re considering getting pregnant I would grab information from multiple sources (research articles, books). In addition, consult an OB-GYN and your psychiatrist, and build a team to help you learn more about having a baby.

I want to hear from you…

  • Do you think that women with bipolar disorder should have children?
  • Would you take medication while pregnant?
  • Are you a woman with bipolar that has had a child? Please tell me more!
  • What are your thoughts on this article?

You can comment here or email me at katgalaxy8606@mail.com. You can also find me on Twitter @KatGalaxy. Thanks for reading!

-KG

 

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8 thoughts on “Bipolar Disorder & Pregnancy

  1. Anyone having a baby needs support and it’s preferable if a pregnancy is planned. This becomes more important when you have a mental illness.

    Mood stabilisers are discouraged during pregnancy, I don’t know of any that are regularly used with pregnant women. Though it’s a cost/benefit calculation and if stopping a mood stabiliser would endanger the mother’s life it wouldn’t be worth it. That said, antipsychotics can minimise risk/symptoms of mania and some of these are relatively safe in pregnancy. There are also some safer antidepressants. So, pharmacologically, things can be managed.

    I don’t know what country you’re in, but I’m familiar with the English Mental Health System (NHS FTW). If a woman was pregnant over here and she had bipolar, she may receive extra support from her care co-ordinator. She may be automatically referred to the home treatment team/crisis team around the due date. This would be to give more support and minimise risk of crisis and hospitalisation.

    I’ve seen women with bipolar have babies and become wonderful mothers. Don’t let a diagnosis define your life.

    Best of luck for the future.

    1. Thank you for your information. I really appreciate it. It’s nice to hear from people like you! 🙂

      I’m glad to hear you say that pharmacologically, things can be managed. The only thing I’m really worried about is becoming unstable while I am pregnant. Perhaps I could start the medication regimen before I become pregnant, to see how it goes…I’m just worried I’ll get sick. I guess you can’t predict the future so my fear is something I am going to have to get over if I want to do this. Maybe this just shows this is not my time.

      I am in the US. Sounds like you all have a better set up in the UK. I don’t get much help at all for my illness and I don’t know if any programs that would help me more than any other mother while I’m pregnant or after pregnancy–someone please correct me if I’m wrong, by all means. Sometimes living in this country under current healthcare conditions, having a baby seems impossible, especially for someone like me that has a full time job.

      Thanks for the encouragement; it means a lot to me, it really does. This is something I’ve been struggling with–letting bipolar run my life, rule my life, control my life. I’m tired of it. You’re right, I can’t let this diagnosis control me. This is very wise advice. Thanks again.

      KG

      katgalaxy8606@mail.com

      1. Part of having bipolar disorder is the worry that you could relapse any time. That’s why it’s really important to plan ahead with your healthcare professionals. You could make a pregnancy and birth plan with them and stabilise on a new medication regime prior to trying to conceive.

        The American healthcare system sounds hideous. I remember whilst there were debates going on regarding Obama’s changes to healthcare, some Republicans were saying how terrible the NHS is. Quite frankly, I have never met a single person in my country that wants to go to an American system. The NHS has it’s faults but, when it comes to having a severe and enduring mental health problem, you’d much rather be a Brit. Actually, make that any health problem,

  2. I dont think that having Bipolar in and of itself is a reason to not have children, as with any mental illness. I really do think its a case by case thing, and up to each individual to decide whether or not theyre capable of parenting. I dont have Bipolar, but BPD, and I know that at the moment Im not stable enough to have children, but I do believe that I could get there and that I could potentially be a very good mother.
    Personally, I would not take medication while pregnant, but Ive never had any good results with meds, just massive amounts of side effects. My sister just had a baby (her 2nd). She was on Celexa through both pregnancies, which she isnt very happy about. The decision to stay medicated through pregnancy was really difficult for her, but what it came down to was, after talking to her doctor, what she thought would be worse on her baby, the medication, of her symptoms if unmedicated.
    I dont know if any of this was helpful at all, but…

    1. No, this was very helpful gypsy! I thank you for your comment. It’s nice to hear of real life situations in which bipolar mothers have had children–I have hardly come across any real cases in my life, only studies. Were both of your sister’s babies alright? I hope so. I can definitely understand that she wasn’t happy to have to use antidepressants. Was it a negative experience? How did she do? You can email me if you’d like at katgalaxy8606@mail.com.

      I appreciate your encouragement because I’m trying to think like you, that this is not a reason for me not to have a child. While it may be more strategic and maybe more difficult than most women, I still want to do it. So I really do appreciate that.

      Thank you so much for your comments and I hope you come back! 🙂

      -KG

      1. Yes, her daughters are ok, and her pregnancies went fairly well as well. I dont think a mental illness diagnosis says that someone isnt suited for motherhood. My sister is a great mom, and Ive know others that are too. I think awareness is important, and you are obviously aware of your issues, so where you go from there is up to you.

  3. Thank you so much for sharing this. I have bipolar type 1 and my partner & I are currently planning a family. She doesn’t have bipolar and will be the one to carry, but she has other medical conditions that may cause us to use the backup womb- me. I’ve been apprehensive, naturally, and find it hard enough to maintain BP stability. This info is really comforting & thought-provoking as well. Thanks & best of luck to you:)

    1. Thanks for your comment! That means a lot. You are right, it’s hard enough to maintain stability, but that doesn’t keep us from wanting to have children. I admire you and your partner for staying courageous even though it can be scary at times to 1)think about a pregnancy with bipolar and 2)think about what would happen if you didn’t have children at all. Keep going! And come back to the blog, ya hear? 🙂

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