Bipolar disorder and pregnancy: how am I affected?

Managing bipolar disorder and pregnancy can be challenging, but it can be done healthily with the right support.

Bipolar disorder is a mental health condition that affects a person’s mood, causing mood swings.

The specifics of these effects vary depending on the type of bipolar disorder. The potential effects on a pregnancy or fetus also vary, largely depending on your current management of the disorder and the severity of your symptoms.

Bipolar disorder does not affect a fetus. But the potential medication management tools and some of the complications of bipolar disorder can potentially impact the fetus.

“The increased stress, along with the change in hormones, can make a person vulnerable to an episode of mania or an episode of depression,” says Leighya Richard, Registered Mental Health Counselor, Perinatal Mental Health Counselor and Certified Mental Health Professional perinatal care with the Relive the Mental Wellness Group.

Richard suggests making sure all aspects of pregnancy and childbirth are discussed with a medical team, including a therapist, psychiatrist, and anyone on your natal or birth and delivery team.

Medication Management Effects

When it comes to pregnancy and bipolar disorder, one of the biggest concerns is about potential medications used to treat symptoms.

The exact effect of common medications on the developing fetus is unclear, but it’s possible they could affect your pregnancy, according to a 2017 report. These drugs include:

Some decide to go completely off their medication during the conception and breastfeeding stages. On the other hand, some may choose to replace their medications with medications with less risk of fetal interaction.

For some, continuing a medication plan is the best option to avoid an acute episode, according to research 2008.

There is no single correct solution. The best course of action for managing your medications is something you and your medical providers can collectively determine.

If you choose to change or go off your medication, you still have options for managing your bipolar disorder symptoms, including various types of behavioral therapy and support groups.

Effect on nursing

Breastfeeding is another factor to consider when discussing pregnancy with bipolar disorder.

According to 2017 report previously mentioned, studies are inconclusive about the potential effects of antidepressants on an infant. For this reason, it is best to proceed with caution before taking antipsychotics.

Since there are often strong incentives to breastfeed your children instead of using bottled formula, this consideration can be difficult.

To make the best decision for you and your baby, consider talking with a doctor about your medication management options.

It is important to pay close attention to your pre-existing symptoms and their fluctuation. It’s also important to stay aware of new or alternative symptoms that may or may not be related to bipolar disorder.

Postpartum depression

Studies suggest that the likelihood of developing the already common postpartum depression is increased in people with bipolar disorder.

Postpartum depression is not the same as clinical depression, even for those who were diagnosed with the latter before conception.

This variation of the disorder is more severe than the mood changes expected after childbirth. It has the potential to harm you and your baby if left untreated.

Signs of postpartum depression include:

  • recurring crying without explanation
  • feeling disconnected or having negative thoughts about your baby, including intrusive thoughts about hurting yourself or your child
  • about changes in your relationship to food or sleep
  • withdrawing from friends and family, especially for fear of being judged on one’s feelings
  • unmanageable mood swings, including anger or frustration
  • trouble concentrating or remembering things
  • strong urges to get away from it all

Postpartum psychosis

Bipolar disorder increases the risk of a biological parent developing postpartum psychosis. This condition is rare and sometimes misdiagnosed as postpartum depression.

Postpartum psychosis is a serious condition that requires immediate attention, as symptoms include:

  • severe mania or depression, usually beginning within 2 or 3 days to 2 weeks after birth
  • hallucinations
  • delusions
  • act out of character
  • suspicion or fear
  • depression, mania, or a mixture of the two resulting in a rapidly changing mood
  • weak inhibition or restlessness

Postpartum psychosis can worsen quickly and pose a significant threat to both parent and baby.

baby roses

Richard also discusses the presence of postpartum euphoria, also known as baby pinks, which is a play on the phrase “baby blues.”

Euphoria is described as a spontaneous but exceptional feeling of being “uplifted”, elated, or physically or emotionally exceptional.

It might seem counterintuitive to view positive feelings as cause for concern. Still, any jarring or spontaneous mood swings are worth noting and reporting to your doctor.

Because euphoric feelings are common during times of hypomania, which is a diagnosable facet of bipolar disorder, it’s important to take these experiences seriously.

Sleep schedules

Babies and their likelihood of inconvenient sleep schedules is a well-known fact.

Because sleep hygiene is important in managing bipolar disorder symptoms and preventing episodes, it may seem counterproductive.

It’s not impossible to navigate between a hungry baby and bipolar disorder. But that means ensuring quality sleep might need to be at the top of your self-care list. This is especially true if you have noticed that symptoms have increased after a period of poor sleep.

Partners not born with bipolar disorder

Richard suggests that both parents should remain aware of episode triggers and signs when pregnancy is involved.

You may consider talking with your therapist or doctor about how you can continue to support yourself and your partner, especially if this is your first child.

“Non-birthing parents with bipolar disorder should be aware of their early signs or red flags of an acute episode. Continuing self-care activities, including taking their medications, continuing to therapy, sufficient sleep and adequate nutrition, can mitigate the risk of relapse,” says Richard.

Richard also talks about the importance of informal support for both parents. Help from those you trust can act as a stabilizing factor for all new parents, especially those living with bipolar disorder.

You can receive this support from:

  • friends
  • family
  • support groups
  • the presence of a birth doula

Although a diagnosis of bipolar disorder calls for increased intentionality around conception, that doesn’t mean expectant parents with the disorder should give up on their dreams.

More than one aspect of your condition and its management determines how you can manage your pregnancy and the postpartum period. Try to keep in touch with your medical team for advice and support.

According to a 2010 study.

For this reason, the added stress and staggered sleep schedules can be a potential concern for either parent.

You can build your support network early on by:

  • join support groups
  • connect with a postpartum doula experienced with various mental health conditions
  • stay in touch with friends and family

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