Motherhood and bipolar disorder

While bipolar disorder can affect anyone, it could be a matter of concern, especially for pregnant women. A bipolar parent does come with a set of worries and challenges that parents without mental illness don't have to worry about.

However, in no way does it imply that one has to suppress their desire to become a mother or miss out on the extraordinary moments of motherhood. It can be managed easily. 

If you or your loved ones have bipolar disorder, you can connect with mental health professionals at Cadabam's Hospitals whenever you want. Our helpline number 9741476476 is available to you 24x7 to get you all the help you may need. 

Signs and Symptoms of Bipolar Disorder

Bipolar Disorder symptoms results in two extreme moods - Mania and Depression. 

Mania and Hypomania :

They display similar symptoms although hypomania is less severe than mania. The individual may also face difficulties in maintaining and managing work, school, family, and  personal and professional relationships. 

Such episodes will include three or more of these symptoms:

1. Abnormally upbeat, elated, or jumpy. 
2. Unusual talkativeness
3. Racing thoughts
4. An exaggerated sense of well-being and self-confidence or a feeling of euphoria
5. Poor decision-making — for example, making impulsive decisions/investments, going on buying sprees, or taking sexual risks.
6. Decreased need for sleep
7. Increased distractibility
8. Heightened activity, energy, or agitation

Major Depressive Episode‍

A major depressive episode includes severe symptoms that cause noticeable difficulty in day-to-day life including work, school, social activities, or relationships. 

An episode may include the following symptoms:

1. Depressed mood. 
2. Increased loss of interest or feeling no pleasure in all or almost all activities. 
3. Feelings of worthlessness. 
4. Excessive or unnecessary guilt or shame. 
5. Indecisiveness or lack of thinking prowess. 
6. Either insomnia or sleeping too much
7. Either restlessness or slowed behavior
8. Fatigue or loss of energy
9. Significant weight loss in individuals. There will be a possible decrease or increase in appetite

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Bipolar Disorder and Pregnancy

Women with bipolar disorder diagnosis are at an advantage since they know the challenges of mental health illness and can address them in the best possible manner when taking the big step of starting a family. The big question becomes, does bipolar disorder affect pregnancy?

If one has bipolar disorder then the doctor will consider the overall well-being along with:

• How well the bipolar disorder is managed
• Current medications 
• Severity of symptoms
• Potential risks to the baby.

Before pregnancy :

After the doctor gives an all-clear, the couple needs to discuss the next part of the plan carefully since usually bipolar patients do not like huge changes suddenly. Here are a few things that must be taken into consideration :

1. The mother and the partner must make a conscious and aware decision about becoming pregnant. Everything needs to be considered right from medical help to taking care of the baby after it is born etc. 
2. In case the couple wants to wait longer before having a baby, adequate measures of contraceptives must be taken to prevent any unplanned pregnancies.
3. While trying to get pregnant, the pregnancy should be planned under the guidance of a medical and mental health professional. 

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During pregnancy :

When the mother decides to get pregnant, it is one of the most beautiful parts of motherhood. To ensure a smooth journey it is necessary to be aware of certain precautionary measures :

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1. The diagnosis, process, and treatment must be collaborative between the patient, spouse, and doctor as medication for bipolar disorder as part of treatment for bipolar disorder can impact fetal development. 
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2. There are high chances of bipolar disorder being passed on genetically from the mother to the child, so the parents should be aware of this possibility. The support of family, friends, and medical and mental health professionals can be extremely important in this journey.  
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3. Some medications prescribed for bipolar disorder can not be taken during pregnancy. This change in medication must be balanced with the risk of relapse. 
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4. One cannot stop taking the medicines abruptly, hence it is best to consult both the gynecologist and the mental health professional during pregnancy. 
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5. Extra time, attention, and care must be given to the mother to understand reactions to the change in medicine or any other additional symptoms. 
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6. Lack of proper care and medications may lead to low birth weight or significant effects on the brain structure of the baby. The mood changes could lead to behaviors like poor nutrition, half-hearted attachment, and prenatal care, which may prove to harm the baby. 
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7. The mother could add nutritional supplements like flax seeds to everyday meals to make them healthier. Self-care, adequate sleep, and psychotherapy are simple steps that could help deal with the symptoms of the disorder. Daily exercise could also boost serotonin in the body, a crucial hormone to regulate mood and happiness, and feelings of well-being. Therapy for bipolar disorder could also help the person.

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After Pregnancy

After the delivery of the baby, one can face complications, although those can be managed too. 

1. The mother usually experiences complications like postpartum psychosis due to bipolar disorder. It is a severe condition that may require emergency treatment. However, it only affects about 1 in 1,000 women. This could result in a severe attack of depression that starts within two to three days after delivery. Hallucinations are common with this type of postpartum mental illness. It could require extreme support and care or it could potentially be dangerous for both mother and baby.

2. Breastfeeding is also a major concern for new mothers with bipolar disorder. Certain medications can be transmitted from the mother to the baby through breast milk. It could also affect sleep patterns, essential in preventing bipolar relapse. Studies show the postpartum period as a particularly high-risk time for relapse in women with Bipolar Disorder. The risk of recurrence of the symptoms was significantly higher in women who did not continue treatment with mood stabilizers during pregnancy. They were also sicker during pregnancy compared with women who continued medication. Unfortunately, most healthcare professionals are not trained to treat pregnancy during the treatment of a chronic mental health illness. Hence the parents must consult the right medical health professional for both physical and mental health. 

Doctors and psychiatrists/psychologists who have experience in treating pregnant women with bipolar disorder can be extremely helpful in such cases.  

The next step

Bipolar disorder does not mean that you do not get to experience every joy in the world, including motherhood. With the correct care, support, and treatment plans, your desire of being a mother can be fulfilled.