Bipolar, Want to Get Pregnant Again

[Hopeful_9]

Hi, please comment below if you can.

I am the mom to a 6 year old child and had Post partum psychosis after her birth. My whole pregnancy I experienced symptoms, which became worse after her birth. I stayed in the hospital, mental health section and was put on medication and am now recovered.

I want to try for another baby but I am scared. One thing that worries me is after her birth I was diagnosed with bipolar disorder. As a result of that, and maybe because I am doing so well with the meds, I am STILL taking the medication I was put on 6 years ago after her birth. (I feel anxious about stopping it. Don't want to get unwell again.)

I just don't know if I can have another baby. I want to, but will the medication pass through the bloodstream when I am pregnant? Will I have to stop taking medication (I've considered it, of course talking to my doctor first). But because I am bipolar, if I stop taking the medication, is it a greater risk for me? I can't find a lot of resources for bipolar women who have had postpartum psychosis online.

Are there any other moms who can tell me if they have had successful pregnancies after post partum psychosis? And what did you do with the medication? Did you take it or stop or take it after you give birth? If anyone else is bipolar I would be interested in hearing your story.

Is anyone that is bipolar MEDICATION FREE after psychosis? That is my dream, to stop taking the meds one day and be ok. But I feel scared.

Thank you ladies.

[Naomi_at_app Volunteer]

Hi Hopeful_9

You've asked really important questions that many women taking medication face when thinking about another pregnancy. If possible, it would be worth having a consultation with a specialist perinatal psychiatrist before you try for a baby. This would help you to get advice about your specific mefication and its safety to take during pregnancy. These decisions can be very tricky and specialist advice will help you to consider all your options including changing or stopping medication. You are right, it's really important for you to stay well during pregnancy and give yourself the best chance of preventing symptoms after baby is born.

This section of our website has lots of advice for mums with bipolar disorder:app-network.org/what-is-pp/...

We are also writing a guide for all mums at higher risk of PP which I will link in this thread later in the autumn when it is live on the website.

Glad you have found the forum - and well done for asking these important questions when considering another baby.

Naomi xx

[Florence21 Action on Postpartum Psyc]

Hi there, you ask about someone who had a PP, is bipolar but was well second-time around: I fulfil that criteria so it might be helpful for you to read my account on the Personal Stories page of this site - scroll to the bottom left for "PP and how I avoided it second time around". I agree 100% with Naomi's advice: the best thing you can do is ask for a referral to a specialist perinatal psychiatrist (if there isn't one in your area, insist that they send you to someone in a neighbouring trust and use the NICE guidelines as ammunition if you need to). Hopefully you will get a positive response because you are being totally responsible and sensible by trying to prepare in advance.

Re you meds, it really depends on which medication you're taking and your own personal history - sometimes its best to come off for the 9 months, sometimes it's better to switch to something else, and sometimes it's better to stay on (perhaps reducing for the 1st trimester) to ensure that you're not ill. And you're right to identify the immediate period after birth as the very high risk period for women with bipolar - I chose to start taking my lithium again immediately 2nd time round and I was fine.

If you want to meet other women in this situation and join a workshop with me and APP's Chair Prof. Ian Jones, we'll be holding a 'Bipolar and Pregnancy' workshop at the Bipolar UK National Conference in London on Sat. March 7th. You can check the bipolar.org.uk website or this one for more details nearer the time.

Stay hopeful! There's every reason to be

All the best

Clare

[dioni]

Hallo Hopeful_9,

I want to add my personal story, which is pretty similar: After the birth of my first baby, I experienced pospartum depression and almost a year later I had a psychotic episode. Of course I was put on meds and I has diagnosed bipolar by one psychiatrist but not by another. Anyway, I took medication for almost 3 years after the birth, when my doctor and I decided that I was ready to stop it. I had to wait some months (following my doctor's advice) to get the meds out of my system and then I got pregnant again. Four months after I gave birth to my second child, unfortunately I experienced PP again. Again on meds, but the story has (I hope) a happy end. Now, I have reduced a lot the meds (stabilizers) and I am in the process (with the help of my doctor and of course, very slowly) to stop them completely. Very important though, is that I had psychotherapy and I continue it because it helps me a lot. I am so grateful I had my second child, although I went through very difficult times.

I wish you the best, be brave and ask for help when you need it.

[TraceyR72 Volunteer]

Hi, my situation is similar to others who've replied. I had manic psychosis very soon after birth of my first baby 10 years ago, with no previous history of mental illness. I wasn't very compliant with medications (due to stigma and side effects) and stopped them as soon as I was holding things together reasonably well, thus ended up with severe depressive episode when he was 4 months old (which taught me that I had to take the antidepressants and mood stabilisers for a while to stay well). At that point I was diagnosed bipolar by one psychiatrist, but others didn't necessarily agree. I did manage to ease myself off all the meds after about 2 years (with professional guidance and support), and was medication free for conception and pregnancy with my second baby. What was important for me was seeing a specialist perinatal psychiatrist before and during my second pregnancy and coming up with a preventative plan. This involved starting antipsychotic meds immediately the baby was born (I chose one that was safe to breastfeed with), and having very robust support around me. That plan worked for me in preventing recurrence of the manic psychosis. Unfortunately it wasn't enough to hold off the depression which kicked in as another severe episode when baby was 9 weeks old. So I had to restart mood stabilizer and anti-depressant and stop breast feeding. Although the relapse was disappointing it is positive that I avoided the psychosis, and the recovery once on meds was so much quicker second time around, so please don't take my experience as disheartening as the distress and the risk was much reduced second time around.

As for the final question in your initial post, I'm not sure whether I'm bipolar or not, and neither are the psychiatrists, but I did manage to some off meds again within 2 years and have coped without them for about 4 years now with no major relapse. I certainly have my ups and downs, and sometimes suffer anxiety. I've been tempted at times to go to GP and ask for meds, but instead just try to remain vigilant, notice my warning signs, manage stress and monitor work-life balance, get enough sleep/exercise/healthy foods. All that just about keeps me on the straight and narrow. So, in my experience I think you're right to be hopeful of being med free, and you should keep that dream alive. It's scary, even terrifying, when you first some off but you're obviously strong and determined so I'm sure you can get there if you can get the right support around you.

[Naomi_at_app Volunteer in reply to TraceyR72]

Thanks so much for your reply TracyR72

I can really identify with your story as I also had a severe depression after my second baby, but no psychosis. As you say, it can be really disappointing to become unwell again, but having a plan in place and support from a perinatal psychiatrist or specialist team is so valuable - even when things don't go quite to plan.

It's great to hear that you have found good ways to monitor your mood and manage the inevitable ups and downs that life brings.

My girls are 8 and 3 now, and it is a real joy to be well and enjoying the new challenges that motherhood brings each year.

Thanks for sharing your story and your encouragement.

Naomi xx

[TraceyR72 Volunteer in reply to Naomi_at_app]

Nice to meet somebody with a similar story Naomi (although of course would prefer nobody else had to suffer such things.) My kids are 10 and 6 now, can't believe how time has flown. Getting emotional already about eldest transferring to secondary school next year! It's hurts sometimes thinking about the lost months of both of their first years, but I guess what I'd like to say to others is that time does heal, and the years of joy of having your family complete are really worth considering taking the risk. Just be prepared by having good support in place to make sure the risks are well managed. x

[Naomi_at_app Volunteer]

Hi Hopeful_9

How are things going with your thinking and planning about another pregnancy?

I thought you would find this resource very helpful as it gives easy-to-read leaflets summarising latest research on the safety of different medications during pregnancy. Could be very useful to look through together with your partner and psychiatrist/GP. medicinesinpregnancy.org/Me...

All the best

Naomi x