Bipolar II diagnosis after PP

My psychiatrist seems to think I may have Bipolar 2 and would benefit from staying on the anti psychotic and anti depressant medication I am on. I was put on the anti psychotic meds after my PP in Jan 2013. And then the anti depressant some months later for post natal depression. This was after my 4th child who was born in Jan 2013. ( I had PP after my 1st child but never medicated, and was completely well after my 2nd and 3rd children).

To be honest I have never felt better in my life than how I have felt since being stable on these medications, about Jan 2014.

I have been writing a book about my life and using my diaries as a guide. It became obvious that I have always struggled with low moods through my life but I could always blame it on my surroundings, until my life became a very positive one and I still had trouble with low moods.

I would be interested to hear from anyone else who has been diagnosed with Bipolar 2 since having PP. Or anyone who has stayed on the meds because life is better than it has ever been before them.

7 Replies

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  • Hi PPx2

    Just wanted to share a bit of my experience - I had recurrent episodes of depression in my late teens and twenties, but no mania. When I became pregnant 9 years ago we were expecting postnatal depression but I had PP out of the blue which began with sleeplessness and extreme mania. I went on to have another baby 3 years ago, and again experienced mild mania and started back on antipsychotics, sadly this was followed by depression and we eventually found a really effective antidepressant.

    My psychiatrist doesn't seem to be a fan of diagnosis (!) but my suspicion is that I'm somewhere on the bipolar spectrum. Like you say, it's easy to look back and relate episodes of depression to life - work stress and moving house seemed to be particular triggers for me - but since I had PP I have found myself more vulnerable to 'hypomanic' episodes with lots of ideas, plans and high energy and my sleep patterns go out of whack. It's taken me a few years to learn what works for me, but I have now had a year of really well-balanced health and like you this is with a combination of an antipsychotic (low dose used as a mood-stabilizer) and an antidepressant. I've worked closely with my psychiatrist to find the combination that seems to work well in terms of not making me too sleepy, and (having had a depression relapse 18 months ago) I do feel that long-term medication seems a very sensible choice. It's been important for me to stay well not just for myself but for my two lovely daughters and we have really enjoyed the last 12 months of me being well.

    Do you have any concerns about being on medication longer term? I know for me, my antipsychotic carries a risk of raised blood glucose and diabetes, so my psychiatrist is supporting me to try switching to an antipsychotic with less metabolic effects. I've gained some weight, but again over this last 12 months of being well I have been able to build more exercise into life and slowly but surely dropped a few pounds. My hope is that I'll be able to continue with a healthy diet and exercise and get back to a healthy BMI over the next year or so - it's slow progress but worth it for my mental health!

    Good to hear from you and it's wonderful that you've had almost a year of being stable on your medications. For me personally, it's definitely been the best choice.

    Naomi xx

  • Hi PPx2,

    My experience of PP was a long time ago but I was diagnosed with Bipolar after PP. I very gradually improved and came off all my medication when my son was eight months old. At that stage I was nearly recovered. I then moved house, got married and started a new job which was all too soon, I tried to run before I could walk!

    I then realised I had tried to go to work too soon and had problems with concentration. I left my job on the grounds of ill health. I then got depressed, this was the first time I had ever experienced depression. When I had PP I had manic and psychotic symptoms.

    I was then put on antidepressants until eventually I became high. I then started having extreme swings in mood. I had episodes of severe depression followed by full blown mania. This was very destructive and eventually I was diagnosed with Bipolar and started on Lithium. Luckily for me I got better, within weeks my moods were stable. I have been well on Lithium for many years.

    It would be great to hear how you are getting on,

    Take care,

    Sarah

  • Hi Naomi and Sarah,

    thanks for your replies. It does help to hear of others who have similar experiences to mine. So thank you for sharing.

    I do not have any side effects from the medications so would be ok to stay on them if my life is better with them. The only downside is the taste of the anti psychotic (Saphris), it is an under the tongue wafer that tastes foul. But I eat one of my favourite chocolates after it as a treat so that helps.

    If I was to stay on the meds I would like to have a break off them first just to see for myself what I am like off them. This might sound strange but in the back of my mind I am always thinking I do not need them and would be ok without them. I have an apt with my psychiatrist in a few weeks so will be discussing this with him. At first he said I would have to stay on the meds at least 12 months from the time I was back to normal. But then at my last apt he said I would need to stay on them for 2-3 years! At the time I did not ask him why so much longer. Wish now I did. My husband seems to think it was because I was so unwell when he said the 12mths and at that time if he said 2-3 years it would have seemed like an eternity to me and he did not want to dishearten me.

    I am 2 months off being back to normal for 12 months ( 2 yrs. since PP) and am really wanting to try coming off the meds then rather than waiting another 1-2 years. Even though this is what I want to do I am kind of scared at the same time. Scared of becoming unwell again.

    Another reason I want to try coming off the meds is because I would like to try for another baby. My husband says no more for me but I am 44 years old and would like to have the chance to at least try for another one. At my age this may not even happen. I have 3 adult children from a previous marriage and just the one, almost 2 year old daughter, with my current husband. He does not have any other children. I would like to give her a playmate. I know I have a high chance of getting PP or depression again but I have been reading about others on this site who have had success with proper prevention plans in place.

    I would be interested to hear how long others have stayed on meds after PP.

  • Hi I had pp imn aug 13 and tried to taper in may but felt awful - probably withdrawal symptoms. But since then with a particular brand of quetiapine I also felt terrible and was fine once back to my normal brand. So I feel I still need them. The thing is though, I do feel the best I've felt in years. I feel I've been near to psychosis unrelated to childbirth twice in mmy life and a crisis was only averted due to resolution of issues such that I did not need help but I came very close to breaking down. Therefore I feel I perhaps have underlying issues. I now don't want to come of this medication.

  • Hi I had pp imn aug 13 and tried to taper in may but felt awful - probably withdrawal symptoms. But since then with a particular brand of quetiapine I also felt terrible and was fine once back to my normal brand. So I feel I still need them. The thing is though, I do feel the best I've felt in years. I feel I've been near to psychosis unrelated to childbirth twice in mmy life and a crisis was only averted due to resolution of issues such that I did not need help but I came very close to breaking down. Therefore I feel I perhaps have underlying issues. I now don't want to come of this medication.

  • Hi PPx2

    I can really identify with that feeling of wondering what you are like without the meds. I guess I can only advise caution really from my own experience - after our second baby I came off my antipsychotic (Olanzapine) within a few months and was stable for a little while but then experienced severe depression, which took almost a year to stabilise and I had to try a whole range of antidepressants before we found one which worked.

    Fast forward to around 18 months later and I came off my antidepressants as I felt I was getting a little bit 'high' (with hindsight I needed to address the busyness in life and probably re-start an antipsychotic). Sadly this resulted in another brief but very severe relapse of depression and I needed to be hospitalised.

    I think looking back now, I would definitely make more cautious decisions and err on the side of staying on medication. But I think this is something you often only learn through hindight! I do feel now that the priority is staying well for my beautiful daughters - and especially for the youngest (now nearly 4) as she's had a very poorly mummy on two occasions in her young life.

    In terms of trying for another baby, there are definitely options for staying on medication during pregnancy, if this is what you decide to do - which could help to maintain your current good mental health throughout the pregnancy. It would be really helpful for you to talk all this through with a specialist perinatal psychiatrist before you think about trying for your next baby. If there isn't a specialist in your area you can use the free second opinion service at Cardiff Uni here app-network.org/what-is...

    We've also just produced a comprehensive guide for mums thinking about another pregnancy which takes you through lots of the issues you might want to think about and discuss with your partner. Here's the link app-network.org/wp-cont...

    Hopefully my experience doesn't paint too much of a gloomy picture - I can only reflect on my own learning through periods of coming off medication, and I know this is a very personal choice for you. If you do decide to withdraw from medication, we are all here for you to chat to, and you can make sure you have good support from your psychiatrist in withdrawing carefully and gradually.

    All the best

    Naomi xx

  • Hi PPx2,

    I don't have a diagnosis of Bipolar, but did have PP in 2009 after the birth of my 1st son. You say you'd be interested in how long others stayed on medication; in my experience, I took an antipsychotic in a reducing dose for over a year, probably nearer 2. I also took Lithium (which was added to the mix when they were trying to stabilise me enough to be discharged from the MBU after a few ups and downs) and took that for about 3 years, again in a reducing dose. I then was medication free for about a year and we tried for another baby, with my 2nd being born in 2013. I didn't take any medication in pregnancy, although I did (eventually) get referred to the mental health team and had a Social Worker allocated and a Psychiatrist consultation ahead of giving birth, so they were aware I might become ill again and we could put plans in place. I then took a low dose of anti-psychotic on delivery, and for about 4 months - again reducing after 2 or 3 months. Luckily in my case I stayed well and am fine a year on.

    As others have said, if the meds help you feel better, there's no shame or defeat in taking them. I had to have monitoring with the Lithium and it did damage my thyroid levels, but it's a price to pay. My good mental health now is worth it I think. I hope it works out for you whatever you decide to do, and keep talking to the professionals and others in your life who support you, to make the best decisions for you and your family.

    Take care, x

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