Not Bipolar

[Ekich]

Hi all- I'm so glad I found this group. I've been feeling so alone since I came down with PPP after the birth of my baby girl in Sept. 2014. I had no history of mental illness and no one in my family is bipolar. My therapist said it was the "perfect storm" which made me susceptible to PPP. We had a lot of stress when I was pregnant. When I was 4 months pregnant we moved out of state, I quit my job, and we moved away from all our family and friends. Also I had a horrible labor (48 hours of hell). But our daughter was born healthy and perfect. About 3 weeks after she was born I became delusional. I was hallucinating and having hyper religious thoughts. I had not slept for 4 days. I was sent to the hospital and then psychiatric hospital. They out me on lithium and seroquel (for sleep). It has been 14 months since I got sick and I'm still on the Meds. I know I don't have bipolar but my psychiatrist is not convinced because I'm on lithium. I'm hoping to start weaning off the lithium soon. Just wondering if there's anyone else out there whos had PPP who is not bipolar? I know it is rare to get PPP and not have bipolar but I KNOW I am not. Thanks for your help!

[lgreen]

Hi my story is very similar to yours. No mental health history with me or my family except my mum got Alzhiemers. I got PPP in Feb 2012 after I had my second child and was hospitalised when he was about 2 weeks. I was never on lithium but respiradol for psychotic thoughts and antidepressants. I'm off all meds now but do worry about getting bipolar or something similar in the future altho u hear mixed rumours as to if there's a connection or not?? Its so difficult but it does get better with time xx

[Jenny_at_APP Partner]

Hello Ekich,

I'm glad you've found the forum and hope you already feel less alone.

I had PP in 2012 and also had no history of mental illness. I've not been diagnosed with bipolar.

I'm not a health professional and I'm sure there will be others with more informed advice to offer, but this is my (non scientific and simplified!) understanding.

Women who already have a diagnosis of bipolar disorder are at a known higher risk of developing PP after having a baby, but I think the statistic is about 50% of women who have PP have no prior history of mental illness.

PP is classified as a bipolar type illness because of the high and low features (mania and depression being possible symptoms). These symptoms are not always present however (I, for example, didn't have mania or depression, mainly just delusions, confusion, detachment from reality).

I don't know what proportion of women are subsequently diagnosed with bipolar - some will have had pre-existing bipolar which has never been diagnosed but will now be confirmed, for others the PP will be the first episode but subsequent episodes and symptoms will lead to a diagnosis (so I think only time will tell on that one).

I believe PP increases your risk of having a further psychotic episode in the future (not necessarily linked to childbirth) but I don't know how much of a risk that is.

For others, PP is linked purely to childbirth. There is around a 50% risk of PP with a subsequent birth but that still means 50% won't go on to suffer PP again with the next baby (or hopefully ever).

Mental illness is very complex. In terms of diagnosis of bipolar, I don't know if there is a clear route of diagnosis to follow (e.g. X episodes of Y = bipolar). I'm sure there are other threads on here (try putting 'bipolar' into the search) that suggest you can get quite differing opinions even between psychiatrists.

I don't think being on lithium makes you bipolar, there are different medications out there and the treatment that works for you presumably depends on all sorts of factors, and how your illness and symptoms present.

Like I said at the beginning, this is my simplified understanding and I'm not an expert so don't rely on anything I've said!! But there are plenty of women who have PP who are not bipolar and won't go on to be diagnosed as bipolar.

I hope that helps a bit. I'm sure others will be able to share their experiences and there is also a lot of great information on the APP website at app-network.org/

Take care x

[Mims2014 in reply to Jenny_at_APP]

There's a 50% chance of having an episode again unrelated to childbirth, basically triggered by stress.

[Mims2014]

I thought I had no history of mental health problems, however I had pp in March 14 and I've been reflecting recently a lot. For about 15 years, I have periods of happiness and I'm more productive and I sleep less but have more energy and I'm much more sociable however I have periods where I lack motivation, I slept more, I'm more tired. Anyway, I basically think I've had mild bipolar and if u look at the info on bipolar, childbirth can cause onset and u may have some family that just hide it well x

[Lilybeth Volunteer]

Hello Ekich

I'm so glad you found the forum too ..... it's such a relief to know that you're not alone isn't it? Thank you for sharing your experience, the delusions are all very real and frightening at the time. As you had 'religious thoughts' I wondered if you had seen the post on here entitled "Delusions of grandeur and 'religious experiences'. The replies will also give you an insight into what some mums here experienced.

I had PP twice many years ago and eventually fully recovered on both occasions. Thankfully I am not bipolar although this is an extra challenge for some mums.

I think 14 months into recovery is very early days and you are doing very well. I was in general psychiatric care here in the UK for the first six months when PP hit after my first son was born. It took me a while to regain my dignity and place but I did it as you will too. I had a similar experience with my second son, though mostly treated at home, except in times of crisis when I was hospitalised.

There are also APP Insider Guides, i.e. "Recovery after Postpartum Psychosis" and there is also a guide for partners which might be helpful. I'm not very good at links but I'm sure other mums here will be able to direct you although you can also type into the 'search' box. You could also mention APP in your next appointment with your Psychiatrist?

Try not to worry ...... when I found APP a few years ago it made such a difference to how I felt about myself and is a great source of support.

Take very good care of yourself and be very proud of how far you have come in such a short time.

[bluestarlady]

Hi, I had PPP in March 2013 and went onto have a second psychotic episode linked to stress earlier in February this year - like many I had no previous history. My psychiatrist thinks they are potentially unlinked but other psychiatrists I have seen have waved the bipolar tag around. My family are convinced I do not have bipolar so that is helping influence my care and I even had that written into my care plan. My psychiatrist did day that treatment for bipolar these days is very effective and I do try now to follow the general guidelines for dealing with bipolar which is about taking care of your diet and managing stress. I wish I had known about the relapse rate for PPP as I would have changed my job sooner! My thought, that I have said to the psychiatrists on occasion, is that they only see you when you are "unwell" (ie in crisis) so how do they know the real "you" to make a diagnosis?

Please take care of yourself, particularly in regard to sleep & stress. I now have it in my care plan that I need to take sleeping tablets immediately that I have any problems.

S x

[skgerdes]

Hi Ekich,

I'm glad you found the forum. My PPP was 36 years ago with my second son. It was also the perfect storm of a premature baby, husband overseas in the armed service, etc. I had no mental health issues with my first or third childbirth experiences. I was in a psych ward for 2 weeks, and after weaning off my meds had a relapse. My psychiatrist diagnosed me as being bipolar. I refused to take lithium, recovered completely within a few months, and have been fine for all these years. I did have some sleep issues when I started menopause and was going through a very stressful period. Those issues were resolved with valium and some sleep hygiene habits (cooler bedroom, fan for white noise, etc.)

Over the years I have paid very careful attention to diet and exercise as a method to maintain my mental balance. There were times when I chose a less stressful path in my career, but I do have a successful international consulting business, and there are certainly times when I experience job or personal stress.

I think each mother's situation is unique. Perhaps you could work with your psychiatrist to wean off the meds gradually, while maintaining that safety net of support. It's wonderful that your family supports you. That means a lot.

I wrote a novel, "Back In Six Weeks," about my experience. I am now the Vice-President and media chair of Postpartum Support International. I am trying very hard to reduce the stigma of PPP and support moms like you. As terrible as your experience has been, you are not alone, and sadly there are a lot of moms who have had an even worse experience. Take care and be well.

[Hannah_at_APP Administrator]

Hi Ekich,

Thanks for coming to the forum and asking this question, I think it's a common one. I just wanted to share my experience, together with others to basically say I don't think you necessarily have the diagnosis but am not a professional either so hopefully this will help...

I had an episode of PP in 2009, completely out of the blue, no mental health problems before (or since). I spent 3 months as an in-patient and took anti-psychotics, had a course of ECT and also was on lithium for 3 years. I had very manic and psychotic symptoms and lost all touch with reality. I don't think I ever had the depression as bad as some, but I certainly lost all confidence and felt shattered into a million pieces, which took time to rebuild. I was certainly quieter and felt lower, quite sad in a way, but that was also from wanting to be back to "me" and move on from an awful experience, so I probably was a little depressed. From what my psychiatrist said at the time, and other professionals have also said since, Lithium is recommended for that period (or at least it was for me) and also the 3 years is linked to the psychotic episode and how long the community team wanted to have me under observation, because of the psychosis.

I have had no bipolar diagnosis and have had another baby with no recurrence of the PP - I was told I was at 50/50 risk of it again, perhaps a little higher. And also at higher risk (than the general population) of having another psychotic episode, perhaps brought on by stress or similar, so I try to minimise this in every day life as much as possible. The 50% of women with no bipolar or other MH illness getting PP also fits for me. It's a big thing for professionals to understand I think, as they seem to connect PP and bipolar or other MH diagnoses, when my understanding is that this is only for half of all women. But as others have said, perhaps the bipolar has previously been undiagnosed... I think it needs more research before a blanket coverage though.

I also had a traumatic birth and ended up with an emergency caesarean, no sleep, quick discharge home afterwards and struggled to breastfeed - all of which are really stressful and I believe could well have contributed. The main cause of PP for women with no previous history is largely unknown, but likely hormonal I believe. There are other people I have met who have had difficult births and other stresses who have also gone on to have PP... but equally others who haven't. I do think there might be something in it though, and with my 2nd child, we reduced risk where at all possible, which included a planned c-section, low dose of meds on delivery and general quiet time to avoid any possible stress. And luckily we had a very different experience.

I hope some of this is helpful to you, the APP website has some useful info and also a 2nd opinion psychiatry service if you wanted any further advice or input. Take care, I hope you continue to recover well, xx

[Lilybeth Volunteer]

Hello Ekich

I hope you found the replies here helpful. I just wondered how you are?

Take good care.

[lucinda123]

Hi, I haven't got bipolar and got PP with my little boy in Sept 2014. I worked until 2 weeks before birth and work struggled to get maternity cover. Had a week handover. Then once baby was born I had to express feed which I couldn't keep up with demand, plus family members all decended on the house when we got home so the house was very chaotic. My mil took over even giving my little boy his first bath without me!! I felt I didn't have time with my baby except at night when everyone has gone home/was asleep. Then after 9 days of no sleep I became manic. I was put on olanzapine and zopiclone for sleeping which was weaned off after 6 months. No further treatment was required. .