17 Months after PPP

[Ekich]

Hi all- I came down with PPP in September 2014 after the birth of my daughter. My psychiatrist thinks I am bipolar. I have never had any history of mental illness though and I do not think I am bipolar. I am still on Lithium but I have been slowly decreasing my dosage. My question is- how do you know if you are bipolar or not? Do I just continue to wean off my meds and see how I do? Wondering how other people have handled this? It's been 17 months now that I've been on Lithium. Anyone out there who was diagnosed bipolar but was actually not? Would love to hear from you! Thank you!

[Lilybeth Volunteer]

Hello Ekich

Welcome back to the forum. I don't have any experience of bipolar but there will be mums here who can help and advise you. In the meantime if you search 'bipolar' on this forum you will find a few interesting posts and replies.

Try not to worry ...... you are doing very well only 17 months into recovery from PP.

Take good care.

[Hidden]

Hi!

I had a similar experience to you in December 2014 and I was diagnosed as bipolar after one episode of PPP. I too didnt think I was bipolar and my psychiatrist in my home town said it was a snap decision to make after only one manic experience and i came off lithium after about 5 months and have been fine for the time being.

I am now pregnant again and was experiencing a major low coinciding with conception and went to see my psychiatrist who said I am depressed and has given me the diagnosis of bipolar himself this time.

The best thing you can do is to wean off the lithium and see how you feel in yourself after a period of time. I still dont think i am bipolar, i only feel off balance when pregnant/post delivery so will try to avoid lithium after birth.

Best wishes

Xx

[Ellie_at_APP Partner]

Hi Ekich

Thanks for your post. It is a good question, and I know you posted something similar a few months ago and got a lot of responses.

I too had no mental health history before PP (which was 4 and a half years ago for me) and I have not been ill since I have recovered from the PP.

I do know that technically postpartum psychosis is not a diagnosis in itself, but is put under the 'bipolar' diagnosis - so technically your psychiatrist is right. However I think a lot of psychiatrists do like to differentiate between bipolar and postpartum psychosis as many women do only become ill after having a baby and never have another psychotic or depressive episode (though you are more at risk once you have had one psychotic episode), and also the psychotic episode postpartum is often more acute than a 'normal' high / psychotic episode if you do have a bipolar diagnosis.

If you are in the UK, and do want a second opinion about treatment / diagnosis etc you could ask your psychiatrist, or GP, to refer you to Dr Ian Jones in Cardiff for the second opinion service - app-network.org/what-is-pp/...

Are you weaning yourself off medication with your psychiatrist's permission / support? I would not recommend coming off medication yourself - many women on here have shared how they became unwell again when they did this. It's really important you take your psychiatrist's advice. Do you feel you differ from your psychiatrist in terms of what treatment you should have (e.g. does your psychiatrist want you to stay on medication, and you want to come off?) if so the second opinion service would probably be a good thing to ask for.

I hope this is helpful, and it's good to hear you're recovering well.

[bravesurvivor411]

Hi ekich,

I had pp about 21 months ago. I never had mental illness problems myself however my sister had a small nervous break down in college due to stress and my grandfather had some sort or episode and was in a psych hospital for 6 m. So it does run in my family.

I to was diagnosed with bipolar from my first psychiatrist he said that it could have been a first episode since I have been well in the past. I saw another psychiatrist and she was nicer about the delivery of the diagnosis( I was crushed after the first diagnosis...and scared because the doc was so blunt about it) but she said the same thing. I saw a 3rd doc who is more conservative with meds and not as rude and she takes a stance on watching symptoms and taking care of myself. Over the months I have came off of Invega(antipsychotic) and Prozac and currently finishing up on lamictal. All by being monitored. But I believe I handle stress and moods differently now. I can see how it could be easier for me to slip into depression but not psychosis. To remedy that I do a lot of work on myself. I see a naturopath doc for natural supplements and diet help. I saw an acupuncturist for a year and have done other healing modalities too. So if I am bi polar I am contracting it by prevention. I also am a huge believer in diet and lifestyle playing a major part in mental health.

Many times over the past 20 months I have wanted to cold turkey quit my meds. I was talked out of it by friends each time. I'm so glad I didn't. Because there is a time and a place for meds and I'm glad I have them if I ever become psychotic again. Hope this helps. I also wrote a post about a year ago with the same question as you. And there were some good replies.

hope you and your baby girl (well toddler😀) have a great 2016!

[Vee82]

Hi Ekick, such an interesting question you pose and I wonder how the psychiatrists differentiate between the two paticularly if there is no history of mental illness before.

I had no history of mental illness but became manic after the birth of my first child, I had no insight at the time of course but was sectioned and placed in a general psychiatric ward for 8 weeks and dosed with haloperidol. this was followed by a crippling depression. I was diagnosed as having ' peurperal hypomania' and until a few months ago didn't even realise it was a symptom of PP and bi-polar of course. The whole episode was just too painful to think about so I buried it and got on with my life with no problems since. This was over 30 years ago and interestingly my son has just been diagnosed as bi-polar although treated with depression for a year before, so I guess it brought everything to the surface again. Anyway all the very best to you. Vee Xx

[JaneHW Volunteer]

Hello, I gave birth in dec 2010 and by feb 2011 was suffering from PP symptoms and was saddled with a bi-polar diagnosis. I was furious about the latter ( still rather high!). I think the rationale was that I had had two depressive episodes prior to giving birth ( but still fairly small scale, handled by GP) and a fairly obvious hypo manic then manic episode post-natally, then followed by a very serious depression. In other words, I had experienced both 'poles'.

Like you, after a period of time ( can't remember how long exactly) I began to recover to the extent that the whole episode felt well and truly in the past. I was bright, busy and could hardly remember being any other way. We started thinking about another baby and were advised that to reduce risk of birth defects I should come down slowly from lithium. I managed to do so, but began to feel unwell again in the process-- felt very cross all the time and unresonBly annoyed with people. I had apparently launched myself into a bi-polar 'mixed episode'. There were obviously risks attached to coming off the lithium too... Thankfully I then found some better advice and reinstated the lithium.

I think after that I just sort of made my peace with the diagnosis. I was responding to the lithium well, also taking a bi-polar antidepressant alongside. One psychologist I worked with was very interesting on the subject. she said that It was unhelpful to view this label of 'bipolar' as a predictor of how the rest of my life would be-- a series Of highs and lows thst one should brace oneself for and be constantly watching out for. Rather to view it just as a map of where I had been. As something in the past to be aware of, but no more than that.

I'm not sure if any of that resonates with advice you've been given, but that's roughly how I handle it. I don't like labels in general, least of all if applied to myself and especially when they're as contested and loaded as 'bi-polar'. It's an uncomfortable business and it's difficult not to get hung up on it to some extent.

All best,

Xx