PP to Bipolar: I asked this question in... - Action on Postpar...

Action on Postpartum Psychosis

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PP to Bipolar


I asked this question in another thread but would like to know if anyone can interpret this article: orca.cf.ac.uk/20268/

What are the chances you will be bipolar after PP within 14 days post birth with zero history of mental illness.

Relative risk and odds are not my strong suit!

Thank you!!

13 Replies

Hi Chadlink

Thanks for this. The most accurate answer is probably on our frequently asked questions. app-network.org/what-is-pp/...

The last question, whether you'll go on to have another psychiatric illness probably answers your question the best?

I will take a look at your link, which I haven't managed to look at yet as I'm just replying quickly.

Take care


From what I can see, in this study 14% went on to be diagnosed with bipolar subsequently. Remember that some of these women may have had un-diagnosed underlying bi-polar before giving birth so in reality the number will be lower.

Also this article: bjp.rcpsych.org/content/186...

I guess I am looking for chances of relapse for a women with "out of the blue" post partnum Pyschosis and or/chances of lifetime bipolar disorder.

Hard to decipher the data. I believe I am reading there is a 60% chance or so?

This is an interesting subject. I believe that you can actually lower your risk of having any further psychiatric illness by carefully managing your diet, exercise, stress and sleep. I would suggest you read "A Mind of Your Own" by Kelly Brogan, M.D. The book primarily discusses postpartum depression rather than bipolar illness, but I believe some of the same principles hold true.

I don't agree with everything that Dr. Brogan says in the book, but I do agree with her basic premise, that you can and should take control of your mental health. If you had zero history of mental illness before childbirth, then your chances of making a complete recovery and living the rest of your life without mental illness and medication are very good.

I believe that diagnosing bipolar illness is not an exact science. I had zero history of mental illness before childbirth, rejected the diagnosis of bipolar, and have lived a very successful and happy life without medication. It's been nearly 40 years, so I think I can safely say that my psychiatrist was wrong in diagnosing me as bipolar.

Iamfree247 in reply to skgerdes

Gosh it makes me so reassure to know that you challenged your diagnosis, I was the same....my psychiatrist wanted to diagnose bipolar as I had pp after both kids and previously one psychotic episode when I was younger,so he said technically this put me in the category of bipolar.I fought it though as I have never had clinical depression or manic episodes apart from pp which was mainly psychotic and high mood but I function as normal as anyone else in day to day life. I went to see the local psychiatrist team recently and even she didn't like that I had challenged this!?!xx

Hi Chadlink,

Not an easy article to decipher and I have just read the abstract rather than the full text. I mainly picked up the point that 14% of women who had PP were later diagnosed with bi-polar within a 15 year follow up period.

The link that Ellie provided is a lot clearer:

" over half of women with Postpartum Psychosis will experience an episode of depression, bipolar disorder or related illness at some point in their lifetime. (This estimate includes women with and without experience of mental illness before their PP episode, and so the risk may be lower for women whose PP episode was ‘out of the blue’.)"

Many of us never have any other psychiatric illness again and go on to lead perfectly normal, fulfilling lives. It is a fascinating subject though, my son, aged 32 , was recently named diagnosed with bi- polar disorder which makes me wonder about genetics. No other family history though other than my blip 34 years ago. All the best to you Vee X

chadlink in reply to Vee82

Thank you Vee82. How is your son dealing with his diagnosis? I hope all is well

Thanks Chadlink. He was initially diagnosed with depression on anti- depressants for a year or so, and then a bi-polar. It was heartbreaking to see him struggling with depression and then anti-psychotics. It brought back so many painful memories.

However, he is doing well, off all medication and just about to finish his PhD .

Every cloud has a silver lining, it fuelled my interest in mental health issues which brought me to APP and this excellent forum which has helped me come to terms with my own experience which I had buried for over 30 years. I cannot thank you all enough.

Best wishes Vee xx


Hi Chadlink

Sorry I didn't write more fully earlier. I have just had my son's 5th birthday party yesterday and so was very busy with that.

I'm glad to see Vee82 has quoted what is on our website, which is what I wanted to do. APP is made up of leading perinatal mental health clinicians, and women with PP and we do look at all research etc about PP and the information on our website is the most up to date and accurate.

The other bit of relevant information is on our 'what is PP?' section. In there, under diagnosis, it says:

"Postpartum Psychosis is the label used by most professionals for an episode of mania or psychosis with onset soon after childbirth. However, other names can be used and this can be confusing. You might hear the terms: Puerperal Psychosis; Postnatal Psychosis; Mania or Bipolar Disorder triggered by childbirth (this doesn’t necessarily mean that your partner will develop ongoing Bipolar Disorder); Schizoaffective Disorder with onset following childbirth (this doesn’t necessarily mean that your partner will develop ongoing Schizoaffective Disorder); Postnatal Depression with psychotic features.


So you can see with diagnosis it is very confusing. And it is true that some professionals diagnosis the same illness with different names.

I hope with all this information it creates a clear a picture as possible!

I personally feel the same as what many others have said above - I wouldn't feel comfortable with the diagnosis of bipolar as I haven't had a psychotic episode outside of childbirth, and wasn't ill before I had my son either. My diagnosis was postpartum psychosis, rather than bipolar. However I am aware that there is a risk that I could become ill in the future so I do try and look after myself, limiting stress and doing things that make me feel good.

I hope all this information is helpful - keep asking any questions you need to


Thank you Ellie. My wife is doing well, but we still struggle with the idea that she may have this underlying mental illness...more so not because we are scared of the stigma, but just hard to believe because she has never had any symptoms outside of this PP case or even light mood swings. Most stable person ever met....with that said we just want to understand that it is indeed possible to have full blown PPP out of the blue and recover fully with no other illness. It has been 3 months not almost and the past 2 weeks have by far been the best. 8-9 hours of sleep a night and most if not all delusional thinking, racing thoughts, and confusion have gone away. We mainly deal with social anxiety, some processing, and that's about it.

Hoping it continues to get better!

Ellie_at_APPAdministrator in reply to chadlink

Hi Chadlink,

Sorry, I've just realised after Lilybeth wrote that I didn't reply to you after you wrote over a week ago - huge apologies.

So good to hear your wife is getting better. Sleep is definitely a great healer, and so important. I hope she continues to do well?

I would try not to worry if this is something she will have for the rest of her life. It's good advice I think to just focus on the 'now' and supporting her to recover. I can imagine the thought she may be ill in the future is quite anxiety provoking for both of you. The majority of people make a really full recovery, and don't go on to have any other relapses etc. i think what I have tried to focus on during recovery and now, is how to stay balanced and well, something I didn't do so much before PP, which I think is a good thing really, focusing on my needs, and doing things that give me life and that stay well (for example for me I'm trying to do yoga, meditation, some art etc).

I remember someone I know who was a psychiatric nurse who said if you were to get any kind of mental illness PP is actually the best one to get because you recover really well from it, and often doesn't have any long lasting effects. Not sure if it's 100% accurate but that was but it's nice to hear somehow!! And I think it is true - the majority of women recover really well from PP, with the right medication and support.

I have been really well, happier even than I was before PP, since I recovered from PP, and so are many other women I've met through APP. I hope that we give you hope!

Take care, and keep writing whenever you want X


Hello chadlink

It's best not to dwell on the whys and wherefores of your wife's illness ..... all you can do is support her in the here and now. I know it's hard to believe PP has struck because she never had any symptoms, etc. That's the case for many of us here ..... all very stable and looking forward to our babies being born and all hit with, as you describe, full blown PP out of the blue.

I can reassure you that although I was very ill and could not have ventured out socially as early as your wife has, I fully recovered and have had no other illness, except low moods relating to other life events.

Your wife is doing really well in such a short time and you must be very proud. It does make such a difference when the delusions and confusion fades. I hope your wife continues to do well and you can look forward to many happy times as a family.

Take care.


Hello chadlink

I hope your wife is continuing to improve and is keeping well. I'm sure you are a great support with all your care and understanding.

Take care.

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