Diagnosed with Bipolar really desperate for a baby aged 40 with PCOS! help!!

[Bluelady-sing]

I really want to try for a baby next year what are he option guys, what do I do about meds

[Hannah_at_APP Administrator]

Hi Pumpkins and welcome to the forum.

It's good that you have found us and I hope there will be other shared experiences here that will be helpful to you. With a diagnosis of bipolar, you may be at higher risk of a postpartum psychosis - something which we have all been affected by here. I had an episode of PP in 2009 "out of the blue" after my first child was born, but stayed well after my second in 2013 and do not have a bipolar or other MH diagnosis. There are lots of ladies here who do though so hopefully you will get some shared experiences from them too.

APP produce some great information about PP and also pregnancy when you are at risk, such as with a bipolar diagnosis, here is the link: app-network.org/what-is-pp/...

Bipolar UK also have some good info and their Guide is at the bottom of the above link, the APP website also has this info on Bipolar & Pregnancy: app-network.org/what-is-pp/...

Pre-conception advice can be invaluable when considering a pregnancy, I don't know if this is offered where you live? If you are in the UK, there are some teams but not in all areas. If you are already under a MH team, perhaps you can ask for an appointment to discuss your options, or ask your GP to be referred for more support. Sadly my experiences are that services can be patchy in different areas so APP also offers a 2nd Opinion Service with Prof Ian Jones which your GP or MH professional can refer you to, with no cost to them or you. Here is another link about that: app-network.org/what-is-pp/... I had a consultation when pregnant with my 2nd and it was absolutely invaluable, pulled all the relevant info together and gave my midwife and others locally the specialist info that was missing, as I was not under MH services anymore.

As for medication, again a professional will be able to advise you on this. There are some meds that can be taken safely and some that are best avoided. Overwhelmingly it is important to ensure a well mother in order to have a well baby too and there is no shame in taking medication if you need it. The same also goes for breastfeeding and whether you choose not to due to medication or other factors.

I hope that some of the links and info here is helpful to you, please feel free to ask any more questions and all the best, xx

[Orea]

First of all, don't panic! I would follow all the advice below, and you can ensure you get good MH support as and when you get pregnant. Make sure you are well tied in with community mental health team, midwife, and the secondary advice service as listed by Hannah. Be worth while checking how close you are to an MBU just in case. Good luck!

[Cicerenella]

Hi Pumpkins,

I have a diagnosis of bipolar type I, and am currently trying for a baby. I had an unplanned pregnancy just under three years ago, and my son had complications because of the meds I was on. So, it's been really important this time around to plan getting pregnant. I think my best advice would be to have a really frank conversation with your prescribing doctor about what your options are. Some meds are reasonably safe in pregnancy, and some are not - but your choice about what to take will be largely dictated by how "severe" (for lack of a better word) your illness has been, how well controlled it is normally, and what medications or other therapies have worked well for you in the past. I feel that it's really important that if you change, reduce or cease medication that you keep in contact with your psychiatrist so they can keep a check on how you're travelling - also keeping in mind that some medication which is unsafe in the first trimester may be ok later on in the pregnancy. Other therapy like CBT or interpersonal therapy (etc), and psychoeducation, is also really helpful in making sure you have strategies to notice if and when you're becoming unwell.

As far as PCOS goes, that's something you'd have to discuss with your GP. Antipsychotics can make you a more insulin resistant too, which could make symptoms of PCOS worse if you're on them. If you're overweight because of meds that again makes PCOS worse, and even a really small reduction in weight (5kg) can increase fertility tremendously.

On a personal note, my pregnancy planning has been centered around being on drug monotherapy - so I am only taking 10mg of olanzapine, and have stopped taking valproate (which is teratogenic). Being on olanzapine puts me at higher risk of getting gestational diabetes, but to me that is much more manageable than having a bad manic or depressive episode. I've had this reduced amount of meds for almost three months now, and so far so good. Now I just need to actually get pregnant (we're in that horrible two week wait at the moment, so fingers crossed!!).

[boat1]

Care plans are a lot better now. The thing that I found was having an epidural really helped. It cut the pain which I found hard to deal with and also the stress lack of sleep / rest. Sort this all in ur care plan. The hospital shud keep u in for longer if you have a baby. The nurss can help with night feeds ask family too to help when u at home.i tuk Quetiapine short time v Gd for helping you sleep even a small dose. Just rest try to sleep as much as possible and all shud be ok. And pray lol

[boat1]

As for quitting meds during pregnancy it's tricky and high risk. I was ok without and hated the idea of taking meds when pregnant. But I can't say that wud be the cas for you. Assess ur life how stable and stressful it is. Some meds like lithium can be taken after 26 weeks or others in 2nd trimester. The first trimester is imp to avoid meds unless I have to.play it by ear

[Bluelady-sing]

Worried that I won't be able to enjoy being pregnant negative treatments form CMHT

[Ellie_at_APP Partner in reply to Bluelady-sing]

Hi Pumpkins,

If you don't have a perinatal mental health team in your area which specialise in supporting women with perinatal mental health, and don't feel you've had positive experience of your CMHT do ask your GP or your mental health team to refer you to the second opinion psychiatry service with Dr Ian Jones who specialises in bipolar and PP. He would help you to think about what you need to put in place, advise on medication, and write to whoever would be supporting you to ensure you get the right support. It is free to access - for you and your funding authority.

The link is here: app-network.org/what-is-pp/...

I do hope that things go well with your thinking and planning.