No pp with second child. Bipolar disorder after postpartum phychosis?

[violetx]

Hi all

Ive shared many posts previous of my experience of PP with my first child. I went on to have another who is now 10 months and i have remained well. You will find details of my care plan and strategies of worrying whilst being pregnant and dwelling on becoming unwel again if you are reading this and are pregnant you may find helpful.

Anyway, i had a review today with my phychiatrist. I had lots of questions about what now and long term. She mentioned before i was queiried bipolar. I had no mental illness before I had my son and then i become phycotic and diagnosed with pp. So i said to her so does this mean iam now bipolar and she didnt really give me a straight answer. Just that under the bioploar disorder spectrum as its linked to high/low mood and mania which makes sense. But ive remained well since my first experience.

So my question is, is this the same to all of you aswel? I understand that our mental health is more vulnerable. So the title bipolar disorder i suppose is in black and white on my notes and phychosis if i was needed to be looked up. She also said its put down so if i were to fall unwel it is down for a clinical perspective and they would then know exactly what meds help etc i would need. I dont know just felt a bit low after the appointment.

Thats why i was asking all the questions as it was my last appointment with my phychiatrist who ive had for 3 years. They are now changing me to a long term team and she deals with people from early intervention.

I mean i do still get days where i can feel really low. But also get high and happy on things too. I just fellt slightly saddened of the thought of always having to rely on meds. But i dont want to cause negative vibes onto anyones eles, its nothing to be ashamed of. I think what happened in the beggining was me at my worst and im certain that it cannot get that bad again with health professionals in place. I just didnt know that bipolar was anything to do with it.

Im no longer ashamed of having Postpartum phychosis. I wouldnt change my children for the world. From this experience i will continue to make all the positives i can out of it even if it means giving someone comforting advice on this forum.

So am i right in saying that post partum phychosis is or can be linked to biopolar.

Could it be possible that i had it all along but it went unnoticed??

Any knowledge/advise would be appreciated

Thanks in advance

Violet x

[Hannah_at_APP Administrator]

Hi violetx,

I too had PP "out of the blue" with my first child and remained well after my 2nd child. I don't think bipolar has ever been mentioned to me although the appointment when I was discharged from Early Intervention was before I had my second child, as I had a longer gap than you between babies (4 years). I too asked lots of questions then and was just told to make sure to have plans in place for any future pregancies, which I did, and happily that turned out well.

As you will probably know, the risk of PP in the general population is 1-2 in 1000. For women with a pre-existing bipolar diagnosis, this rises to 1 in 4. I have also known ladies who have received a bipolar diagnosis after PP as they had previous episodes of low or high mood that were never serious enough to warrant treatment, and those who have had further episodes afterwards which confirmed a diagnosis. There is more info about further episodes of illness on the PP (linked to childbirth or otherwise) under FAQs: app-network.org/what-is-pp/...

There is a particular possible link to times of hormonal change, such as menopause, but more research is needed. This is mentioned in the last point on the above link. I know it's something that I will be on the lookout for. I also try to monitor stress levels (& avoid it where possible!) and generally look after myself. To me, nothing is worth getting ill again for!

I know how you feel about relying on medication, and whilst taking meds I was desperate to be off them, as it felt like a reminder. With hindsight, I know it helped me to get well and stay well though, so I'd like to think if I needed to take anything now, for whatever reason, I could see the benefits. People take tablets for all sorts of physical health problems, so why it shouldn't be the same for mental health as well. Sadly the stigma can still be difficult.

I also wondered if you are in the UK and have considered accessing the APP 2nd opinion service? app-network.org/what-is-pp/... Prof Ian Jones is a world expert in mood disorders, including PP and bipolar. Whilst I had a consultation linked to my 2nd pregnancy, he will consider referrals not linked to pregnancy from women who have experienced PP and would like further info and guidance. I found it really invaluable and your GP or psychiatrist can refer you at no cost to you or your health authority area.

Sorry to hear that your review today has left you with more questions, I hope some of my reply will be helpful to you. It's positive that you have found the forum to be of a comfort and also in sharing your experiences with others. Like you, I would not change my children for the world, and you're right - PP, or any other mental health diagnosis, is nothing to be ashamed of.

Take care, xx

[violetx in reply to Hannah_at_APP]

Thank you for your reply. I agree at the end of the day if taking medication keeps me stable then so be it id rather that then be away from my children. Thats the thing the stigma, if no one has experienced these types of ilnesses they are very quick to judge.

I have had replys before regarding Ian jones and i think it is something i will look into.

Take care xx

[skgerdes]

Hi - I have not been on the forum for a while. I had PP with my second child, but not with my first or third. I think that there is a tendency for psychiatrists to put that diagnosis on all moms who have PP.

I think that the most valuable thing you can do is to realize that you might be vulnerable, but not worry about a label. My advice to moms with PP who want to have another child is to wait a while to give yourself time to stabilize. I waited 6 years, and by that time PP was only a distant memory. I had regained my self esteem and was very stable mentally. Also, my family was super supportive in the next pregnancy.

There's lots of things that you can do, such as hiring a doula, pumping your milk so you can skip one late night feeding, reducing stress in your life. All will help you maintain good mental health.

As far as non-pregnancy, I try to maintain regular sleep habits, eat a balanced diet, exercise regularly, and do some type of meditation or positive mental attitude reading. The only time that I had issues was during menopause, and that all resolved with time. You might need some brief hormonal therapy and extra self-care during that time. Also, for international travel where I have to jump a lot of time zones, I use a sleep aid. I've been well for almost 40 years.

[violetx in reply to skgerdes]

Hi thank you for your time to reply. I know sleep is so important and that is my main thing i focus on. The meds have made me flatuate in weight so much. I do enjoy going to exercise classes when i can.

I need to go find some positive reading im sure that will help too.

Im so pleased for you that you have stayed well for long. It just shows that its key to focus on yourself.

Take care xx

[suzannah0]

Hi I got brief reactive paychosis 5 years before being pregnant with PPP. At the time the psychiatrist in the hospital wrongly diagnosed me with schizophrenia. Because of my family's story and coz I was so worried in hospital. The psychologist a few days after said no way and my go a few years later said never mention the diagnosis of schizophrenia to anyone again. Drs can get diagnosis wrong. When I had pp in hospital they were worried re bipolar which made me worried so much that I ended back in hospital voluntarily. I recovered so well they said no way again. So I guess my story is just get better and prove to those doctors that you are fine! Take the medicine when you need it as per Drs prescription but don't worry re labels