Very scared about future

[mfc83]

Hi all, I have been reading very scary information about a high risk of having another psychosis episode for people that had PP and also that it is common that PP is the begging of bipolar disorder...I am not sure wether these sources are reliable. My understanding was that PP is normally a once in a lifetime thing (unless you want to have another baby) and now I am deadly scared that this might be just the beggining of a lifetime filled with psyquiatric illness. Please somebody can calm me down? Thanks!

[Jocelyn_at_APP Partner APP]

Hello MFC83,

Thank you for reaching out to us.

You're right, PP is a very scary illness but is also very treatable. I had PP 5 years ago and haven't been diagnosed with bipolar, but I know some women who have. I know that the women who been diagnosed with Bipolar after an episode of PP are able lead a fulfilling and 'normal' life - what ever 'normal' is really! - with the right input from doctors.

I know women that have had PP with their first *and* second baby, other women just with their first baby and other women just with their second baby. So as much as there are those statistics and information, you just never know. There is so much support available now though throughout the perinatal period and with Bipolar.

It might be worth having a look at the FAQs on the APP websites : app-network.org/what-is-pp/...

Please don't be scared, with the right support and information, if you were to be diagnosed with BP, it can be managed. I know many wonderful women who do.

I am sure some of them will be able to share their experiences with you.

Thinking of you and we're here for you.

Xxc

[Maria_at_APP Moderator]

Hi mfc83

I empathise with you, I had pp in 2018 and I have not had a diagnosis of bipolar disorder, but the memories of my psychotic period are still fresh in my mind and not a place I want to revisit ever again (or anyone else to go through that, for that matter). Despite the intensity of this illness, mums do recover from pp and go on to live full lives after it, it takes time and it will have its highs and lows, but it is possible.

My personal experience of pp I'll say has made me more succeptible to some situations which would not have affect me as much before. On the other hand, I have gained a good deal of self awareness which helps me to try to seek help early from myself (by being compasionate to myself) and others before my mental health takes too much of a dip. What I try to say with this is that despite having struggled somewhat more with my mental health since having had pp, I have also gained some tools to counter those situations.

Take good care, we are thinking of you and write here whenever you feel the need to, sending you a hug from a distance

[AlexandraJay Volunteer]

Morning msc83,

Sorry to hear you are so worried. I did have post partum psychosis with both of my children and was diagnosed with bi polar disorder which I disagreed with and stopped taking medication. I stopped taking olanzipine when my son was 3 months old and was doing relatively well for four years until this summer when I had a manic episode not related to childbirth so now I know for sure it's bipolar. I will continue to take the medication to keep me calm and balanced. I don't want to worry you or scare you, I just want you to know that even bi polar can be managed with the right medication. Hope you stay well. I'm here if you need to ask any more questions. This isn't the case for everybody but this is my story. Best wishes xxx

[Varvarita]

Hi dear mfc83!So sorry for you and i feel your pain deeply. Everything will be back to new normal, i promise. All amazing women on this exceptional forum are living proof.

Have some thoughts based on my personal experience.

1) on bipolar-or-not. As i got from your previous posts you are currently fighting with anxiety and your doctor doesn’t want to give you antidepressants not to trigger relapse.

In my experience this is a protocol many psychiatrists follow when they deal with PP or/and when they assume that PP might have triggered the debut of bipolar.

may i ask - was your PP manic? did you have delusions or hallucinations? and how long were you on olanzapine?

i was very manic for 3 weeks before i was hospitalised with delusions and hallucinations and they were scaring my family that it might have been a debut of schizophrenia or bipolar.

they gave me a bit of haloperidol to stop the hallucinations , then a couple weeks of shots of olanzapine to battle with delusions and then i was switched to aripiprazole to hush my mania. mania was gone in 4-6 weeks but i continued with aripiprazole slowly tappering off month by month and in total i was on atypshichotics for 7 and 1/2 months. i was never manic or mentally unwell before PP and so far i had no relapse (it’s been 14 months since my PP)

I was also scared like you that my anxiety will not go away and that i have become bipolar and during my long first year of PP recovery i talked to 5 different psychiatrists and read every article on the subject i could find (being worried about all of that was not helping with anxiety either)

i came across broadly two schools of thinking:

a)one school is that - unfortunately - any episode of mania (even if it is a part of PP, triggered by birth hormones of a previously mentally healthy person) is a sign of a debut of some kind of bipolar process. it doesn’t immediately mean that it will be classical bipolar I, when mania will be followed by depression which will be followed by new mania again and so on - for some it’s mania once and then a lot of resisting depression after, or mania can come back after next birth, during menopause or during some stress, lack of sleep and exhaustion. this category of doctors would suggest that i start antidepressants only along with antipsychotics to prevent the possibility of relapse and that i continue with normotimics (lamotrigine in my case). also when it comes to bp there’s an opinion that only fluoxetine (prozac) may work and other antidepressants don’t fix bipolar depression.

b)the other view is like you said - that it’s likely a once in a lifetime event, mostly linked to hormones and stress, and lactation(prolactin), which happens to a woman only postpartum and may not even happen again after her second/third/etc birth. as i never had any mental health history in the past or in my family , and i had enormous lactation, i hoped this is my case and sticked to the advice of those psychiatrists who supported this view.

....finally i met a doctor who said that this all happens to be true, that’s why it is so complicated and that it takes time to monitor the particular patient (about a year) and see what’s her particular case: there are people who will have PP once, as a reactive psychosis, there are people who will have PP after every birth as a reactive psychosis, there are people for whom birth triggers debut of bipolar or schizophrenia, and also there are people who were bipolar previously but they had bipolar II (only hipomania, not full blown mania) and they just didn’t know that about themselves and that their bipolar escalated from bp II to bp I during PP and became obvious.

however what i learned talking to people on this wonderful forum is that manic episode of PP is very,very often followed by severe depression (your anxiety in the chest region is one of the symptoms) but it doesn’t immediately equal bipolar! this old school standardised psychiatric view that any mania followed by depression equals bipolar processes doesn’t always seems to be the case for this unique illness of PP. but due to its unique nature and case-by-case peculiarities your psychiatrist has to be brave and experienced enough to develop correct personal approach towards your treatment.

2)on anxiety.

i lived 7 months with the kind of anxiety you describe, at first they said it’s due to antipsychotics, then they thought i’m just sad and nervous after PP, then they thought i might be bipolar and that this anxiety/depression will be followed by new mania. then my anxiety turned into insomnia and i stopped sleeping at all - but still no relapse of mania! and only after 11 months of anxiety (out of which i had 4 months of insomnia) they finally concluded that i’m not bipolar (no relapse within a year) and gave me antidepressants (prozac), and anxiety went away pretty quickly. like in a month. i was not taking any antipsychotics or normotimics along with prozac and still there was no relapse of mania. which is another kind of proof i’m not bipolar.

before prozac i tried EVERYTHING i can think of to battle anxiety- talking therapy, Erikson hypnosis , yoga, mindfulness, sports, getting back to work, being a full time mom, journaling, moving to seaside, vitamins, spiritual practices, and sedating meds like clonazepam - nothing helped to turn this anxiety off. but prozac helped!!!!! my point is that in my case medication was the only solution as my PP turned out to be comprised of two pieces - psychotic mania+anxiety/depression/insomnia and still it didn’t mean bipolar (if it was bipolar, prozac would have already sent me to mania again)

sorry for such a long story .

my main point is that if it’s your doctor’s projection that you may have bipolar is keeping your doctor from giving you antidepressants - you probably have to look for a second opinion and maybe not wait as long as i did with your anxiety and see if antidepressants (combined or not combined with antipsychotics depending on your doctor’s opinion) help you. or just aks your current doctor how long she/he is planning to wait until she/he gives you antidepressants.

take care

xxx

[mfc83 in reply to Varvarita]

Hi Varvarita, thanks a lot for this detailed and super useful post. I hope that it is my case as well, that the psychosis was just an isolated episode in the context of giving birth and that now I am just struggling with a bit of anxiety/low mood in the mornings. I will ask my psyquiatrist the next time I see her, but I guess that the fact that she doesnt want to give me meds is in general also a good sign. Take care

[lillyofthevalley37]

Hi sorry to read you are scared about the future but you shouldn't be I think knowing the cause of pp really helps to lessen the fear , my sister had ppp and went on to develop bipolar disorder but that isn't the case for everyone My sister s bipolar disorder was never really successfully treated with anti psychotic drugs and whilst I know the importance and value of antipsychotic drugs I do think hormones play a vital part in ppp , after giving birth the hormone progesterone drops dramatically giving rise to estrogen dominance which can be problematic, causing autoimmune disorders such as hashimotos and also ppp , supplimenting with natural progesterone cream seems to me a valuable complementory therapy, I suggest you do your own research into the calming properties of natural progesterone

[Bluelady-sing]

Pp is not bipolar, you WILL recover.