Worried about pp risk

[Mintchocchip89]

Hi. I’m don’t have any children and am not currently pregnant but my husband and I have been trying to conceive for a few months.

I’m worried though about developing pp as I’ve read I’m higher risk than the general population (my mum has bipolar, triggered after giving birth to me) - and though I don’t have bipolar myself I do have anxiety issues (as well as health anxiety) and ocd tendencies. I’ve never been on any medication for my own mental health - my anxiety and ocd stuff always gets worse when I’m feeling stressed, but is okay/manageable most of the time.

How high is the risk that I’ll develop postpartum psychosis? Is there anything that can lower the risk? I’m also terrible at taking tablets, I find even tiny pills hard to swallow so I’m also feeling anxious at the thought of, if I were to become unwell, potentially making recovery worse.

Not sure how relevant this is but I’m 33, and my mum was 27 when she was diagnosed with bipolar.

My husband and I really want children and don’t want to delay any longer but I’ve been feeling really anxious about the risk of pp and sad at the prospect of no pregnancy.

Sorry for such a long message.

[Lilybeth Volunteer]

Hello and welcome to the forum where you will find lots of support. Thanks for reaching out as I can understand your apprehension about developing PP due to your increased risk.

I wonder if you can see the forum page with your post and at the side Related Posts, one of which is “Risk of PP” with replies and links which might be helpful? There is a lot to weigh up but although devastating at the time, PP is a temporary and very treatable illness.

I had PP twice, many years ago, six years apart. Thankfully there’s a lot of support available so I wish you well with your choice. There will be other mums here to share their experiences but for now I hope you find the Related Posts helpful.

We are here to lean on .... take care.

[alisonrw Volunteer]

Dear Mintchocchip89

Thank you for getting in touch and welcome to the forum. You have found a good source of information and support here. I understand your concerns about being more vulnerable to PP as I was in a similar situation when planning my pregnancy.

I think the chance of developing PP is different to each person and broadly depends on whether you have a bipolar diagnosis, have experienced psychosis outside of childbirth or have had an episode of PP before. I understand that vulnerability to PP falls significantly if these factors aren't present. If you have a close relative that has experienced PP the chance of developing PP is slightly higher than the general population, but not as much as if you have the diagnosis of bipolar or have experienced psychosis yourself. You are doing the right thing by finding out more about PP and I believe this can increase the chance of staying well.

I was at higher risk as I had experienced psychosis myself outside childbirth. I was concerned about becoming ill and took steps to try to manage my pregnancy and mental health during this time as I knew I could be vulnerable to relapse of symptoms.

I had preconception counselling with my GP and was referred to a specialist perinatal mental health team by my midwife early on in my pregnancy. At one of my first midwife appointments, when we reached the questions about mental health in the green book notes, I gave information about my mental health history and we discussed referral to the perinatal mental health team. I was able to access support from the perinatal mental health team after this referral. I also looked at information on the APP website to find out more about PP and things I could do to stay well.

If you feel comfortable doing so, would it help to raise these concerns with your GP? They may be able to offer preconception counselling. Broadly this would involve speaking about your individual situation and the steps that you could take to maintain mental and physical health for pregnancy, as well as talking through things that could help while you are trying to conceive.

Please keep in touch and ask if you have any questions - there are so many supportive people on this forum.

All the best,

Alison

[AuroraDis]

Obviously I cannot comment on your individual risk but I just wanted to offer some reassurance that I have been in that same boat and know how it feels to worry about the unknown. I have a diagnosis of bipolar disorder and like you longed for a family but was fearful of PP. I researched alot before conceiving and throughout my pregnancy and was as prepared as I could be. I wrote out a signs and symptoms plan for my husband and what he should do at each stage and agreed it in advance so that I could have as much input in my care as possible. As it happens I was perfectly fine after having my little boy and so far 15 months later I'm back at work and our plan still sits in a safe place to be brought out again next time!

My advice would be to read up as much as you can so that you and your family are as prepared as you can be and know how to access support if you need it but try not to let it weigh too heavily on your mind. Focus on staying positive and remember that while it could happen, it is a risk not a guarantee, so all you can do is prepare for the worst and hope for the best!

Good luck with your conception and pregnancy journey!

[HelenMW Volunteer]

Hello there, thank you for posting. Never apologise for a long post , we are here for you.Just thought I would share a little. I am 62 and had PP in 1988. I did have two more children without PP. My daughter had a baby 5 years ago and she was a little concerned like you, knowing I had PP after her birth. Well the good news is that she was absolutely fine. Because she had a Caesarian at the last moment I was able to be on stand by for any lifting and driving. She lives in the next village and I popped round every morning and was able to take her to all the check ups and such for the 3 months as she recovered. It was such a relief for me to watch her through the post natal period and be well. So unlike me, I had moved from up north to down south and had no support in 1988. She had support and I think that was a tremendous help.

I wonder if you can access any of the talking therapies or CBT for your anxiety?

I really wish you well and hope you feel able to post again as you go on your journey.

Warm wishes and blessings, Helen x

[Naomi_at_app Volunteer]

Hi Mintchocchip89

Thanks so much for connecting with us at APP, and I'm really glad you've been able to share your understandable worries about what your risk of postpartum psychosis might be.

The FAQ's on our website give some statistics that having a first degree relative who has had postpartum psychosis (rather than bipolar like your mum) is around 1 in 30, compared to the risk of around 1 in 500 in the general population. I know you said your mum was diagnosed with bipolar disorder after your birth, however as you say - probably the most significant risk factor would be if you had suffered from bipolar disorder yourself.

It's really good that you know yourself so well, and recognise that you do experience health anxiety - so it's very positive to reach out for some support as you navigate these worries about PP whilst you are trying for a baby.

Pre-conception Zoom appointments are available free on the NHS with Ian Jones, who is a specialist perinatal psychiatrist and researcher in bipolar disorder. It might be really helpful for you and your husband to chat through some more of your mum's history and how you both feel - along with how to access good perinatal support during pregnancy. You can be referred to Ian Jones by your GP (or psychiatrist if you are under mental health services) and more info about the service is here with an email address for GP/psychiatrist to make a referral app-network.org/what-is-pp/...

We also have a really useful guide to planning a pregnancy with a higher risk of PP which was written by clinicians, researchers and mums with personal experience. You can take a look at the guide here app-network.org/wp-content/...

During pregnancy, as other mums have said above, it's great to talk to your midwife really early on about your worries, your own mental health and your family history. In most areas of the UK, your midwife can refer you to a specialist perinatal mental health service who will meet you during pregnancy and help you make a supportive post-birth plan for all eventualities.

We are all here for support and any questions that you want to ask throughout your journey, please don't ever worry about a long post!

Warm wishes

Naomi

[Keziah8 Volunteer]

Hi Mintchocchip89 I think it’s great you are doing some early research. I wish I had known about PPP before I had it. It’s good to prepare but I’m sorry it’s causing you some anxiety.

At this time whilst trying to conceive, try not to think about it too much. Once you are pregnant then you can get lots of support from your local perinatal team.

If you are monitored throughout your pregnancy due to high risk then you will feel more at ease. Plus once you give birth then any early signs you can see doctors to get help. The main problem is when new mums, family members and professionals don’t recognise the early signs and symptoms. So if you and your husband have that knowledge then you can get help early which is half the battle. I knew I was unwell before things really got out of control. So if like you I had that knowledge, I may have saved myself from experiencing as much as I did. There’s a lot of support out there and you are doing the right thing to look for it. Take care x