Introduction
Pregnancy is a phase in a woman’s life full of ups and downs. It can be said to be a rollercoaster journey for some women. The most important thing is to have good physical and mental health before, during, and after the pregnancy. This can increase the likelihood of a healthy pregnancy. Just as physical health in pregnancy affects both mother and baby, the same way mental health during pregnancy affects both mother and baby as well. Various mental illnesses negatively affect pregnancy. This article will explore the effects of bipolar disorder during pregnancy.
What Is Bipolar Disorder?
Bipolar disorder, formerly known as manic depression, is a mental illness marked by sharp fluctuations in mood. Emotional highs, referred to as mania or hypomania, and lows, referred to as depression, are examples of these swings. People who are going through a depressive episode could feel down, hopeless, and uninterested in things. On the other hand, they might experience euphoria, excessive energy, or unusual irritability during manic or hypomanic episodes. Aspects of life such as sleep, energy levels, activity, behavior, judgment, and cognitive function can all be impacted by these mood swings.
Episodes of mood swings can vary in frequency, ranging from rare occurrences to multiple episodes within a year. While some individuals may experience emotional symptoms between episodes, others may not. Despite being a lifelong condition, bipolar disorder can be managed through a treatment plan. Medication and psychological counseling are usually combined in treatment.
Does Bipolar Disorder Run in Families?
Yes, it commonly runs in families, with a high percentage of individuals having relatives with bipolar disorder or depression. Bipolar disorder is categorized into three types: cyclothymic disorder, bipolar I, and bipolar II. Environmental factors like stress, sleep disruption, and substance abuse may trigger mood episodes in susceptible individuals. Although the exact causes of bipolar disorder are not fully understood, it is believed to involve an imbalance of brain chemicals leading to dysregulated brain activity. Onset typically occurs around the age of 25.
Other mental health conditions like attention-deficit hyperactivity disorder (ADHD), substance use disorders, and anxiety disorders are frequently experienced by people with bipolar I disorder. They also face a higher risk of suicide compared to the general population.
What Are the Risks of Having Bipolar Disorder in Pregnancy?
If a pregnant mother has bipolar disorder, there are potential risks associated with the condition. Limited research has been conducted on bipolar disorder and pregnancy, leading to uncertainty regarding the risks of untreated bipolar disorder and the safety of medications during pregnancy. Additionally, the factors contributing to relapse during pregnancy remain unclear.
However, bipolar disorder can exacerbate during pregnancy, increasing the risk of hospital admissions for pregnant women or new mothers with the condition. Studies suggest that discontinuing bipolar medications during pregnancy can significantly elevate the risk of relapse, with a heightened risk of recurrence within a short period, particularly if medication is abruptly stopped. Moreover, pregnant women who cease bipolar medications may experience bipolar symptoms throughout a significant portion of pregnancy, substantially more than those who continue their medication regimen.
Planning a pregnancy with medical guidance is advisable for women diagnosed with bipolar disorder before conception. Some bipolar medications pose risks during pregnancy, necessitating careful consideration and potential adjustments under medical supervision to balance the risk of relapse. Abruptly stopping medication is not recommended, and treatment decisions should involve collaboration between the individual, their partner, and healthcare providers.
The period following delivery carries a heightened risk of bipolar relapse, particularly within the first month postpartum. Additional monitoring from healthcare professionals during this period is beneficial, and for those with recurrent episodes, initiating or adjusting medication immediately after delivery may be considered.
While most women with bipolar disorder have healthy pregnancies and babies, the condition increases the risk of postnatal depression and postpartum psychosis. There is also a possibility of sudden symptom recurrence during pregnancy or shortly after childbirth, with a higher likelihood of postpartum psychosis for individuals with a history of the condition or a family history of it.
What Are the Treatment Options for Bipolar Disorder in Pregnancy?
Treatment for bipolar disorder during pregnancy involves a comprehensive care plan developed in collaboration with a healthcare team specializing in pregnancy and mental health. This team typically includes doctors, midwives, general practitioners (GPs), and health visitors. Together, they create a care plan tailored to the individual's needs, which includes monitoring for symptoms indicating worsening mental health and providing information on accessing help when needed.
Regarding medication, it is better to consult a mental health specialist before making any decisions about discontinuing or altering medications. The specialist will discuss the benefits and risks of various treatment options, which may include staying on the current medication, switching to a different medication, or gradually reducing the dosage. Certain medications, such as lithium and sodium valproate, can increase the risks to the baby during pregnancy or breastfeeding, and decisions regarding their use must carefully weigh the benefits against the potential risks.
In addition to medication, talking therapy or psychoeducation may be offered to provide support and coping skills. These therapies, such as cognitive behavioral therapy (CBT) or interpersonal therapy (IPT), can help reduce the likelihood of bipolar disorder recurrence during and after pregnancy, particularly if medication changes or discontinuations occur.
For individuals experiencing periods of extreme mood swings, immediate consultation with a perinatal psychiatrist is recommended. Adjustments to medication dosage or alternative treatments may be suggested to manage symptoms effectively.
Most parents with mental illnesses, including bipolar disorder, are not automatically referred to social services unless additional support is required to care for the baby. Family and friends can play an important role in providing practical assistance and understanding the individual's condition.
Self-care strategies, such as maintaining a healthy lifestyle, adhering to medication regimens, and communicating openly with loved ones about the condition, are also important for effectively managing bipolar disorder during and after pregnancy. Close monitoring and support from healthcare professionals can help optimize both reproductive and mental health outcomes for individuals with bipolar disorder.
Conclusion
Bipolar disorder during pregnancy can make women think too much about themselves and their babies. The anxiety of being a good mother and other overthinking can lead to stress, which is harmful during pregnancy. This disorder can make them over-happy sometimes and over-sad sometimes. Therefore, this high frequency of fluctuations in mood affects not only the mother and baby but also the partner and family. Hence, if a woman already has bipolar disorder, it is better to consult a psychiatrist beforehand prior to conceiving a baby.
