Bipolar Moms Forum
Bipolar Moms Face Extra Struggles
Lack of sleep and other stressors add to their challenges during pregnancy, child's early days
Monica, shown with her daughter, struggled with mood swings throughout her pregnancy and her daughter's first year. "I think I was more manic during the pregnancy, and the depression was what I fought after my daughter was born," Monica said.
(January 01, 2007) -- Most new parents pine for a full night's uninterrupted sleep, but for mothers with bipolar disorder, infant-induced insomnia can shatter emotional equilibrium.
"To this day, we go to bed at 8:30 p.m. and get up at the hole of dawn, but we get a full eight hours of sleep and that makes a great difference in our world," said Monica, 35, the single mother of a 5-year-old girl, who asked that her last name not be used.
Bipolar disorder, also known as manic-depressive illness, is a serious medical illness that causes shifts in a person's mood, energy and ability to function.
• Signs and symptoms: Bipolar disorder causes dramatic mood swings from overly "high" and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. Severe changes in energy and behavior go along with these changes in mood. The periods of highs and lows are called episodes of mania and depression.
• Treatment: Most people with bipolar disorder can achieve substantial stabilization of their mood swings and related symptoms over time with proper treatment. A strategy that combines medication and psychosocial treatment is optimal for managing the disorder over time.
National Institute of Mental Health
Diagnosed as bipolar more than a decade ago, she struggled with mood swings throughout her pregnancy and her daughter's first year.
Lack of sleep is a known trigger for manic episodes, according to psychiatrist Dr. Lauren B. Marangell, founder and director of the Mood Disorders Center at Baylor College of Medicine.
However, it is just one of several stressors that present special challenges for mothers such as Monica.
A suicide attempt in her early 20s led to Monica's bipolar diagnosis; however, she believes her symptoms began as early as age 10.
"I always felt different," she says. "I wasn't happy and playful like most kids. I was deep in my thoughts and worried about things. I had sleepless nights, and days I would stay up and play and play and play."
She got her condition under control only a year or so before her unplanned pregnancy.
"The whole time was very stressful for me. I didn't have support from my family or my child's father," she recalls. "The mood swings were very elevated. ... I think I was more manic during the pregnancy, and the depression was what I fought after my daughter was born."
She was unable to work at her job for a shipping and delivery service throughout most of her high-risk pregnancy.
A physician's guidance
Monica was referred to Baylor's Mood Disorders Clinic in her seventh month because of concerns that her medication might harm the baby.
Many bipolar women stop taking their medications during pregnancy because of similar concerns, but Marangell says doing so without a doctor's guidance can do more harm than good.
"It's a very individual evaluation," she says. "It's important that women talk about these things with their doctors and psychiatrists, preferably before they make a decision to become pregnant, and definitely before they stop taking their medications."
Bipolar mothers also must weigh the risks and benefits of breast-feeding more carefully than other women as some medications may pass through breast milk and because of the sleep disruptions.
While women with milder cases can manage round-the-clock feedings, others may want to let their spouses bottle feed at night.
Psychological counseling for bipolar mothers focuses on just such practicalities. Instead of delving into childhood experiences, Baylor therapists help patients anticipate problems.
"A lot of stressors come with pregnancy and child rearing that can be planned for in advance," said Barbara Kertz, Monica's psychotherapist.
"You can make decisions about who is going to step in and spell you."
Kertz helped Monica identify friends and family members who could take her to doctor's appointments or watch the baby while she grabbed the occasional nap.
Monica moved in with her mother before her child was born, chose to breast-feed and switched medications during pregnancy. Today, her daughter is thriving in kindergarten.
Positive outcomes for women such as Monica can require careful planning and consultation with mental health professionals, Marangell notes.
"These are biological, brain-based disorders," she says. "They have nothing to do with being happy or unhappy about the circumstances and can really trigger the illness in susceptible women."
Source: The Chronicle