Pregnancy can be an exciting but also worrying time for women; for those who are pregnant or have just given birth and have a Bipolar Affective Disorder diagnosis, there will be additional considerations to take into account.
Common Questions Around Bipolar and Pregnancy
Here are some of the most frequently asked questions about bipolar and pregnancy.
If I have bipolar disorder should I become pregnant?
This is a personal decision that you and/or you and your partner should make. If you are pregnant or make the decision to become pregnant or have just had your baby, then make sure you find supportive and non-judgement health professionals to guide you.
Should I continue my bipolar medication during pregnancy?
This again is a decision for you to make.
There are medical guidelines for doctors on how best to manage your bipolar disorder during pregnancy, set by the Royal Australian and New Zealand College of Psychiatrists (Malhi G et al, 2015), The Royal Australian College of General Practitioners (Boyce P & Buist A, 2016) and the UK National Institute for Health and Care Excellence (2014). Ask your GP and/or psychiatrist for this written information, as it is a good idea to be informed of the facts before making a decision. Weighing up the risks and benefits of either option is important.
Can I breast feed?
Again, this decision needs to be an informed one. Choosing to take or not take medication will have an impact on your course of action. Your doctor can give you advice on the risks and benefits to you and your baby around choosing to breast feed.
Will I have a relapse after the birth?
It is understandable that you will have concerns about having either a manic or depressive relapse of your bipolar disorder after having your baby. Giving birth can be a stressful event and there are links between stress and relapse. Research indicates that there is a high likelihood of relapse after childbirth, with 37% of women affected, increasing to as high as 66% of women who are not on medication. A reduction to 23% of relapse occurs for women who are taking medication for their bipolar disorder (Wesseloo R. et al, 2016).
What can I do to prevent or best manage a relapse?
As with many things in life, planning is the key.
Relapse prevention is a key management strategy for bipolar affective disorder. Receiving advice and close monitoring from your GP and mental health professionals during your pregnancy is a good start.
Sitting down and writing out a relapse prevention plan is recommended, as this is an opportunity for you to record what may be your triggers, what your early warning signs are, and how you would like these to be managed.
Including loved ones, support people and health professionals is a good idea. Share your plan with these others helps them know how best to help, and can be done with your mental health counsellor.
To make an appointment try Online Booking. Alternatively, you can call Vision Psychology Brisbane on (07) 3088 5422.
- Boyce P, Buist A, RACGP – Management of bipolar disorder over the perinatal period. Volume 45, No.12, December 2016 Pages 890-893, viewed June 2018, https://www.racgp.org.au/afp/2016/december/management-of-bipolar-disorder-over-the-perinatal-period/
- Malhi S, Bassett D, Boyce P et al. (2015). Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders Australian and New Zealand Journal of Psychiatry 2015, Vol. 49(12) 1-185. https://www.ranzcp.org/Files/Resources/Publications/CPG/Clinician/Mood-Disorders-CPG.aspx
- NICE National Institute for Health and Care Excellence. Antenatal and postnatal mental health: clinical management and service guidance. Clinical guideline [CG192] Published date: December 2014 Last updated: April 2018, https://www.nice.org.uk/guidance
- Royal Australian And New Zealand College Of Psychiatrists Clinical Practice Guidelines Team For Bipolar Disorder (2004). Australian and New Zealand Clinical Practice Guidelines for the Treatment of Bipolar Disorder. http://journals.sagepub.com/doi/abs/10.1080/j.1440-1614.2004.01356.x
- Wesseloo R, Kamperman A, Munk-Olsen T, Pop V, Kushner S, Bergink V. Postpartum relapse risk in bipolar disorder and postpartum psychosis: A meta-analysis. Am J Psychiatry 2016;173(2):117?27. https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2015.15010124