Bipolar disorder & pregnancy

[JackJack84]

Hi I have bipolar disorder & I'm worried about how ill cope once the baby is here. Just wanted to hear other people's experiences.

I take quetiapine & have read this can affect the baby soon after birth. I'm also worried about how ill cope with lack of sleep. Most of my previous manic episodes have been triggered by not sleeping. I've also been very unwell in the past & been sectioned with an scute psychotic episode.

Are there are any bipolar Mothers who can give me some idea of how they felt after giving birth? TIA x

Hi, are you in touch with the mental health team at your hospital? You should be registered with them and they should be able to tell you about things like how the medication affects baby.

GL x

Thank you for your reply @georgarina
At my booking appointment my midwife felt it wasn't necessary to refer me as I'm stable but when I see her next I'm gonna ask if she can put me in touch with them. I've read a lot of research about what can happen, it would help to hear some real world experiences too x

No real life experience but just to say you do definitely need to be referred to the perinatal team, even with a close family history of bipolar and certainly if you have it yourself even if stable. You are right to ask again, I would ask to be referred by GP if any further problems. Hope all goes well for you.

Hi there, just to echo what was said above, your midwife should have referred you to the perinatal mental health team. I work for one and unfortunately with a bipolar diagnosis you are high risk for postpartum psychosis. I'm surprised your midwife hasn't done this...a little worrying they haven't! Hope this doesn't scare you, all being well you should be fine but the perinatal team will help you to create a mental health birth plan and monitor you after baby comes to make sure everything is OK. This plan will cover issues like sleep which you mentioned previously - it's a huge trigger for a lot of people!

Re medication - it's a risk/benefit discussion (which can be had with the perinatal team consultant when you are referred) however I have worked with women who have been on quetiapine throughout pregnancy, some v high doses and baby has been fine. When someone is high risk in terms of their mental health we think about the risk of not taking medication, as well as the risk of taking it. The most important thing for your baby is you being well.

Congratulations on your pregnancy and hope all goes well :)

Ps! Check out the website for Action on Postpartum Psychosis (APP). There are a lot of positive stories on there from women who were high risk/had previous episodes of illness, who managed to stay well with support. They have forums too which are heavily moderated so they are factual and not triggering for people. There's also some really useful leaflets on there and information about what care you should be getting :)

Congratulations! I just want to echo Jazzle's reply. You are exactly the sort of person that the Perinatal Mental Health Teams are in place to support! It is fantastic that you are stable, but their role is to help you to stay stable and to support you through the changes in pregnancy and early parenthood. I would maybe drop an email to the Community Midwifery Manager or get in touch with your Community Mental Health Nurse (if you have one) and they will get you on the right track. Best of luck with the pregnancy.

Thank you all so much for the replies, very helpful & reassuring! I must admit I was very surprised I wasn't referred to the mental health team at my first appointment, I have quite an extensive history of being unwell so I'll definitely make a point of getting a referral.

Thank you @Jazzle1290 for the info about post partum psychosis, I'll check it out. With regards to the Quetiapine I'm on quite a low dose so I'd imagine it won't be a big problem.

@JackJack84 it's great that you are doing well and are stable, however, you definitively need a referral.

If you, or a Sibling has bi-polar there is a 50% chance that you may develop Puerperal Psychosis, this can usually be avoided if there is a care plan in place and you choose to take medications after birth (anti-psychotics, such as Olanzapine for example)

The trouble is, many people haven't heard of Puerperal Psychosis, or have any experience of it, including health professionals.

It effects around 1 in 1500 women, so depending on your midwife she may never have come into contact with anyone who has had it, or may be at risk of it.

I think that given you have had previous episodes of psychosis, it is absolutely essential that they refer you.

Another poster mentioned the charity Action on Postpartum Psychosis - they are wonderful and there's lots of information on their website. I think this is a case of needing to take ownership of your own mental health (which you obviously do, and have already) and educating your midwife who by the sounds of it, is a bit naive/ignorant.

Don't be scared, forewarned is forearmed and by getting a referral and a proper care plan in place it will give you the very best chance of continuing to keep stable and as well as possible.

www.app-network.org/

The charity APP offer a peer support service too, which you may find helpful.

www.rcpsych.ac.uk/mental-health/problems-disorders/postpartum-psychosis

Hi just wanted to update this post in case anyone in the future comes across it. Thank you to everyone for the advice!

At my 16 week midwife appointment I asked to be referred to the mental health team, MW seemed surprised & asked why I wanted to be referred. I explained about my previous psychotic episodes (which she knew about as she did my booking appointment) & that I wanted a care plan put in place before I give birth.

She referred me & I got a letter the next week from the mental health team with an initial assessment appointment. The team came to my house on Wednesday & they were fantastic. I explained my history & the nurse said 'I'm so glad the midwife referred you' I told her that I had referred myself & she was very surprised. She told me I am at high risk for postpartum psychosis but they would do everything they could to support me. As the appointment went on she must've said a further 3 times 'I'm so glad you referred yourself'.

I'm on a waiting list at the moment to be assigned a mental health nurse who will do my plan but I feel so reassured that I will be looked after.

So if anyone reading this is concerned about their mental health in pregnancy please advocate for yourself & ask to be referred. Don't rely on midwives to do it off their own back. They are really busy at the moment so don't let yourself fall between the cracks.

Hey, so great to hear you got things sorted, glad you posted on here! Hope all goes well :)