Bipolar Disorder in Pregnant and New Mothers
What is Bipolar Disorder?
Bipolar disorder is a mental illness marked by extreme mood shifts. Symptoms can include an extremely elevated mood called mania or low time called depression. Many women are diagnosed for the first time with bipolar depression or mania during pregnancy or postpartum.
The criteria for a diagnosis of a bipolar mood disorder is that the symptoms last longer than one week and interfere with functioning and relationships. Sometimes the highs and lows seem to happen at almost the same time; this is called a mixed episode. These cycles and emotional states are more than the moodiness of pregnancy or postpartum.
Many women with bipolar disorder have healthy pregnancies and babies, but there are some risks around having a baby with the condition.
If you have bipolar disorder you may be at risk of:
developing postpartum psychosis, particularly if other women in your family have had postpartum psychosis
developing postnatal depression
your condition coming back (having a relapse) during your pregnancy if you have had any severe episodes recently and/or need medication to prevent relapse.
Types of bipolar disorder
There are two main types of bipolar disorder: Bipolar I and Bipolar II.
This classic form of bipolar disorder used to be called “manic depression.” In bipolar I, manic phases are clear. The person’s behavior and shifts in mood are extreme, and their behavior quickly escalates until they’re out of control. The person may end up in the emergency room if left untreated.
To have bipolar I, a person must have manic episodes. In order for an event to be considered a manic episode, it must:
include shifts in mood or behaviors that are unlike the person’s usual behavior
be present most of the day, nearly every day during the episode
last at least one week, or be so extreme that the person needs immediate hospital care
People with bipolar I typically have depressive episodes as well, but a depressive episode isn’t required to make the bipolar I diagnosis
Bipolar II is considered more common than bipolar I. It also involves depressive symptoms, but its manic symptoms are much less severe and are called hypomanic symptoms. Hypomania often becomes worse without treatment, and the person can become severely manic or depressed.
Bipolar II is harder for people to see in themselves, and it’s often up to friends or loved ones to encourage someone with this type to get help.
What causes Bipolar Disorder?
Bipolar disorder is a common mental health illness, but it’s not yet clear what causes some people to develop the condition and not others.
Possible causes of bipolar disorder include:
If your parent or sibling has bipolar disorder, you’re more likely than other people to develop the condition (see below). However, it’s important to keep in mind that most people who have bipolar disorder in their family history don’t develop it.
Your brain structure may impact your risk for the disease. Abnormalities in the structure or functions of your brain may increase your risk.