Bipolar Symptoms Developing after Birth of a Child?
[Home] [Bipolar News] [Bipolar Disorder] [Medications] [Treatments] [Bipolar Disorder/Job/School] [Disabilities] [Ask the Doctor] [Ask David] [Self-Injury] [Personal Stories] [Graham's Column] [Steven's Column] [Storm's Column] [Columnist Archives] [Suicide] [Community Support] [Family Members] [Expressions] [Greeting Cards] [Books] [Awards] [Links & Rings] [About Us] [Contact Us]

 


Q:  Bipolar Symptoms Developing after Birth of a Child?


I was wondering if you had ever seen bipolar symptoms develop after birth of a child?  My mother was dx w/bipolar in the early 70's after my birth.  Her previous birth of my brother created postpartum depression.  My family is concerned about me having children, and developing bipolar.  I would ask my mother but she died last year.  Plus my parents divorced and they did not get along at all, so I partially question her diagnosis as correct.  My father says she was fine before birth.  I have a masters in counseling and in my work had never seen, heard of this.  Although I no longer practice I wondered if you had some information for me.

Thank You for your time.
Rachel


Dear Rachel --

Post-partum onset of mood symptoms is actually quite common, as you know, namely "post-partum depression."  However, it is not so widely recognized that postpartum depression is a marker for bipolar disorder.  Not everyone with postpartum depression has bipolar disorder of course; but that timing of onset raises the probability that a person's depression is actually "bipolar".  Since plain old "unipolar" depression is more common than bipolar depression, this shift is a moderate statistical change.  Technically, using the most recent epidemiologic study in the United States, the shift in probability is roughly from a one in four chance that a depression is "bipolar depression", to something more like a one in three chance.  Obviously these figures are very rough, but that gives you an idea of the ballpark we are in here.

In my experience, developing bipolar symptoms "out of the blue", after delivering a child, is not very common.  Much more frequently, women have had some degree of symptoms before giving birth, and then find a symptoms are more prominent afterward.  I have a working hunch (i.e. preceding your note) here that this is more likely after the second child than after the first; as though each pregnancy is a kind of sensitization experience (but it does not seem to get worse after the second, just after the first. This is just my clinical observation, I have never seen anything about this in print).

The main point in that last paragraph: if you have no mood symptoms now, no sense of "mood swings", I think that lowers the likelihood that pregnancy is going to have some impact on your mood stability.  On the other hand, if you already have a fairly noticeable capacity to have mood swings, then your risk is probably somewhat greater that these will be worse after pregnancy.  Unfortunately, nothing in my business comes with a guarantee or a firm probability. 

You have a certain degree of risk based on your mother's diagnosis of bipolar disorder.  I have never seen anyone publish a statistical assessment of a persons risk, given a first-degree bipolar relative, based on his or her gender -- let alone based on how many pregnancies you have had or are contemplating having.  The point there is that if there was a really substantial change in the risk of having symptoms, for a person who is symptom free now and contemplating pregnancy, I think someone would have written something about that.  So, not seeing such an opinion anywhere is perhaps a slight reassurance for you.

Conversely, I have definitely seen people write that it is a mistake, even unethical in a sense, to encourage women who have bipolar disorder not to have children.  Usually this is a warning that the potential risk to the child of developing bipolar disorder, because of the genetic risk, is not high enough to warrant discouraging the parent.  Again, in such discussions, I've never seen anyone raise the issue of the risk to the mother of worsening her already-diagnosed bipolar disorders.

I hope this makes sense.  I'm trying to reassure you as much as possible without offering any degree of false reassurance.  The problem is, we just don't have enough data on all this.  I suppose you could wonder out loud with your father and your partner/husband: suppose someone could give you a 100% probability that you would develop bipolar symptoms if you become pregnant.  Would you choose not to?  Suppose that probability was 80%?  Or 50%?  Does it really make any difference what the probability is?  If you find that sure enough, the percentage really does matter, then you might want to get even more specific than this informal question-and-answer exchange we are having here.  The extreme in that respect would be to contact the "reproductive psychiatry" clinic at Massachusetts General Hospital, led by Dr. Lee Cohen and his wife (he is a psychiatrist; she is an obstetrician/gynecologist) and ask for a consultation, bringing this question.  If you have the means for such a consultation, see if you can find out in advance whether they really have much of an answer for you, before you commit to it.

Good luck with all that --

Dr. Phelps


Published November, 2008
 
 

Bipolar World   1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014
Owners: 
Allie Bloom, David Schafer, M.Ed. (Blackdog)
Partners:  John Haeckel, Judith (Duff) 
Founder:  Colleen Sullivan
 

Email Us at Bipolar World

 

About Us  Add a Link  Advance Directives  Alternative Treatments  Ask the Doctor   Ask Dr. Plyler about Bipolar Disorder   Ask The Doctor/ Topic Archives  Awards  Benny the Bipolar Puppy  Bipolar Chat  Bipolar Children  Bipolar Disorder News  Bipolar Help Contract  Bipolar World Forums  Book Reviews  Bookstore  BP & Other mental Illness   Clinical Research Trials & FDA Drug Approval   Community Support   Contact Us  The Continuum of Mania and Depression   Coping   Criteria    Criteria and Diagnosis  Criteria-World Health Disabilities,  DSMV-IV   Dual Diagnosis  eGroups  Expressions (Poetry, Inspiration, Humor, Art Gallery, Memorials  Family Members   Getting Help for a Loved One who Refuses Treatment  Greeting Cards  History of Mental Illness  Indigo  Job and School  Links  Manage Your Medications  Medications   Medication and Weight Gain    News of the Day  Parent Chat  Pay for Meds  Personal Stories  Self Help  Self Injury  Significant Others  Stigma and Mental Health Law  Storm's Column  Suicide!!!  The Suicide Wall  Table of Contents   Treatments  Treatment Compliance  US Disability  Veteran's Chat  What's New?