Bipolar disorder

Bipolar disorder is a serious mental health condition that affects between 1 and 3 per cent of women during pregnancy and after the birth.

Bipolar used to be known as 'manic depression', because people tend to experience extreme moods – both low (depressed), and high or excited (manic). Some women with bipolar disorder also experience psychosis. While we don’t know exactly what causes bipolar disorder, it is often inherited and can be linked to stressful life events.

If you have a history of bipolar disorder in your family, you’re more likely to develop the condition when you’re pregnant or after the baby is born. If you’ve previously had bipolar disorder or puerperal (postpartum) psychosis, you’re at greater risk of relapsing at this time.

If you notice these symptoms in yourself or someone close to you, it's important to seek professional support and treatment.

Symptoms of bipolar disorder

Bipolar disorder causes you to have extreme moods that change regularly and may not relate to what’s happening in your life, although mood swings may be triggered by certain events.

The symptoms of bipolar disorder during the antenatal and postnatal period are the same as those at other times. Pregnant women and new mothers with bipolar often fixate on fears about their own and their baby's health and wellbeing, or on whether they’ll be a good mother.

As well as symptoms of depression, bipolar involves periods of mania.

The biggest feature of my bipolar disorder has been the depression. These episodes can be intense, almost like they ‘swallow me up’, leaving me paralysed and able to do very little, except cry and lie on my bed. Plus, I self-isolate.

Common manic behaviour includes:

  • Increased energy
  • Irritability
  • Overactivity
  • Increased spending
  • Being reckless or taking unnecessary risks (e.g. driving fast or dangerously)
  • Increased sex drive
  • Racing thoughts
  • Rapid speech
  • Decreased sleep
  • Grandiose ideas (e.g. being famous, knowledgeable about everything)
  • Seeing or hearing things/people that are not there (hallucinations)
  • Having beliefs that are not based on reality (delusions)
  • Feeling everyone is against you (paranoia) 


Treatment and management of bipolar disorder

Bipolar disorder is a biological condition that won’t go away without medical treatment – you’ll need to take medication to treat and manage it.

That’s why recognising symptoms of bipolar disorder and talking to a doctor are so important. The earlier you’re diagnosed, the quicker you’ll be able to receive appropriate treatment.

The first step is to talk to a GP who can develop a treatment plan, organise referrals and explain how to access Medicare rebates.

Medication

Bipolar disorder is treated and managed using medications that stabilise your symptoms and help to reduce the likelihood of relapse. Different types of medication are used to treat the range of symptoms that you may experience, including depression, mania or both depression and mania (mixed episode).

These medications may include:

  • mood stabilisers – stabilise your mood and help to reduce the likelihood of relapse
  • antidepressants – reduce depressive symptoms which are part of a depressive phase of bipolar disorder
  • antipsychotics – help with both manic symptoms and psychotic symptoms (delusions or hallucinations).

It’s important to discuss and review medication with your GP or psychiatrist if you’re planning a pregnancy, when you find out you’re pregnant, and following the birth. The type of medication you’re prescribed will depend on your symptoms and the stage you’re at – whether you’re planning a baby, pregnant or breastfeeding.

If you’re prescribed mood stabilisers or antipsychotic medications (such as sodium valproate, clozapine or lithium, your psychiatrist will need to weigh up the potential risks and benefits to you and your baby. Particular care is needed with sodium valproate and a psychiatrist should always be consulted. 

If you’re taking mood stabilising medication while trying to conceive and in the first trimester of pregnancy, it’s important to include folate supplements in your diet. This reduces the small increased risk of birth defects with these medications. 

You should always seek advice from a psychiatrist before changing or stopping medications, and always stop gradually. Your health professional may also help you develop a care plan (including contact numbers and support people) that you and your family can refer to as needed. 

Hospital/mother–baby units

If your symptoms are severe, you may need to go to hospital – especially if you or your family think you may be at risk of harming yourself or your baby. This allows health professionals to monitor you and provide treatment and ongoing support in a safe place.


Psychological treatments

As your prescribed medication begins to work and you start to recover, psychological therapies can help you develop effective coping strategies. Mother-infant therapy can also help you bond with your baby.

If you’re supporting your partner or loved one as she recovers from an episode of bipolar disorder, it’s important that you take care of yourself and have your own support network to call on. Talking things through with a counsellor can also be helpful for partners and support people.

Electroconvulsive therapy (ECT)

Electroconvulsive therapy (ECT) is a specialist treatment that can be used safely for treating acute mania, psychosis and severe depression following the birth.

There’s lots of misinformation about ECT, so we’ve put together some of the facts to help you make a decision about your own treatment, or that of your partner or loved one.