Bipolar and Perinatal Mental Health: Part One by Eleanor

I havn’t been sure for many months whether I was ready or wanted to share about the many issues I have been grappling with for a number of years. However, writing for me is therapeutic and so I wanted to share about the reality of mood disorders and thinking about starting a family.

To begin with, this is such a personal and complex issue for anyone with what is termed ‘severe mental illness; ie bipolar disorder, schizophrenia, psychosis. Our illnesses mainly have to be managed on daily medication and for some people with severe mental illness, they may still live with daily symptoms which can cause difficulties for them.

So this article is my personal experience of living with Bipolar 1 disorder and anxiety. To note, I was started on Lithium in 2014 after my last hospitalisation- which has stabilised the bipolar episodes into remission (it does something to the seretonin in the brain). I still live with some anxiety, but the combination of Lithium, Quetaipine (an anti psychotic) and anti depressants has meant that I do not become manic or psychotic and nor do I suffer from severe depression or suicidal depression. I feel more stable and I have engaged in therapy for the trauma I went through, for 2 years. So, thankfully at the moment my illness is very much controlled well and I have support from Rob and my family.

One side effects of my medicines has been weight gain and I aim to lose weight over the next year. This is important to me because it can sometimes impact on fertility and also makes a pregnancy more high risk (physical side effects such as blood clots etc). I will also be 34 in July and so this has become more pressing for me in terms of wanting to try for a baby. However, there are many risks in choosing to do this and going ahead, without speaking to a perinatal psychiatrist or mental health team.

Today, I got my referral letter to the mental health team to discuss planning a pregnancy and am on an NHS waiting list til June. For me, because my type of bipolar can be dangerous with the mania and psychosis- and having had several psychotic episodes in my life to date that have ended me up in hospital- a pregnancy where I carry a baby myself, has to be carefully planned in terms of my medication. For many reasons, I want to stay on my medicines for the entire pregnancy- so that I don’t end up relapsing during or straight after pregnancy (with bipolar there is a greater risk of relapse and post partum depression/psychosis due to the hormonal changes straight after birth).

I have been terrified for a number of years over what to do in order to keep me and a potential baby safe. I have researched surrogacy so I don’t risk making myself unwell, but this comes with a whole host of legal challenges around who is the parent, high financial costs (of treatment and paying expenses for surrogate/agencies) etc and the wait for the right surrogate. Surrogates can also pull out before giving. birth, you have to put your trust in them if you don’t know them- and you are trusting them with something hugely important! We also thought about adoption but with my mental health history and the potential issues that a child in care may be facing, I just didn’t want to put myself through the stress of being scrutinised.

So, please God even if we are blessed with a healthy child- the pregnancy may be as a friend of mine has termed ‘high risk’. This scares me and it scares me about potentially ending up in hospital again, on a mother and baby unit. I want to stay on my mood stabiliser and anti psychotic so the bipolar doesn’t cause this- however, I have decided that as long as I can stay on my medication and have the support of an experienced perinatal psychiatrist and mental health team (as well as my therapist),- plus regular monitoring and scans… and of course a proper plan put in place in case of relapse, this is what I will do (again, no one knows until you start trying for a baby and there can be many hurdles but I am trying to think positively).

I have also been asked whether I am worried about passing bipolar on. This is a worry as it does run in my family- however, I believe the risk of this with one parent is only about 10% (I got unlucky). Sometimes, I sit and question- am I being selfish for wanting to be a mother? And I realise, no I am not selfish. I don’t want my potential child to get bipolar disorder but equally if they do, we will deal with it. We also both want to get tested by Jnetics as we are both Ashkenazi (East European) Jews so may be carriers for certain illnesses.

Some women don’t want to be mothers, but I always have done since I was a little girl and I can’t imagine never having a family with my husband. I want to be the best Mum I can be and reduce my illness risk as much as possible to remain stable and well.

Do I wish things were different and I didn’t have this illness? Yes. but the reality is that I do but that I have been stable for a long time. I know we will make good parents whatever way it happens and I just hope the road ahead won’t be paved with challenges… it is never easy. I write this because its not often talked about… and I know there will be more to come on this subject but I wanted to share- if you yourself are going through something similar, you aren’t alone.

It took a lot to share this because its so personal and I worry about sharing too much- but this blog has been years in the making really! There is never a right time to open up- but maybe now I can allow myself to a bit and release the burden.

People sometimes ask me if I have children (as im mid thirties and married) and my answer is always, I hope to one day soon but leave it in Gods hands.

With love,

Eleanor x