Postpartum Bipolar Disorder: The Invisible Postpartum Mood Disorder

In response to my blog post from February 3, 2016 titled “15%-21% of Moms Suffer from a Perinatal Mood Disorder” in which I mention yet another mother who suffered from a postpartum condition that resulted in tragedy, fellow maternal mental health advocate Dyane Leshin-Harwood left me a comment that prompted me to offer her to explain why it’s so crucial to know the difference between postpartum bipolar and postpartum psychosis.  I explained to her that I haven’t seen much out there on a comparison between the two, and of course, the more we speak up about these conditions, the better off we all are!  These are illnesses that are extremely misunderstood, which can result in unnecessary stigma, mothers not getting the help they need because they don’t know who to go to for help, doctors not necessarily knowing how to properly diagnose and/or treat these mothers……and sometimes leading to tragic circumstances.

So, without further ado, I’d like to share Dyane’s story and important information about postpartum bipolar disorder.  Thank you, Dyane, for all the work that you do as a maternal mental heath advocate!

Postpartum Bipolar Disorder: The Invisible Postpartum Mood Disorder

Like father, like daughter: I grew up close to my father, a professional violinist who had bipolar disorder. In this photo I was eight months pregnant, and I never suspected that childbirth would trigger my bipolar disorder.

Like father, like daughter: I grew up close to my father, a professional violinist who had bipolar disorder. In this photo I was eight months pregnant, and I never suspected that childbirth would trigger my bipolar disorder.

By Dyane Leshin-Harwood 

Bipolar disorder, postpartum depression and postpartum psychosis have recently made media headlines. Katie Holmes stars as a lovestruck poet with bipolar disorder in the film Touched With Fire. The British hit television show EastEnders featured a postpartum psychosis storyline that gained national attention. Last January in a landmark decision, the U.S. Preventative Task Force called for screening for depression during and after pregnancy.

While the greater awareness of postpartum mood disorders is promising, postpartum bipolar disorder, the mood disorder I was diagnosed with, is virtually unheard of. Postpartum bipolar is also known as bipolar, peripartum onset, and it’s arguably the least known of the six postpartum mood and anxiety disorders.

It might seem unimportant to publicize an obscure mood disorder, but every mom’s postpartum experience counts. Many medical professionals are unaware that postpartum bipolar exists. Some postpartum and bipolar organizations are unfamiliar with postpartum bipolar or they’re unclear about its definition.

When I was pregnant, my obstetrician didn’t question me about my mental health or my family’s mental health history. My father had bipolar disorder, but before and during my pregnancy I didn’t show any signs of mental illness.

When I went into labor, my life changed overnight.

We went to the hospital and I stayed up all night in pain. When my daughter Marilla was born the next day, I became hypomanic. I was exuberant and talkative (both signs of hypomania), but I appeared relatively normal. My baby attracted most of the attention, and no one noticed that I was in trouble. Exhausted, I sensed something was off, but I kept my fearful feelings inside.

Within forty-eight hours I had hypergraphia, a rare condition in which one compulsively writes. I wrote at every opportunity, even during breastfeeding, when I should’ve been resting and focusing on my baby. I could barely sleep as my mania escalated, and poor Marilla didn’t gain enough weight because I didn’t breastfeed her sufficiently.

A month postpartum, I knew I was manic; after all, I had witnessed mania in my Dad. I frantically searched the internet about postpartum mania, but my search only yielded postpartum psychosis statistics. During Marilla’s six-week checkup, her observant pediatrician heard my racing voice and pressurized speech (symptoms of bipolar) and blurted out “Dyane, I think you’re manic!”

I burst into tears. While I felt ashamed, I was relieved that he realized what was happening. It was clear I needed hospitalization, but leaving my newborn was agonizing. I admitted myself into a hospital’s psychiatric unit where I was diagnosed with postpartum bipolar disorder.

After years of hospitalizations, medication trials, and electroconvulsive (ECT) therapy, I’m stable and doing well. While bipolar disorder ravages many relationships, my husband and I have stayed together, in part, thanks to the guidance of counselors and psychiatrists. Life will always be a challenge, but my two daughters inspire me to take care of myself.

While chances of postpartum bipolar are low, it can affect any mother. Obstetrician and Perinatal Mental Health Lead Dr. Raja Gangopadhyay of West Hertfordshire Hospitals NHS Trust, UK, explains,

“The risk of developing new-onset severe mental illness is higher in early post-childbirth period than any other time in women’s life. Family history, pre-existing mental health conditions, traumatic birth experience and sleep deprivation could be potential risk factors. Bipolar illness can present for the first time during this period. Accurate diagnosis is the key to the recovery.”

Confusion abounds regarding postpartum bipolar and postpartum psychosis. While the two conditions can present together, postpartum bipolar isn’t always accompanied by postpartum psychosis. Perinatal psychologist Shoshana Bennett Ph.D., co-author of the bestselling classic Beyond the Blues: A Guide to Understanding and Treating Prenatal and Postpartum Depression and Anxiety says,

“Many women I’ve worked with had been previously misdiagnosed with postpartum depression. I always make a point of discussing this during my presentations. In addition, postpartum bipolar disorder deserves its own category separate from postpartum psychosis.”

Mental health screening during pregnancy would be of immense value to every mom. Women with a family history of bipolar disorder could be observed postpartum, and if symptoms manifested they’d be treated immediately. It’s imperative that doctors and other caregivers assess women not only for postpartum depression but also bipolar symptoms.

Everyone who lives with a stigmatized illness deserves a chance to find support and empathy from others who understand her experience. Through connecting with those who can relate to our mood disorder, we may not find a magic cure, but virtual support can be profoundly helpful. Postpartum Support International recently created online support groups in English and Spanish led by trained facilitators, while the Postpartum Progress website offers moms a private forum to interact with one another. I’ve never personally met another mom who has postpartum bipolar and I yearn to do so. If you or someone you know is or might be suffering with postpartum bipolar disorder please reach out — I’d love to hear from you!

Kona

My daughters Avonlea, Marilla and husband Craig stood by me through the roughest times.

Dyane’s bio:

Dyane Leshin-Harwood holds a B.A. in English and American Literature from the University of California at Santa Cruz. A freelance writer for over two decades, she has interviewed luminaries including Madeleine L’Engle, Dr. Kay Redfield Jamison and SARK. Dyane was diagnosed with postpartum bipolar disorder (bipolar, peripartum onset) in 2007. Dyane was selected as an International Bipolar Foundation Story of Hope and Recovery, and a PsychCentral Mental Health Hero. She’s raising her daughters Avonlea and Marilla with her husband Craig and serves as women’s postpartum mental health advocate. Dyane founded the Santa Cruz, California chapter of the Depression and Bipolar Support Alliance (DBSA) and facilitates free support groups for moms with mood disorders. She’s a member of the International Society for Bipolar Disorders and Postpartum Support International. Dyane’s memoir Birth of a New Brain – Healing from Postpartum Bipolar Disorder will be published by Post Hill Press in 2017. Dyane is a Huffington Post blogger. Visit Dyane’s blog Birth of a New Brain at: www.proudlybipolar.wordpress.com and find her on Twitter: @birthofnewbrain

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