October 28, 2012

Kelly remembers experiencing depression during her first pregnancy. Although she did not identify what she was experiencing at the time, looking back she realizes that she was depressed during her pregnancy. She had so many life changes going on that it is no wonder she was overwhelmed. Kelly got pregnant in August, started a job in September, got married in October and moved in December. If that was not enough, when she was 7 months pregnant her best friend died unexpectedly. Kelly new she was experiencing difficulties but she didn’t know she needed help.

Kelly is not alone. According to the American Congress of Obstetricians and Gynecologists (ACOG), between 14 to 23% of women will struggle with some symptoms of depression during pregnancy. Because one to four women will experience depression at some time during their lives, it is not surprising that pregnancy can be one of those times.

The American Pregnancy Association is a national health organization committed to promoting reproductive and pregnancy wellness through education, research, advocacy, and community awareness. The Association states that depression during pregnancy is not properly diagnosed because people think it is just another type of hormonal imbalance.

In the case of Anglena, she had experienced postpartum depression after the birth of her first child but was stable when she got pregnant with her second child. Anglena had a history of Anxiety and Obsessive Compulsive Disorder prior to her pregnancies but both seemed to be under control when she was pregnant with her second child. However, when she was 5 1/2 months pregnant, she began to have difficulty sleeping. This led to irritability, agitation and guilt. All of which can be symptoms of depression. She did not identify them as such and dismissed them as hormonal and pregnancy related.

Thankfully, in Kelly’s and Anglena’s cases, they eventually got help but not until things escalated and got worse after the their babies were born. It seems that often the symptoms of depression and anxiety during pregnancy are often dismissed as “normal” or related to changes in hormones. But, in reality, if a pregnant woman is experiencing any of the following symptoms, she should seek professional help, preferably professionals with experiencing treating women experiencing mental health issues related to childbearing.

Trouble sleeping
Sleeping too much
Lack of interest
Feelings of guilt
Loss of energy
Difficulty concentrating
Changes in appetite
Restlessness, agitation or slowed movement
Thoughts or ideas about suicide

So if you are pregnant and experiencing any of the symptoms mentioned above, please know that there is help available. You should not feel ashamed or guilty because you are not to blame and you are not alone.

The information on this site is not intended to diagnose or treat any medical or psychological condition. Please consult with your healthcare provider for individual advice regarding your own situation.

RESOURCES AND ADDITIONAL READING:

American Pregnancy Association: Depression During Pregnancy

March of Dimes: Pregnancy Complications

Depression during and after pregnancy fact sheet

Coping With Depression During Pregnancy

Depression During Pregnancy & Postpartum

Postpartum Support International

September 23, 2012

I was recently interviewed for an upcoming production that will address bipolar disorder and pregnancy. As a result, I thought it would be an appropriate time to share my thoughts on bipolar disorder and pregnancy. The pressing question is can a woman with bipolar disorder have a successful pregnancy and postpartum period?

I believe the answer to this question is yes but there seems to be debate over whether or not a woman with bipolar disorder should even become pregnant let alone have a successful pregnancy.

In my opinion, the decision to become pregnant and have children is a decision that is up to the woman with bipolar disorder. Of course, I believe she should consult with her physician, who hopefully has experience in mental illness related to childbearing, specifically in treating women with bipolar disorder. She should also take in the consideration the level of social, emotional and practical support available to her.

I do not believe she should be told “do not get pregnant” but rather she should be told “if you choose to get pregnant, be sure to have a comprehensive plan in place to address prevention, treatment and recovery.” It seems the better prepared a woman is, the better the outcome will be.

But even when the woman has everything in place, a relapse can still occur. For this reason, I believe having a plan in place to address a relapse, can help her become stabilized more quickly. The treatment plan usually involves medication, therapy, and support.

Often women are reluctant to take medication during pregnancy or when they are breastfeeding. I can certainly understand why but there is always a risk/benefit analysis when it comes to taking medication. It is for this reason that a pregnant bipolar woman work closely with her physician before, during and after the pregnancy. I also suggest consulting with her pharmacist, who has tremendous knowledge about medications, to determine what is the best option during her pregnancy and after the baby is born. In my opinion, the USA can definitely learn from the United Kingdom in addressing the support needs of postpartum women.

Of course, there is always risk in pregnancy, whether or not there is a history of mental illness. For me, personally, I did not have a prior history of mental illness yet I was still stricken with postpartum psychosis, a rare but serious mental illness related to childbearing. Although postpartum psychosis can strike any woman after the birth of a baby, there is a much greater risk for women, who have a history of bipolar disorder.

In my case, I would eventually be given the diagnosis of bipolar disorder, postpartum onset. Thankfully, after many trials, tribulations and attempts at treatment, I have been in remission for six years. Unfortunately, I have not been able to have a successful subsequent pregnancy. Yes, as difficult as the illnesses have been, I have no regrets and would do it all again. The blessings of motherhood and having my son in my life have been worth it all.

I welcome feedback and comments on my blog. I would love to hear about the experiences of other women and those that provide treatment to women with bipolar disorder. Please be sure to write your comment below. I look forward to hearing from you.

Also, please consider “liking” my Facebook page. You will find it under Mental Health Advocate Jennifer Moyer.

Resources and additional reading:

Do Pregnancy and Bipolar Disorder Mix?

Pregnancy with Bipolar Disorder-Stay on Medications or Not?

Managing Bipolar Disorder and Pregnancy

Management of Bipolar Disorder During Pregnancy and the Postpartum Period

Postpartum psychosis: Affected parents speak out