Bipolar disorder in pregnancy

This information is for women, birthing people and families of those who are pregnant and managing a bipolar disorder.

If you are not pregnant yet there is more relevant information on our page for those planning a pregnancy with bipolar disorder.

During pregnancy

It’s important to tell your GP or midwife that you have bipolar disorder as soon as you find out that you’re pregnant. They should refer you to a specialist perinatal mental health team or the community mental health team. 

Do not stop taking medication for mental health problems before talking to your doctor. This can lead to withdrawal symptoms. It could also make your symptoms come back or get worse. 

Most women and birthing people with bipolar disorder have healthy pregnancies and babies.  But having the condition increases your risk of:

• postnatal depression
• postpartum psychosis.

There is also a chance that your symptoms could come back suddenly (relapse) during pregnancy or in the first few weeks after the birth. 

You’re more likely to get postpartum psychosis if you have had it before or your mother or sister has had it. 

How will my condition be managed during my pregnancy?

Care plan

Your healthcare team will work with you and your family to make decisions about your care. The team will include doctors who specialise in pregnancy or mental health, midwives, your GP and health visitors.  

Together, you will write a plan for your mental health treatment during pregnancy, birth and afterwards.  Any health professionals involved in your care can check this care plan to make sure you’re getting the treatment you need. 

Your care plan should include a list of symptoms to look out for, which may show that your mental illness is getting worse. It should also have information about how to get help if you need it. Ask for a copy of your care plan. You may also want to share it with your family to help them support you. 

Medication

It’s very important to talk to your mental health specialist before you make decisions about stopping any medications you’re taking. They will clearly explain the benefits and risks to you and together you can decide on the best treatment. They may suggest: 

• staying on the medication you are on now
• switching to another medication
• slowly stopping or lowering the dose of your medication.

Some treatments for bipolar disorder can affect your baby if you are pregnant or breastfeeding. For example, taking lithium during the first 3 months of pregnancy can increase the chance of heart problems in the baby. 

After the birth, lithium can pass into breastmilk so you may decide to use formula instead to feed your baby.

Read more about feeding your baby when you’re taking medication. 

If you need to take lithium to stay well, you and your doctor may decide that the benefits of treatment outweigh any risk to the pregnancy. Make sure you understand the risks and benefits of all your options before you decide. 

Read more about taking medication for mental illness during pregnancy.

Sodium valproate 

Women and birthing people who are taking sodium valproate should not become pregnant as it can cause problems with your baby’s health. If you’re taking valproate and you get pregnant, speak to your doctor straight away.  

Talking therapy and psychoeducation

Your specialist may offer you psychological (talking) therapy or psychoeducation (giving you information, resources and coping skills). Types of talking therapy include cognitive behavioural therapy (CBT) and interpersonal therapy (IPT).

Talking therapies can lower the chances of bipolar disorder coming back during and after pregnancy. This may be especially helpful if you change or stop taking medication. 

Read more about talking therapies.

Depression and mania

Speak to a perinatal psychiatrist straight away if you’re having periods of extreme highs or lows. They may offer you medication. If you’re already taking medication, your doctor may change the dose or offer another medicine or treatment.   

Will I be referred to social services?

Most parents with mental illness are not referred to social services. This would only happen if you need extra support to look after your baby. 

Social services work with parents to help them care for their children at home. They would only take a baby into care if they were worried about the child’s safety. 

You can read more about how social services support families.

How can I help myself?

Some things that may help you stay well during and after pregnancy include: 

• eating well and staying physically active
• keeping a mood diary, such as this one from Bipolar UK
• taking your medication, even if you’re feeling fine ‒ talk to your doctor if you want to stop taking it
• making sure your close family and friends understand your condition and how it affects you – for example, what medication you take, possible triggers and signs of a relapse and who to contact if you become unwell.

Read more tips for staying well during pregnancy.

Having a baby affects your sleep and your daily routine. This can make it harder to get enough rest. Family and friends may be able to give you practical help so you have more time to rest. If you’re finding it hard to manage, speak to your doctor or health visitor.  

Check that your care plan has details of who to contact if you need extra help after the baby is born.

 Asking for help if you need it is always a good idea.

More information and support

Bipolar UK

Bipolar Fellowship Scotland

MIND 

Action on Postpartum Psychosis