Bipolar disorder

Bipolar disorder used to be called ‘manic depression’ because it causes extreme mood swings.

If you have bipolar disorder you may have episodes of feeling severely depressed and episodes when your mood is very high (mania), which can bring muddled thoughts and make it hard to sleep.

If you have bipolar disorder:

  • you are more likely to relapse in pregnancy than at other times
  • you may be at extra risk of developing postpartum psychosis.

These are the signs of an episode of depression (low):

  • you feel generally down most of the time
  • you can’t be bothered with things
  • you can’t concentrate or make decisions
  • you don’t enjoy life
  • you’re tired and don’t have any energy
  • you can’t get to sleep and/or you wake up early
  • you feel tearful
  • you feel irritable and don’t want to be with other people
  • you feel restless and agitated
  • you lose your self-confidence
  • you feel worthless
  • you feel guilty
  • you lose your appetite or have a much greater appetite
  • you lose interest in sex
  • you think about suicide.

These are the signs of an episode of mania (high):

  • you feel extremely happy, excited and optimistic
  • you feel you don’t need to sleep
  • you talk quickly and jump from one idea to another
  • you are restlessly active
  • you make grandiose, unrealistic plans.

In a severe episode you may also have psychotic symptoms:

  • You may have beliefs which you are convinced are true, but which other people recognise are not true (delusions). For example:
  • grandiose beliefs (you have special powers or are on a special mission)
  • negative beliefs ( you are the worst person ever)
  • You may hear voices.

If you have bipolar disorder you won’t necessarily experience all of these symptoms.

“I found out I was pregnant when I was 11 weeks gone. I wasn’t supposed to get pregnant because I was on lithium for bipolar disorder. I was really scared and worried so I phoned the psychiatrist right away.” Jeanette, mum of one. Read more...

How common is it?

One in 100 women gets bipolar disorder at some point in their lives. Some women find that their bipolar disorder gets worse when they’re pregnant or after birth.

What is the treatment?

Tell your midwife or GP if you have bipolar disorder and if you are planning a pregnancy or are already pregnant. You should be referred to a specialist service to make sure you can get help quickly if you become unwell.

If you are taking valproate or another anticonvulsant called carbamazepine and you are planning to have a baby or become pregnant, your doctor should advise you to stop the medication gradually.

If you already had bipolar disorder and are already taking medication, your healthcare team will discuss the risks the medication has for your baby (and when breastfeeding). They will discuss the likelihood of relapse if your medication is stopped or changed. They may offer Cognitive Behavioural Therapy or other talking and group therapies to bring down the risk of relapse.

If you develop mania and you're already taking medication, your doctor should check the dose and increase this or suggest changing to another type; if this doesn't work and your mania is severe your doctor may suggest other treatment such as lithium or, as a last resort, electroconvulsive therapy (also known as ECT).

If you're taking lithium and decide to stop this when you become pregnant, your doctor should offer you an antipsychotic.

If you're taking medication for bipolar disorder and you plan to breastfeed, your doctor should make sure that you can take the medication while breastfeeding.

They may also need to make a plan to keep you well after birth, as some women with bipolar disorder are more likely to experience postpartum psychosis.

How can I help myself?

  • Keep a mood diary so you learn to recognise signs your mood is going out of control
  • Avoid stressful situations
  • Talk to your partner or family about the illness
  • Look after yourself - try some of our top tips for looking after your emotional wellbeing.
  • Practise relaxation exercises
  • Don’t take on too much – make time for yourself
  • Eat and exercise regularly
  • Take your medication, even if you’re feeling fine. Talk to your doctor if you want to stop taking it.

More information and support

Bipolar UK. Information and support, local groups and an online chatroom for people with bipolar disorder.

Bipolar Fellowship Scotland. Provides information, support and advice for people with bipolar disorder.

MIND Helpline: 0300 123 3393. Mental health charity providing information, support, local groups and an online chatroom

Other resources

Read more

Sources

  1. NICE (2014) Information for you: Mental health in pregnancy and the year after giving birth National Institute for Health and Care Excellence.  London, Available at:http://www.nice.org.uk/guidance/cg192, p2
  2. NICE (2014) Antenatal and postnatal mental health: clinical and service management guidance, clinical guideline 192, National Institute for Health and Care Excellence.  London, Available at: http://www.nice.org.uk/guidance/cg192, p4
  3. NICE (2014) Information for you: Mental health in pregnancy and the year after giving birth National Institute for Health and Care Excellence.  London, Available at:http://www.nice.org.uk/guidance/cg192, p4
  4.  NICE (2014) Information for you: Mental health in pregnancy and the year after giving birth National Institute for Health and Care Excellence.  London, Available at:http://www.nice.org.uk/guidance/cg192, p4
  5.  NICE (2014) Information for you: Mental health in pregnancy and the year after giving birth National Institute for Health and Care Excellence.  London, Available at:http://www.nice.org.uk/guidance/cg192, p4
  6.  NICE (2014) Antenatal and postnatal mental health: clinical and service management guidance, clinical guideline 192, National Institute for Health and Care Excellence.  London, Available at: http://www.nice.org.uk/guidance/cg192, p38
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Last reviewed on February 1st, 2015. Next review date February 1st, 2018.

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