Tuesday, January 8, 2013

Lessons Learned in Bipolar Motherhood and Planning for Number Two

It's amazing to think that I started this blog almost 6 years ago when I was planning to conceive. Three weeks ago my daughter turned 5 and it has led me to review the last 6 years as I am currently planning for baby number two. For me the planning process takes months as I need to get myself to a very stable place, reduce (and eliminate) some of my medication, and get back to my ideal weight so that I don't gain too much during pregnancy.

So I wanted to talk about what I've learned both good and bad. It has been helpful for me to think about it as I finally decided it was time to try for another baby.

I'll start with the negative so I can end on a positive note. Before I had my daughter I maintained a stable mood for 5 years. I was beginning to believe that I wasn't really bipolar. Maybe it was some kind of misdiagnosis. Of course then I would remember the hospitalizations, hypomania and mania with resulting psychosis that I had experienced not to mention the multiple suicide attempts.

I was confident in my ability to maintain a stable mood when I got pregnant. I worked very hard to maintain it - I believe that managing bipolar is more than just taking your medicine.

So, on to my challenges after having my daughter. I had an extremely stable mood during pregnancy. I mentally felt better than ever even though I had significant issues with hyperemesis (excessive vomiting during pregnancy). After my daughter was born I slipped into postpartum depressive than lasted a year. At first I was in denial, then I didn't want to make changes because I was determined to breastfeed for a full year. I also was under a significant increase in stress due to the financial impact of my husband's failing business due to the construction decline and my reduced work because of having an infant. And of course there was the sleep deprivation.

After a year, I finally realized something had to change. So I increased my Lamictal dosage and added Abilify. This was one of my biggest regrets. The Abilify caused me to start rapid cycling which lead to ultra rapid cycling. I also gained a lot of weight on Abilify It was one of the worst periods of my life. And somehow I didn't really recognize it. I told myself this was the life of someone with bipolar, I said it was due to stress and I started to believe it was just the kindling effect of bipolar disorder getting worse with age.  After 11 months of rapid cycling I realized the Abilify was the cause and stopped taking it cold turkey. The cold turkey was not recommend by my doctor and was extremely hard as I went through withdrawal, but I was at a breaking point. To this day I don't understand why no one close to me said anything. My family and some close friends commented that they knew I was doing worse on Abilify and just figured I knew and my doctor knew. Well, I didn't really know and psychiatrist rely on what you tell them.

So, after Abilify I stopped the rapid cycling and instead fell into regular bouts of depression. Some were mild, some were severe.

My migraines and cluster headaches returned. They had been gone for years and my doctors think the change in hormones after birth made them restart. 

So now that 5 years have passed, I am doing better. But better means I am still having some mood fluctuations. And I had really wanted to get back to a really stable place before having another baby. Which means I need to go back to what I used to do: more regular and higher intensity exercise, super healthy eating and finding more of a support system.

Now to the positive. My daughter has caused some amazing changes in my life. She is amazing. She brings me more joy and happiness than I could have ever imagined. She makes me want to be better. But the most amazing is she has stopped my suicidal ideation and helped give my life meaning.

My daughter is the most kind and compassionate child I have ever met. She is always thinking of others.  When I don't feel well with migraines or depression she tries to make me feel better.

Her kindness has rubbed off on me. She makes me want to be a better person. She has daughter me to be patient. She has made me realize my heart has an infinite capacity for love. She makes me want to be healthier. She reminds me to exercise, she reminds me to take care of myself.

Lately every day she has reminded me how much she wants a sibling. And I too want another baby so she can have a lifelong friend.

So, my journey continues into bipolar motherhood. I am working towards getting ready for another pregnancy, but I have some work to do - map out a backup plan with my doctor for treatment during pregnancy should I become depressed or manic. Exercise 6 days a week (I know it included my mood) and will help me lose 20 pounds. I do not want to have to buy a whole set of new maternity clothes. Reduce my medication - lamictal, figure out if I should take Lithium in the second half of the pregnancy, get off Nuvigal, stop getting Botox injections for my migraines.

Some of this feels monumental as I was on less medicine before my last pregnancy, exercised daily and was at my ideal weight. But, I am determined to get all of this done in the next six months.
Wish me luck.

And I hope that all of you are having a great start to 2013. I have been tardy on responding to emails but promise to improve in 2013 - this blog and my readers are part of the support system I need to restart.

All the best,
Rachael

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