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,


Anonymous said...

I loved reading your post about pregnancy...I'm on 8 psych meds and want a child so bad. Adoption is to expensive and they require a medical history they my husband and I would not be able to pass. He is also bipolar and when one parent has it the odds of the child getting is 10%; with two parents its as high as 55%. I'm also 39 which puts me in the at risk category for other issues as well. Thanks for the post, its been hard trying to make a descion as to kids or not. Check out my blog as well

Unknown said...

I'm glad you found my post interesting.

Although my husband doesn't have bipolar, I have many relatives that do which pushes my daughter's risk higher. I used to worry about the potential for inheritance, but I came to realize that almost everyone has the potential to pass on something. My husband's family has Alzheimer. I have friends with diabetes and cancer. Those all have risks.

What I know is that if my daughter does have BP I will be a great resource and support system for her. Something I did not have when I was younger. And modern medicine is improving every day. It could be a non-issue in the future.

I also decided that the world is a better place with me in it - regardless of the demons I have struggled with.

I know what you mean about age, I am a little younger - but will turn 35 this year. I always figured I'd have any baby-making done before I turned 35.

I look forward to reading your blog as well.

Take Care,

I do believe it is a very personal decision, but think the

Anonymous said...

Rachael, thanks for your blog. I've been reading it again and again the past few years as i think about having a baby and my bipolar. I am wanting to start getting ready for this and need to loose weight, eat better and make a plan. Still need to go to the doctor to talk about meds. I am on lamictal as well and i feel pulled as to the risks and benefits. I am hoping you keep up on this blog during this time while being ready to and having your second child. Your blog is something i really appreciate. Angela

Anonymous said...


Thank you so much for starting this blog, and it is a great coincidence for me that you are back to blogging again! I am about to try to get pregnant with IVF, I have bipolar illness, and I recently tried to wean off all of my meds, at the recommendation of my psychiatrist. The last medication I went off was lamictal, and within a week of stopping the last 50 mg, I began feeling extremely suicidal! I am back on lamictal for just a week, and feeling soo much better! Just a few days ago, I was considering cancelling my upcoming IVF cycle, and I am so happy to find your blog and find positive experiences from women who have taken lamictal during pregnancy! I also started having the worst headaches in my life while weaning off of lamictal and didn't necessarily connect the two events until I read your comment saying that lamictal cured your headaches! Good luck with your upcoming plans, and thanks again!

Anonymous said...

I felt relieved when I saw this blog. I have had emotional problems for years and it wasn't until I was I was about 25 that I was diagnosed with bipolar II. I thought the diagnosis was wrong, as I have never had a textbook manic episode before. My therapist started me on Wellbutrin and abilify and for about three months, I never felt so good in my entire life. Looking back, I was probably hypomanic. My husband and I conceived a child during this time and I stopped the abilify but stayed on the Wellbutrin. I was absolutely miserable throughout my entire pregnancy-especially the first 5 months. I thought about suicide daily and was extremely explosive. The Wellbutrin never did anything for me am I eventually stopped taking it. Amazingly, I made t through my pregnancy and gave birth to the most amazing little girl. I truly believe she saved my life. Hearing her cry for the first time changed me. However, I stopped breastfeeding at 6 weeks due to depression and haven't felt the same since before she was conceived. I have struggled with the most severe depression of my life. I am now taking Effexor and lamictal and feel like I can function again. I have been toying with the idea of having a second child for a long time but I am terrified about making it through the pregnancy. Everything I read or hear about those with bipolar who are pregnant is very positive and I seem to have had the opposite experience. Most women with bipolar are happy and "normal" during pregnancy when I feel thankful to have made it through. Don't get me wrong, pregnancy was amazing- especially when I felt my daughter move- but I don't know if I can go through it again. Don't know if anyone else understands, but thought I would share just in case ...

Anonymous said...

I wanted to thank you for your blog as well, I came across it years ago and it really helped me to start thinking about being able to have a baby despite being bipolar. I'm 7 months pregnant now and with the advice of my regular ob-gyn, a high risk ob-gyn consultation, and my psychiatrist (all talked to extensively before I started trying), I decided to stay on Lamictal and Ambien because I personally feel the risks (considered low) are worth my being healthy. I'm nervous about post partum but I'm working on plans for breastfeeding (including having my husband bottle-feed at nights so I can sleep) with a lactation consultant who has worked with bipolar mothers before and I've got a great medical support network that I really trust. My pregnancy has been perfectly healthy so far, I've had 3 extra ultrasounds to monitor the baby's growth and heart for effects from my medication and she's passed with flying colors every time. Your writings really gave me the confidence and background knowledge to make me feel like I could do this.

Unknown said...

I've been following your blog for some time now with great interest. There is so little out there for women with bipolar who wish to get pregnant. I was diagnosed at the end of last year after a horrendous manic then depressive phase - about the third time that's happened to me in my life - at 34. And it was crushing as I so badly wanted kids with my partner. Your blog has been super helpful to read through and help with the choices. I think as well as being bipolar and on lithium, we also have decreased fertility? There's soooo little out there it is frustrating! But, to give people hope I found out 2 days ago I am pregnant with our first :) a year and a half after trying. Very early days of course but it is possible for us to achieve and succeed despite the odds!

Anonymous said...

I'm too emotional to write more, but I want to let you know that you are brave, courageous, and filled with love.

Jo said...

I have been diagnosed biopolar II since 2001. I have always been told by my doctors that children were "not an option" for me because of my condition and medication. I was told I could never get off the medications (geodon, wellbutrin, xanax) and would probably have horrible postpartum depression. I just wrote it off as another heartbreak of life.

Then for some reason I started thinking about it recently and realized that at 34 I'm not too old. I think looking at photos of my husband as a young child nudged me. I am now researching the idea, and stumbled on to your blog. You are so inspiring and so honest, your blog is just a treasure trove for me. I am putting you on my bookmarks bar!