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 Marcia Purse

Any Psychiatric Illness After Childbirth May Presage Bipolar Disorder

By December 10, 2012

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Mother and babyA massive Danish study that followed over 120,000 women who were born over a 40-year period has yielded interesting information: that the first appearance of any psychiatric illness after childbirth can ultimately result in a diagnosis of bipolar disorder. The study is "Psychiatric Disorders With Postpartum Onset: Possible Early Manifestations of Bipolar Affective Disorders" (abstract).

They began by following a large group of women beginning with the first time they had inpatient or outpatient treatment for any mental disorder except bipolar disorder, including 2,870 whose first psychiatric contact occurred within 12 months after giving birth. They found that after 15 years, 14% of the women whose first treatment was within 30 days after the birth of a child were later diagnosed with bipolar disorder, compared to just 4% of those whose first psychiatric treatment was not related to childbirth.

Other studies have already found that about episodes of postpartum psychosis, which can be a very serious condition, are strongly linked to bipolar disorder. The reverse is true as well - women already diagnosed with bipolar disorder have a higher risk than others of suffering from postpartum depression or psychosis.

More research is needed to establish the reasons for the connection between childbirth and a subsequent diagnosis of bipolar disorder, but this study and others make it clear that it's important for women to treatment for any unusual mental symptoms occurring within a year, and especially within a month, after a child is born.

Photo: Nasirkhan

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Comments
December 13, 2011 at 2:43 am
(1) Ray Tyler says:

This post on this Danish study has come at a very interesting time.
Recently there has been considerable comment on the internet about the possible link between bipolar disorder and childbirth.
It is clear that research is being done in this area. It is important that a connection is established if there is one. This will lead quicker, more accurate diagnosis in this area. The quicker accurate diagnosis is made the easier it is to implement successful treatments.

December 13, 2011 at 2:31 pm
(2) Dr. Jay Carter says:

Many times postpartum depression in women who have bipolar disorder is not postpartum depression at all, but a severe bipolar depression related to circadian rhythm (sleep) problems due to getting sleep disrupted by having to get up with the baby at night. After a woman with BiPD has a baby, LET HER SLEEP. Dad or a relative should be on the scene getting up with the baby, until the baby sleeps through the night. This will avoid the severe depression brought on by sleep dysfunction. Half the battle with bipolar disorder, in general, is … getting enough sleep. That avoids the chronic fatigue that is often mistaken for depression. If Dad says he “doesn’t hear the baby”, invite the mother-in-law over to help. After a few days, Dad’s hearing will get a lot better.

December 13, 2011 at 4:01 pm
(3) Suzanne says:

I found this article interesting–but also disappointing because I had been expecting it to deal with the question of whether a person’s difficult birth might have a connection to his/her later development of bipolar disorder. Does anyone out there know of any research that has been done on that topic?

December 13, 2011 at 6:29 pm
(4) Joyce T, says:

I personally had an onset of deep depression after my first baby. 11 years later I was diagnosed as manic-depressive (bipolar I). When I look back, I realize that childbirth triggered it. I felt like Humpty Dumpty (and used to recite that poem in my head). “All the king’s horses and all the king’s men” couldn’t put me back together again. I’m so glad that they’re making the connection. I suffered so much, couldn’t stop crying & thinking of suicide constantly & well-meaning people called it the baby blues. The only thing that snapped me out of it was returning to work part-time. Seeing that all my co-workers hadn’t changed a bit somehow helped me to get back to “normal.”

December 13, 2011 at 10:47 pm
(5) Laura says:

I had my first bipolar episode after the birth of my first child. No one knew what it was at that time, and thought the depression was due to my husband being in Viet Nam at the time of my son’s birth. I had similar, but not quite as severe episodes after the births of my daughters. I was not diagnosed until I was 33 after my hysterectomy. My daughter is expecting any time, and I am concerned about her. I am hopeful that it won’t happen since she has never shown any symptoms of bipolar disorder. Fortunately, my doctor has me on great meds, and I have been fine for the past 7 years. I think that’s very rare, especially since I have rapid cycle bipolar. Thanks for the article. It all makes a lot of sense now on why it never surfaced before like that.

December 23, 2011 at 3:59 pm
(6) Julie says:

One of the symptoms of bipolar is carrying on even when you are exhausted. Childbirth can be an exhausting period and if there is a pre-disposition to ‘not giving in’, then all concerned should be aware of this as a trigger to an episode of exhaustion. I experienced this after the birth of both my children and have learned to ‘give in’ to stresses and not to try to be super human. Learning to manage this propensity can be of great help to bipolar sufferers.

December 11, 2012 at 12:59 pm
(7) S.L.Coombes says:

When pregnant with first child my GP didn’t want me gaining too much weight and put me on diet pills. After baby was born I tried nursing him and fell asleep on him after taking a mild sleeping pill. This so traumatized me that my milk dried up. Soon after I became very elated with nervous energy. GP told me sometimes women get a little “manic” after giving birth and advised me to go back to work. I evolved into a serious manic state which of course I didn’t understand. It took almost 3 months to get back to my normal state, but I didn’t bottom out, thank goodness. I wasn’t diagnosed as a manic depressive until many years later when I went into a very serious depressed state, was given Elavil at a psych ward, and went into a manic state 3 weeks later. Lithium virtually saved my life.

December 12, 2012 at 7:07 am
(8) Roza says:

Thank you so much for this very interesting article. I recognize very much in Joyce’s story. 10 years after my second child’s birth I was diagnosed BP. I went through a hugh depression and looking back now (1 year later) I realized that childbirth triggered it, just as in Joyce’s story. A traumatizing birth and chronic fatigue afterwards caused it. Thanks to my doctor I get stabalizing medication that works fine so far. I also learned some excercises to overcome the birth trauma. All that together with a good structured life with order and regularity is my way to get ‘normal’. I hope it will stay that way because I’m afraid another depression would be inbearable to me.

December 12, 2012 at 5:14 pm
(9) basil44 says:

I also had my first psychotic break about three months after my third child was born. While I was out walking to ease my mind a deep, deep voice asked “I wonder how many sleeping pills it would take to kill you and the kids.” Terrifying!. I was very bipolar during my teens and then in my twenties I had a “remission” if you want to call it that. Then my third child was born and the floodgates opened.

December 17, 2012 at 5:18 am
(10) Angie says:

I started having bipolar symptoms when pregnant with my first child. I was better after she was born, but became quite unwell again when pregnant with the second only 10 months later. It took another 6 years to be correctly diagnosed bipolar.

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