45 First Person: How I (Mis)Managed my Bipolar Disorder during my Pregnancies

BY CASSANDRA STOUT

Editor’s Note: This chapter contains a discussion of suicide. If you or someone you know is at risk of suicide, please

• Call or text the U.S. National Suicide Prevention Lifeline at 988
• Go to 988Lifeline for additional resources.

For a post with a list of domestic crisis lines, click here and for a post with a list of international crisis lines, click here.

Pregnancy. It’s a time of joy for some, a time of horror for others, and a time of anxiety for most. Becoming pregnant, regardless of the outcome, changes your life forever. And if you have a mismanaged mental illness that’s affected by maternal hormones like bipolar disorder, irrevocable damage can be done.

May is National Maternal Depression month in the U.S., a time to reflect and raise awareness for mothers who face challenges such as postpartum depression.

According to WebMD’s guide to bipolar disorder and pregnancy, “Pregnant women or new mothers with bipolar disorder have seven times the risk of hospital admissions compared to pregnant women who do not have bipolar disorder.”

And I was one of them.

Here are my completely different experiences with my two pregnancies and how I managed and mismanaged my bipolar disorder—and what a difference that made.

During my first pregnancy, warning signs of an undiagnosed, worsening bipolar disorder were missed or ignored by my obstetrician. As I wasn’t aware that I had a mental illness, my anxiety, depression, and mania—a mixed mood episode—quickly grew out of control and ravaged my mind and body.

Because of lingering issues centered around going hungry as a child, my manic fear that my new family would go hungry forced me to build a balcony garden with recycled tin cans and bulk soil purchased for pennies. I was terrified that my husband and I would run out of money despite his stable, high-paying job.

The garden never took off, and due to my burgeoning depression, I quickly became suicidal. I became obsessed with a show I saw once a week on television, Avatar: The Last Airbender, living only for new episodes. I forced my husband to watch the show, saying I identified with the sociopathic character who has a psychotic break in the end because I was so numb and messed up.

Faced with decorating a nursery on what I perceived to be a shoe-string budget, I dove in our apartment’s huge dumpster for mismatched, broken lamps, bassinets, and other baby items. I crammed our guest room/nursery so full of filthy items, we couldn’t even walk through the room.

I could not bond with my baby, instead concentrating on how awful I felt. I was jittery, depressed, irritable, lonely, and physically sick—I suffered from a condition called hyperemesis, which means I threw up several times a day for nine months straight.

Rather than gaining weight like I was supposed to, I lost thirty pounds and only gained back ten, and was placed on bedrest four months in. I lost even more weight after the baby was born. I started out the pregnancy at 148 pounds and ended it at approximately 100–not exactly a healthy weight for a 5’7” woman.

Throughout the pregnancy, I faced challenges such as social isolation (my husband and I had just moved 1,500 miles away from friends and family for his job), limited mobility (I sprained my ankle and couldn’t drive), and completely wild hormones. It’s no wonder that I suffered a psychotic break after giving birth!

Fortunately, I committed myself to a mental hospital with the help of my therapist, whom I’d started seeing at the beginning of the pregnancy. The doctors there gave me an official diagnosis—bipolar disorder type 1—as well as medication that saved my life.

Following the pregnancy, I suffered from a crippling postpartum depression that rewired me completely. I went from a bold, confident, intelligent young woman to someone fearful and constantly seeking validation from others.

It took me three long years and several medication changes to recover—and even now, 13 years later, I’m not quite 100% back to my former self.

However, three years after recovering from postpartum depression, when my first child was six, I was ready to try for another baby. My husband had always encouraged me to be in control of our reproductive choices, so he willingly agreed to a second pregnancy.

For the second pregnancy, I insisted on taking medication. I didn’t want to go back into the depths of suicidal depression. And I faithfully attended therapy once a week, discussing coping strategies I could use.

During the second pregnancy, I once again suffered from hyperemesis. I threw up 6-8 times per day from the moment I conceived until the day I gave birth.

Despite that, I my spirits were high and I didn’t suffer a massive depressive or manic episode. I was no longer depending on a television show to emotionally sustain me.

My routine of medication, therapy, and self-care kept the awful mood episodes at bay. I was sane, stable, and dare I say, happy. I was able to bond with my baby and suffered no ill effects after giving birth.

All things considered, except for the hyperemesis and bedrest, the second pregnancy was much closer to “normal” and expected for a healthy pregnancy. I certainly didn’t suffer as much emotional pain!

My bipolar disorder diagnosis—and appropriate approaches to treatment—made such a difference in my two pregnancies. After the first one, I was terrified to have more children; after the second, I considered having a third.

If you have bipolar disorder or even think you do, carefully consider the risks of getting pregnant before you embark on that journey. It may take you somewhere you don’t wish to be.

But there are steps you can take to sustain a safe and healthy pregnancy. Low-risk psychotropic medications are available to you. Talk therapy poses no risk to the baby. And a self-care routine prioritizing sleep can do nothing but good for you.

I wish you well on your journey.

About the Author

Freelance writer Cassandra Stout blogs at the award-winning Bipolar Parent, a comprehensive resource for parents with mental illnesses. Cassandra holds degrees from the University of Arizona in Creative Writing and Journalism, and aims to return to school for her Masters degree in Clinical Mental Health Counseling. A U.S. resident, she has been a judge for the Pacific Northwest Writers’ Association literary contest for ten years, where her memoir, Committed, recently placed as a finalist. She balances her literary work with raising her children, writing fanfiction, and managing her bipolar disorder.