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Pregnancy and Mental Illness

This issue is close to heart. Mental illness/Bipolar vs. pregnancy. To conceive or not conceive? The odds of having a child also with a mental illness? What are the medication risks? Because of so many facts that go into these issues, and I could write for days, I have limited this more to the mental and basic decision-making aspects, and have limited the detail of pharmaceutical aspects. Going through psychotropic uses during pregnancy (Psychiatric medications are psychoactive drugs prescribed for the management of mental and emotional disorders), would be much too daunting to write about in one article.

Pregnancy is such a wonderful experience and exciting time for parents to be. All parents want their kids healthy. While the capability of testing for some genetic markers is possible, mental illness at this time is not one of those.

In 2007, my husband and I were at the point in our lives of deciding whether to conceive, I decided to look for a book on this topic to help my decision. What I discovered amazed me, finding a book on this topic was difficult. In 2007, one book was in the process of release. The book was entitled “Bipolar and Pregnant” by Kristin K. Finn. ONE BOOK. There were plenty of articles on this topic, but I was just flabbergasted there were not published books. The books I did find only dealt with raising a child with bipolar or mental illness, or dealing with a spouse or significant other with a mental disorder.

Another factor I felt needed to be considered is both my husband and I are Bipolar so that added more complexity to our decision. The odds (according to many sources), of having one parent that is bipolar, passing on the disease is approximately 15-30%**. The statistics can jump to 55%** when two bipolar parents have these genes. I struggled with this tremendously. What would happen to my child if they were diagnosed with bipolar? Would they be angry knowing that I conceived them knowing that the odds were against them? If I was in their position knowing that I would be bipolar, would I be angry with my parents? These questions were just many of the numerous ones that went through my head.

While struggling with the above issues, I needed to look at the physical issues as well. Pregnancy can irritate symptoms. The additional hormones and the decision to manage symptoms with or without medication is an enormous issue to tackle.

Planning a pregnancy, in itself consists of many factors, stopping smoking, caffeine use, and prescription and over the counter medication use. It also involves taking care of one’s general health and eating healthy. Dealing with pregnancy while having any mental illness, comes with many trials and tribulations. For those specifically with bipolar disorder or a mental illness additional questions may arise:

• What psychotropic medications can I take?
• Will my child inherit a mental illness?
• Will pregnancy hormones work for or against me?
• Will there be an increased risk for the severity of postpartum depression?
• Should I breastfeed or not?
• Will medications that I am presently on be transferred through the breast milk?
• Will my disability destabilize me, and influence my ability to care for my newborn?
• Sleep? Will lack of sleep be destabilizing? (Personally, for me, sleep throws me off when I do not get enough, and throws me into either a manic or a depressive episode.)

I wish I had a magic ball that helped me to answer these questions. Bipolar typically emerges during early adulthood, presiding throughout the lifespan, usually coinciding with a woman’s childbearing years. I think many women, like me, grow up thinking I want to be a mommy one day. So trying to deal with this issue and this roadblock was very hard. There are still so many: “Why’s,” Why me? What did I do to deserve this? All I wanted was to grow up and be a mommy!”

Unfortunately, there has not been a lot of sizable and comprehensive research on this topic. While some psychotropic medications have been shown not to “have a significant” impact on the fetus…what does “significant” really mean? There really is no definitive information that answers this question. The answer usually comes down to risk vs. harm, and do you manage the illness or simply consider the baby. Stopping medication is very risky and can contribute to a relapse, which jeopardizes the health and ability of care of the newborn.

What do you do when an infant is depending on you for his or hers’ needs. 
So what do you do when you are not able to stop, prescription medications? The bottom line really comes down to a personal decision to make by the parents. Many folks believe that conceiving a childhood, is worth the risk for both themselves and the child.

Carefully planning before conception will help ease and aid in managing symptoms that may arise. I am still struggling with these questions, as I have been for 6 years. I am still undecided, still trying to stabilize myself. It is a difficult decision, and I think taken for granted sometimes, by those who do not have the same questions we with mental illnesses have. My husband and I still do not have an answer of yes or no...if only I had that magic ball.

***Statistics are estimates and from various sources, they should not be considered as exactly accurate.

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