Are you worried about pregnancy if you have bipolar disorder? (Bipolar Disorder in Pregnancy)

Do you have bipolar disorder ? You may already be pregnant, or you may be dreaming of having a baby. It's normal to have a lot of questions, fears, and hesitations in your mind at a time like this. "Will the medication I'm taking affect the baby?", "What will happen to me if I stop taking the medication suddenly?", "Can I be a good mother with this condition?" These things must be troubling you. Don't worry. The most important thing is to be properly informed about this. Let's talk about this openly and in a friendly way today.

Can Bipolar Disorder become complicated during pregnancy?

In fact, research into bipolar disorder and its treatment during pregnancy is still ongoing. However, based on current data, there is a risk of the condition worsening during pregnancy. Some people think that pregnancy is a time of psychological protection for a woman. But for a woman with bipolar disorder, that is not the case.

One study found that pregnant women with bipolar disorder were seven times more likely to be hospitalized than other pregnant women. Also, a study that looked at women who were planning to have a baby and stopped taking their medication six months before getting pregnant found the following:

• If the medication is stopped, the risk of the disease recurring doubles.
• If you suddenly stop taking medication, whether you intend to or not , symptoms will return in 50% of people within as little as two weeks.
• Those who stopped taking the medication suffered from symptoms for 40% of their pregnancy, more than four times longer than those who continued taking the medication.

Learn about using bipolar medications during pregnancy

This is a big question for many people. There are many mothers who have given birth to healthy babies while taking treatment for bipolar disorder. However, some medications, especially during the first trimester of pregnancy, carry a small risk of causing birth defects.

You see, right? Not taking medication is also risky. So this should be decided together with your obstetrician and psychiatrist. They are the ones who will weigh the risks and benefits based on your situation and make the best decision.

Mood Stabilizers

These are the most commonly prescribed medications for bipolar disorder.

• Lithium: Lithium can cause a rare heart defect in the baby during the first trimester of pregnancy. So sometimes doctors stop giving lithium during this time. But for some women, the benefits of continuing to take lithium far outweigh the risks. Also, continuing to take lithium after giving birth can reduce the risk of the disease from 50% to 10%.
• If you are taking lithium: Drink plenty of water. Use salt sparingly. Check your lithium levels regularly as directed by your doctor. If you suspect lithium toxicity, go to the nearest hospital emergency room (ETU) immediately. You can also call the National Poisons Information Center at the Colombo National Hospital for advice.

• Valproate/Depakote and Carbamazepine/Tegretol: Both of these medications are associated with an increased risk of neural tube defects if taken early in pregnancy. Therefore, doctors often stop these medications as soon as they detect pregnancy and switch to safer medications. It is important to take vitamins containing folic acid during this time.

• Lamotrigine/Lamictal: This may be a safer alternative to the above medications for some women.

Antipsychotic Medications

These medications are used to treat mania, especially hallucinations. There are newer medications such as Aripiprazole (Abilify), Olanzapine (Zyprexa), and Quetiapine (Seroquel). Your doctor may recommend that you switch to an older medication such as Haloperidol (Haldol) during pregnancy.

Antidepressants

There is little data on how these affect pregnant women with bipolar disorder. If you take these medications, doctors will often monitor your mood to see if you suddenly experience mania.

Is ECT treatment (electroconvulsive therapy) appropriate?

Some people are scared when they hear the word electroconvulsive therapy (ECT). But it's actually one of the safest and most effective treatments available during pregnancy. It can be a great relief for pregnant women who are suffering from severe depression or mania. When giving this treatment, doctors take a few extra steps:

• The baby's heart rate and oxygen levels are constantly monitored during treatment.
• Medication is given to prevent stomach acid from flowing into the throat.
• To prevent premature birth, it is advised to consume plenty of fluids and nutritious foods.

What else can you do?

Just like medication, your lifestyle is also very important during this time.

• Manage stress: Keep your mind as free as possible. Exercise, meditate, do something you enjoy.
• Maintain a routine: Go to bed, wake up, and eat at the same time. This will help you control sudden mood swings.
• Get good sleep: Sleep is essential for managing bipolar disorder.
• Psychotherapy: During this time, it is very important to seek the help of a trusted counselor with whom you can talk about your feelings and fears.

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