Bipolar and Pregnancy

cont. from

Managing bipolar disorder during pregnancy requires balancing the competing risks and benefits to the woman and her fetus. Pregnancy, and particularly the postpartum period, is associated with a high risk of relapse for women with bipolar disorder. Mood stabilizers have been shown to increase the risk of certain types of birth defects or congenital malformations in infants who were exposed in utero. All women taking mood stabilizers and antipsychotic medications during the first trimester should obtain a high-resolution ultrasound at 16-18 weeks to detect the presence of fetal malformations. It's important to tell your doctor about all medications you are taking and your complete medical and psychiatric history.

Warnings and Precautions

Take your medication as directed. You will very likely be tempted to stop your medication. Many people with bipolar disorder do so. Don’t do so. Instead, talk it over with your health care provider. Stopping your medication will probably cause your symptoms to come back. It may also cause uncomfortable or alarming withdrawal symptoms.

Depending on which medication is used, you may need regular blood tests to monitor levels and to check for side effects of the drug.

You should have regular appointments with your health care provider to see how well the treatment is working and detect any instability of your mood.

Regular sessions with a psychotherapist or counselor are also important.

Ongoing education for you and your family is crucial to help everyone deal with the disease.

You and your family should be taught to watch for early warning signs of crisis and ways to deal with stress to prevent recurrences.

Prognosis and Complications

Bipolar disorder is a long-term condition with no actual cure, only ways to control the symptoms. With proper medication and regular psychotherapy, however, the disease can be controlled with few flare-ups.

With treatment, many people are able to lead "normal" lives. Some (about 1 in 10) may never have another manic episode. Others battle mood swings for the rest of their lives.

While most patients will show some positive response to treatment, response varies widely, from full recovery to a complete lack of response to all drug and/or ECT therapy. Drug therapies frequently need adjustment to achieve the maximum benefit for the patient. Bipolar disorder is a chronic recurrent illness in over 90% of those afflicted, and one that requires lifelong observation and treatment after diagnosis. Patients with untreated or inadequately treated bipolar disorder have a suicide rate of 15-25% and a nine-year decrease in life expectancy. With proper treatment, the life expectancy of the bipolar patient will increase by nearly seven years and work productivity increases by ten years.

People with bipolar disorder and their families and friends can learn to pay attention to signs and symptoms of the depression or mania emerging and have their medications adjusted to prevent a relapse of the low or high. Through education and support, they can be able to monitor themselves.

If untreated, bipolar disorder may lead to risky activities, dysfunction in family and work, and even suicide or homicide.

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Reviewed: 03/2006