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How to Handle Bipolar Disorders During Pregnancy in 12 Steps

Bipolar disorder is not a rare condition and there is no contraindication getting pregnant as long as you are under good medical care.

Bipolar disorder is not a rare condition and there is no contraindication getting pregnant as long as you are under good medical care.

  1. Plan before pregnancy. The chance of having an episode during pregnancy for the bipolar increases dramatically. This needs to be taken into consideration before planning a child. If a plan is established early on, the psychiatrist can place the female on medications that are less likely to affect a baby and prepare her for the mental changes that will occur during the pregnancy and delivery.
  2. Contact the psychiatrist. Once the pregnancy test has come back positive, the first doctor the bipolar should call is the psychiatrist. This is due to the potential problems with medication affecting baby. There will be an emergency appointment to determine the best medications and treatment plans to keep both baby and mom safe.
  3. Contact the obstetrician. After meeting with the psychiatrist, the mom will need to call the obstetrician. The attending Ob will need the contact information for the psychiatrist in order to discuss the pregnancy with the doctor and establish a plan of action.
  4. Know the risks. There are great risks when carrying a baby. Those risks are compounded when the pregnant woman is suffering from bipolar disorder. Many bipolars are on multiple medications to keep emotions and mood in check. Even for the Type II Bipolar who may be living medication free, the chance of one manic or depressive episode or more is very high.
  5. Discuss medication plans. Not all medications prescribed to a bipolar are safe during pregnancy. The mom needs to discuss the effects of the medications with both the obstetrician and the psychiatrist. This is especially important for a medicated Type I Bipolar. The symptoms for a Type I Bipolar are far greater than those experienced by a Type II Bipolar. These symptoms include attempted suicide in many cases.
  6. Begin seeing a psychologist. A psychologist may be able to discuss the life problems that are occurring during the pregnancy with the Bipolar. While the psychologist will not be able to prescribe medication, the therapy can help to even the emotional ups and downs associated with the disease.
  7. Establish a symptom calendar. About 12 weeks after conception, there is a very good chance of a bipolar event. Mom needs to watch her symptoms closely and write down every feeling she has from the first moments she finds out she is pregnant. This can help her to establish a pattern and possibly head off a manic or depressive episode.
  8. Lithium. Lithium is a common medication used to treat bipolar disorder. There is very little risk to the fetus when Lithium levels are monitored closely. Mothers who are on other bipolar medications may be switched to Lithium during the pregnancy. Hydration is very important when taking Lithium during pregnancy to prevent toxicity levels from affecting baby and mom.
  9. Depakote. Depakote is an anti-seizure medication that is prescribed as a mood stabilizer for people with bipolar. Depakote is not safe during pregnancy. The medication can have developmental effects on the head and face of baby. Many psychiatrists will switch the mom to another medication during the pregnancy. If Depakote must be taken, the obstetrician will supplement Vitamin K to help ward off face and head deformity and watch the baby closely via ultrasound.
  10. Tegretol. Tegretol is another medication that should not be taken during pregnancy. Unfortunately, the effects on the fetus will occur early on so if the pregnancy goes undetected for a month or so, the negative effects of the drug may have already occurred. If mom has to stay on Tegretol, Vitamin K will be supplemented as with Depakote.
  11. Anti-psychotic medications. Generally speaking, both first generation and second generation anti-psychotic medications are considered relatively safe during pregnancy. More safe, as a matter of fact, than many mood stabilizers. Some anti-psychotics increase the risk of high blood pressure and gestational diabetes in pregnancy.
  12. Sedatives. One of the worst triggers for bipolar events is anxiety and lack of sleep. Sedatives stay in the body a relatively short amount of time and can be used to effectively help mom to sleep better and deal with stress more effectively.

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