Pregnancy can be a tricky time for women diagnosed with psychiatric disorders but a new study indicates it’s especially tough on women previously diagnosed with bipolar disorder (BD). Various pregnancy-related factors often trigger a resurgence of symptoms that present “extra challenges” for bipolar women during and after pregnancy, according to Cynthia Battle, lead author of a study recently published online at the Journal of Affective Disorders website.
Battle says pregnancy is a “highly vulnerable time for these women” due to “increased functional demands.” Battle, a psychologist at the Butler Hospital and Women & Infants Hospital, is also an Associate Research Professor of Psychiatry and Human Behavior at Brown University’s Alpert Medical School in Providence, Rhode Island.
Using records from 334 women seeking psychiatric treatment at the Women & Infants Day Hospital Program, Battle and her colleagues identified 32 who were diagnosed with either type I, type II, or unspecified BD. The program focuses on perinatal care for women diagnosed with an assortment of psychiatric disorders including generalized anxiety, major depression, obsessive compulsive disorder, and PTSD.
The Battle research team identified “significantly heightened risk for self-harm and impairment” among the BD patients. Of this group:
- More than 50% had histories of substance abuse, which was a factor in only about 26% of the other women in the program.
- 59% had attempted suicide at some time in the past, compared to only 27% of the others.
- More than 50% of the BD patients experienced delivery complications but only 27% of the others did.
- 78% of the BD new mothers experienced difficulties with breastfeeding while only 42.3% of the other new mothers found breastfeeding difficult.
In the study findings, Battle stresses the need for close monitoring during pregnancy with special attention paid to irritability and elation, both of which are symptoms of bipolar disorder rather than depression. Irritability is symptomatic of both disorders but elation is a symptom of the mania phase of BD. Feelings of irritability were reported in 75% of the larger segment of the study group (not diagnosed with BD) but mania symptoms (elation) were reported by only 24.5% of them.
Now that the extra pregnancy-related challenges associated with BD have been identified, Battle says better support systems for these women is the next order of business. She is already working with a team of specialists to develop specialized psychosocial interventions for perinatal BD patients.
Battle advocates more effective psychosocial therapies but says it’s also important to find pregnancy-safe medications for these women so they don’t abruptly stop taking medications during pregnancy or breastfeeding.
Source: “Bipolar disorder risks for perinatal women.” Brown University. Brown University. Feb 24, 2014. Web. Mar 11, 2014.