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  • Sarah Dionne, MSW, LICSW

Bipolar and Pregnancy : A Story of Conflict


Making the decision to embark on pregnancy while living with bipolar disorder was not easy. Stability from a mental illness largely comes from self care, routine and regular sleep, all of which are drastically compromised by caring for a newborn. Was I going to be capable of making the adjustments needed to care for an infant? Could I handle sleeplessness and fatigue, the hallmark of early motherhood? And then there was medication.


I was taking medication that had changed my life, it provided freedom from wild mood swings and the depths of despairing depression. Could I take medication during pregnancy? Could I expose an unborn baby to its possibly unforeseen effects? And, even if all of the literature said it was safe to continue… did I want to?


I will take a moment to say that for someone with a mental illness, considering discontinuing a medication is not a simple decision even for a brief period of time. It’s not merely, I’d rather not feel depressed so I’ll keep taking it, or, I think I can manage so i’ll stop it for now until my baby’s born. The question is far more than simply quality of life. The questions more resemble, If depression returns will I be able to keep working, would I be able to stave off the potential return of suicidal thoughts or could I end up like my sorrowful friend who lost her ground, hanging herself during pregnancy, could I lose the love for my infant within the gray, numb walls of depression or would I resent the tiny presence for the suffering I’d endured, would mania take hold to the point of delusion that could threaten all the stability I’d worked for…



Yet, the consideration to stop taking drugs was fueled by fear of harming such a vulnerable life, desire for my baby to be exposed only to what’s naturally intended, and also by harsh self judgement. So many women had written their accounts of ceasing medication and making it through pregnancy unscathed. And there I was, a psychotherapist, well versed in managing bipolar disorder, and yet unsure I could let go of a drug to benefit my baby. Regardless of the severity of the decision, I considered myself selfish.


Anxiety as a driving force, I dove into research, read study after study, and asked my psychiatrist a million questions. I visited with a psychiatric specialist in pregnancy and medications for a second opinion. I read anecdotal stories written by mothers’ about their experiences with medication, pregnancy, and their children’s development. Every single one said the mood stabilizing medication I was on was safe. Yet, it did not settle well within me. I decided to try coming off of all medication before making any sure decisions about pregnancy.


I was taking a sleep aid that had proven adverse effects on pregnancy. This one I would have to discontinue, yet, rather than weaning off of it myself, I made an appointment with a sleep specialist. He guided me through methods to improve my quality of sleep while also slowly discontinuing the drug. And, after some time and effort, I found myself waking in the mornings, gratefully rested without having taken the med at all. Excited and hopeful, I viewed it as, one down and one to go.


I met with my psychiatrist regularly as we began to decrease the mood stabilizing medication very slowly. Bit by bit, every two weeks a little less, confident that I could let go of the it completely as my mood remained even. I was sanguine with how okay I felt even as the milligrams dwindled week after week.


Yet…


Depression can be slow and insidious or, at times, more like a freight train crashing into an unsuspecting moment. The freight train arrived one afternoon as I drove home from work, sudden salty tears stung my eyes as the bottom of my stomach became a pool of ice casting chills of fear and crushing sorrow. I waited in our apartment for my husband to appear in the doorway, when he arrived I reached for him through lurching sobs. What’s wrong, he begged with obvious concern. I knew what was wrong. I knew it was depression.


After a week of hoping it would simply abait, i returned to my psychiatrist in defeat. He validated the disappointment and, again, assured me that I could still have a baby. The overwhelming fact became clear. If I wanted a baby I would have to remain on medication. If I did not want to become pregnant while taking it, then I couldn’t have a baby… not if I wanted my sanity too. My psychotherapist self knew that a severely depressed mother would be even more adverse to a developing life. I pondered this choice with a heart filled with disappointment and fears of harming an unborn child, yet desperately yearning for motherhood.


I am a very Spiritual woman and, finally, after running solely on anxiety and fear, I turned to my Wise Self in meditation begging the Universe, what should I do? I believe firmly that we all have a connection to a Higher Understanding, we all have the answers within us, whether we believe they arrive from the Savior, from the Buddha, from Shiva or Ganesha, Alah or Nature itself. The answer is there. Waiting patiently. Wandering lost through a thick fog of anxiety, I’d forgotten this until that moment when I finally turned inward. The answer was resounding and clear. Trust those around you that are trying to guide you, trust your clear Wise Knowledge that you are meant to be a mother and that your baby is waiting for you, trust that you will be able to move with the winds of change, that you are capable of all the challenges of motherhood regardless of fear. Trust that your child will be well. Trust… Trust.



At least for that moment I was able to let the anxiety go. Soon after, resuming the typical medication and feeling level again, my husband and I began to embark on a journey toward a new life. We tried for one month. And I was pregnant. Trust… trust…


The journey through pregnancy is a story in itself… and one I will be sure to share.



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