Q. I'm bipolar and have gone off my meds for this pregnancy. I am worried about PPD. Knowing how common it is, I was wondering how common it is in bipolar mommies? I am continuing with my daily charting and increased my therapy to once a week. I'm doing quite well but fear PPD. I tried suicide a year before my baby is due. If there are any books you could recommend, I would truly appreciate it.
A. You are right to be concerned about it and that means you'll take the steps that are needed to protect yourself.
Women with bipolar disorder need to be especially careful during pregnancy and the postpartum period. It's not easy to decide whether to remain on medication during pregnancy or not, but I'm glad you've stepped up your therapy. You also say you are doing quite well, which is terrific, but that you were suicidal, which of course, increases your risk of illness after the birth. Some docs will suggest you resume medication after the first trimester, but since you're doing well, you may just want to continue monitoring this with your doctor. With this plan, however, it is critical that you resume your medication within hours after delivery, since postpartum depression or psychosis are very real risks for bipolar women. I recommend When Words are not Enough by Valerie Raskin, M.D. She co-authored This Isn't What I Expected: Overcoming Postpartum Depression and her book is a wonderful resource for all women who experience depression and anxiety at any level.