I’ve spoken with quite a few moms recently who, through their experience with postpartum depression, found out they have bipolar disorder. Most often they find out they are bipolar because the typical medication treatment for postpartum depression, antidepressants, either isn’t effective or actually makes things worse.
I was reminded of this issue this morning reading a story in American Medical News about the recent American Academy of Family Physicians Scientific Assembly in Orlando. There, Dr. Thomas Griffin Jr. spoke of losing his daughter to suicide 20 years ago after she was treated with antidepressants for postpartum depression. They didn’t know at the time that she had bipolar disorder, and that treatment with antidepressants alone may lead to mania and even suicidality in people with BPD.
Mental illness is now a major focus for Dr. Griffin:
“To make sure he does not overlook bipolar disorder, Dr. Griffin also talks to a patient about how he or she is feeling and looks for symptoms of the illness, which include irritability, distractibility, insomnia, grandiosity, racing thoughts and pressured speech … To monitor patients’ reactions to antidepressants, Dr. Griffin sees them within two weeks.”
I found an interesting article on the Families for Depression Awareness website featuring Dr. S. Nassir Ghaemi that I think those of you who have been diagnosed with bipolar disorder will find very informative. A couple of the comments I found most interesting:
How long does it usually take for someone to be diagnosed for bipolar disorder? Twenty years on average. It tends to take ten years for a patient to get help. Nineteen years old is the mean age level of onset. So, someone may develop bipolar disorder at 19 years old, and then it takes him or her 10 years to seek help, so the person is 29 years old. Then it takes another ten years for the person to actually get diagnosed with bipolar disorder. Patients are usually diagnosed first with major depression.
Do the symptoms of bipolar disorder differ much among people? Yes, the symptoms differ a lot. People tend to have a classic picture of a person who is manic and if someone doesn’t fit that definition, they think the person is not manic. That is a big mistake. One third of manic episodes are euphoric and two-thirds are irritable or a depressed mood. There are also mixed episodes, which are a depressed mood and an irritable mood at the same time, with other manic symptoms and depressive symptoms at the same time. One-half of manic episodes are mixed episodes.
Photo credit: © Kheng Guan Toh – Fotolia.com
Oh do I wish that I was caught sooner. 3 long friggen years and NOW I'm bipolar.
It's not fair.
thank you so much for writing this out and providing education and advocacy. what a great resource for ppd moms!
I'm one of "those" women….I curse it every single day. So very hard knowing you have something that will be here forever where as PPD should go away eventually.
Hear hear… I've had people tell me they were glad I didn't have PPD again after all – what they miss if the fact that PPD alone does get better with therapy and/or medication, but BP is a lifelong disease, which will need to be treated and monitor from here on end. And that even on meds, you can still have episodes, and sometimes need med changes with all the trial and errors that go with it… Yay.
Hope you're doing ok! 🙂
Yes this is me. Always thought it was depression and anxiety
My diagnosis of bipolar disorder came as a complete shock to me. I was 29 years old and my daughter was just a couple of weeks old and now I have this illness that will last the rest of my life. Fortunately, it was caught during my first manic episode and I've been healthy ever since. I still haven't experienced a major depressive episode. Hopefully more people will have earlier detection these days as the stigma begins to lift and people seek treatment earlier.
The only thing professionals need to be careful about is how psychosis can have very similar aspects to bipolar — the manic, not needing sleep, extreme swings in mood, paranoia, reckless behavior.
So it's important for the patient, the spouse, patient's family, etc to step in & talk about past behaviors.
(at least, that was my experience)
This is my story too…
I had PPD after my first, and now after my second are we realizing that I actually have Bipolar. Thankfully, I had wanted to try and get through the PPD without medication, so I avoided the possible side effects of antidepressant for bipolar people. :/
And 10 years feels right one track. In insight, my first major depressive symptoms were at about 16 years, and have been periodic since then. I'm more BP II so I don't get acute mania, more of a hypomania, but yes definitely lots and lots of mixed stated (it explains LOTS of past behaviour and issues, now that we know!)
I'm in a mixed state right now, and I can attest that it is the most confusing and terrifying state to be in – you're depressed but can't stop thinking, but your thoughts are all negative so you just keep bringing yourself down and down, and down some more until you feel worse than worthless; you have no energy or motivation yet you are agitated and suffer from profound insomnia, and get extremely irritable. (note: these are my symptoms, at this time, they do hugely differ from person to person).
And the average 10 extra years for treatment? I sure hope it's sooner than that! But, I'm in the waiting game now as we wait for a psych referral that will manage my meds (the one I consulted for diagnosis does not take ongoing patients). I'm on temporary medication until then but they are not high enough, but my doctor does not want to mess it with too much as it's not her expertise. So we wait…. and call the crisis line. Get the number for your local crisis line, if possible! They are tremendously helpful!
I'm so very glad you touched on this, Katherine. As someone who has been bipolar for most of her life but didn't receive the correct diagnosis until five years ago, I can most certainly attest to how dangerous the wrong diagnosis can be.
With an incorrect diagnosis there came incorrect medications. Some of the effects I'm still dealing with years after the fact. I know for a FACT that my suicidal attempts were due, in part, to receiving a medication that I never should have been taking to begin with. But bipolar disorder is tricky for doctors.
In the case of diagnosing bipolar disorder, I think it is SO important to look into the patient's past. Bipolar disorder is about patterns and one can only find those patterns if they back in time.
Had my doctor at the time asked me about my childhood or early teen years I'm almost certain I would have received the correct diagnosis when I was 15 and avoided so much pain in my life.
Katherine! Thank you so much for for discussing bipolar illness, and the variety of ways it can look. Cheryl Beck and Jeanne Driscoll (two very wonderful leaders in the field) call bipolar illness the "postpartum depression impostor", because it ofter flares up after the birth of a baby, causing depression. We have including information about bipolar disorder and it's diagnosis and treatment in our Postpartum Support International trainings.
It is a chronic illness, but can be managed, just like diabetes, thyroid dysfunction, or high blood pressure. It's not your fault, and you are not to blame. Often there is a genetic component.
Jim Phelps MD, a psychiatrist in Oregon has a wonderful website that discusses the spectrum of bipolar illness, and has a great book out. http://www.psycheducation.org
Be a good consumer and get the help you deserve. Sometimes it takes a few tries to find the right provider.
warmly,
Pec Indman EdD, MFT
http://www.pecindman.com
I wish I could fully articulate how much I hate having this disease, how consuming, painful and isolating it can be, and how frustrating & exhausting it is to try and cope with it. The hardest part is feeling as though those closest to you don't understand it or don't think it's as bad as it is. This illness is hell and it only takes a slight misstep or trigger to send you back over the edge.
I was diagnosed with major depression as a teen & with generalized anxiety in my early 20's while in the military….after the birth of my youngest I've spent the past 2 years spiraling & just got a diagnosis of rapid cycling BPD 2 in July. I wish I had known the risk factors, the evidence, known what to look for…
Thank you Katherine for discussing this…My hope is that it gives women/moms the push they need to seek help….no one deserves to suffer through this hell alone, without support or without proper treatment…
I would just like to mention that Shoshana Bennett, PhD (former president of Postpartum Support International) does write about "bipolar episodes" in the postpartum period (in Postpartum Depression for Dummies), alluding to the possibility of this only being a temporary disorder. Everyone on this forum seems to be resigned to the diagnosis for life. I have just been referred out to a Psychiatrist from my therapist who beleives I'm sufferring from "Postpartum Bipolar Disorder" and I have hope that with the right therapies I can grow through it and out the other side. Has anyone else received this information? I am just beginning my research. I have had periods of depression for my whole life but coped pretty well (without medication, that is) until now. The most frightening part is not knowing who I am anymore and feeling like i can't predict or control my sudden mood changes. i used to be so lighthearted and now i can have the worst temper, which leads to feelings of guilt because i know i can and should be a better mom!
I gave birth 29 years ago and experienced PPD with severe anxiety, insomnia, horrendous OCD, and depression. Finally I was put on Elavil but nothing for anxiety for years. I was diagnosed with recurrent depression, panic and OCD by 5 different docs. Last year I went to a different doc due to my daughter urging me. He diagnosed me with Bipolar2 or rather as he called it a mixed mood disorder. He put me on Oxcarbazepine and klonopin. It has been a year now with only one depressive episode. My age: 61. 29 years of mental torment and torture and one suicide attempt. Thank God for this doc. He saved my life. I call this disease “The Life Stealer.”