After the birth of my 2nd child Ellie, my mental health changed dramatically. I started to have symptoms of mania, which until then had not presented themselves. After going through what I thought was postpartum depression and anxiety, I’ve come to understand that it was probably postpartum bipolar disorder.
It is a diagnosis that until recently had not been studied. But in 2012, here on Postpartum Progress, Katherine asked perinatal mood and anxiety expert Karen Kleiman, MSW, LCSW to write about this often misdiagnosed postpartum illness, and that information really made me think.
I’ve now seen this study from 2013 that shows women with clinical depression prior to childbirth have a much greater chance of being diagnosed with postpartum bipolar disorder, so I believe its time for the medical community to be more aware of this possible outcome, and take steps to properly diagnose and treat women who are fighting this illness.
Today, I’ve invited Dyane Leshin-Harwood to share her journey with Postpartum Bipolar Disorder. I’m interested to hear if you too identify with her experience like I do. Please welcome Dyane:
On a warm summer night, I was a sweaty nine months pregnant when my water broke. We immediately went to the hospital and I stayed up all night in labor, not sleeping one wink.
This innocent-sounding act — enduring one night without sleep — would be my biochemical trigger for postpartum bipolar disorder.
Despite a strong family history of bipolar, I didn’t have any inkling that mental illness was latent in me. My first daughter Avonlea had been born almost two years earlier, and I was incredibly fortunate that I did not have a postpartum mood disorder after her birth.
My second daughter Marilla was born at noon, on August 26, 2007. At first I was hypo-manic, exuberant with joy over the birth, but to others I appeared relatively normal. Sweet Marilla attracted most of the attention so no one saw that I was already in trouble. I began to sense something was off, but my fear of being an inept mother caused me to keep my feelings inside.
Since we didn’t have family members immediately available to us, my mother gave us the gift of a postpartum doula named Grace. She planned to be with us after Marilla’s birth, but an unanticipated allergic reaction delayed her joining us by four days. As Grace hadn’t previously known my personality, she didn’t realize that my manic behavior was quite different from how I had been before the birth. She had worked with over 150 mothers and while some of them suffered from postpartum depression, none had experienced postpartum mania like I did.
The deceptive part of postpartum mania is that people often think the new mother is simply happy to have a baby. After Marilla’s birth, I was filled with an overwhelming amount of joy and energy. However, not one of my state-of-the-art maternity center nurses, OB-GYNs, or our pediatrician detected my mania right away. My father had bipolar one disorder, and I had suffered clinical depression ten years prior to Marilla’s birth, but still no one noticed.
During my hypomanic state, I could feel my brain thinking much, much faster than it had before. I also had a very rare condition triggered called hypergraphia, which is compulsive writing. I had been a freelance writer for years, but this kind of writing was totally different.
Once I returned home from the hospital, I simply could not stop writing. I wrote at every opportunity, even during breastfeeding, and it was completely bizarre. I went online and typed lengthy emails to friends. I didn’t realize my friends would see the actual time I sent their emails, and some of them later told me they were puzzled that I was writing such lengthy epistles in the wee hours, night after night.
During my sleepless nights postpartum, in a well-meaning effort my husband hid my laptop. As he slept, I cleaned for a good part of the night as quietly as I could. While I scrubbed countertops and organized drawers at 3 a.m., I yearned to have some semblance of peace and balance in my life.
After I barely slept for many days in a row, I was feeling much the way I imagined a coke addict would feel. I was revving with energy, but I also felt exhausted and on the brink of an emotional outburst. But even then, no one thought I should consult a psychiatrist.
During that fateful postpartum week, my brain chemistry was markedly awry in every part of my body. Apart from cleaning the house, I had the other classic signs of mania: tons of energy, pressured speech, no appetite and weight loss. I couldn’t sit still, so my mania also affected my ability to adequately breastfeed my baby. At Marilla’s one-week check-up we discovered her weight had dropped almost a pound.
After almost a week without sleep, I knew that I was sinking fast and something needed to change. I called my OB/GYN and told her medical assistant I couldn’t sleep and was given a sleep-aid. I then called our local Postpartum “Warmline” and found the number disconnected! I was incredulous that such an important hotline had vanished. I called information asking if they had some kind of a postpartum support line. The operator couldn’t find a number and I got even more discouraged. Finally, I called our local maternity hospital’s lactation center and they gave me the number of the Postpartum Support International (PSI) Bay Area hotline.
The PSI volunteer encouraged me to take the medication to help me sleep. I felt so comforted in speaking with someone who understood how difficult the postpartum period was, and I took that first sleeping pill. I got the first decent night’s sleep in five nights and I felt a little rested the following day.
A month after Marilla was born, I knew I was still manic; after all, I had witnessed mania firsthand in my Dad. But before I told anyone, including my husband, I surfed the internet looking for anything related to postpartum mania. I located a statistic that one in one thousand mothers who give birth will have postpartum mania. Then the name “Dr. Alice W. Flaherty”appeared in my search results. She was a neurologist at Massachusetts General Hospital, a Harvard professor, and author of The Midnight Disease, an examination of the drive to write, writer’s block and the creative brain.
In her book, Dr. Flaherty courageously shares her own experience with hypergraphia, the heartbreaking death of her newborn twins, and her hospitalization for a postpartum mood disorder. I had the gut feeling that this woman could help me. After contacting her, she shared how medication had helped her postpartum mania, and suggested I consider supplementing with formula for my mental health, which I did.
At Marilla’s six-week checkup, her pediatrician listened to my racing voice and and blurted out “You’re manic!” and I burst into tears. While I felt embarrassed and ashamed, a part of me felt relieved that he figured out what was happening with me. From that point on, my mental condition deteriorated and it was clear I needed hospitalization. It broke my heart to leave my family, but I admitted myself into our local hospital’s mental health unit. It was there I was officially diagnosed with bipolar one disorder and I took my first mood stabilizer.
I feel that it’s imperative the doctors and other caregivers who assess women for postpartum depression also screen them for hypomanic or manic symptoms. My two daughters and husband have suffered immeasurably due to my postpartum bipolar disorder. But they have also witnessed my hard-won recovery.
After several years of trying many medications, multiple hospitalizations and even two courses of electroconvulsive therapy, I am finally stable. Bipolar disorder ravages many relationships, but Craig and I have been married for fifteen years. With the guidance of counselors and psychiatrists, our marriage is stronger and more precious than ever before.
With any mood disorder, community support can be incredibly helpful. That’s why I’m so glad you’ve found Postpartum Progress. Life will always be a challenge living with bipolar disorder, but my girls have inspired me to work on my recovery with every ounce of my being. I hope you will too.
Dyane is member of the International Bipolar Foundation’s Consumer Advisory Board and IBF blogger at ibf.org. She is working on her first book Birth of a New Brain – Healing from Postpartum Bipolar Disorder and blogs at “Birth of a New Brain” at www.proudlybipolar.wordpress.com.
P.S. March 30th is World Bipolar Day. Visit here for more information on how you can become involved.
Thank you to Katherine Stone and Cristi Comes for encouraging me and giving me the opportunity to share my experience with postpartum bipolar disorder. I have tremendous respect for them and for all the moms connected with Postpartum Progress – that includes *you* if you are reading this comment! Take care! Dyane
Thank YOU! Hugs. xoxox
ramsmommy, your comment brightened an overcast morning for me. I appreciate your hugs and send a bunch right back to you!!! thank you, thank you!
I’m glad it brightened your day. Please keep me in your prayers and keep spreading the word. I haven’t yet climbed completely out of the darkness (my son is 2!) and am still not on the right combination of meds/therapy, etc. I’m terrified. I need good stories and hope!!! I appreciate you! xo
I totally will keep you and your family in my prayers, ramsmommy! You WILL make it out of the dark!!!! It’s wonderful you discovered the Postpartum Progress community too – I didn’t even know about PP until years after my dx. As you know, it takes time to find that magic combo. but I know you will. Keep reading good stories, reach out for support, for yourself and your sweet little boy. xoxoxoxoxo lots of love, Dyane
a tearful and heartfelt THANK YOU. The stories help so much!!!! xoxoxox
I’m thinking of you too. there is so much hope. I promise. and just reading these stories and knowing we’re not alone helps so much. there is a community of us who understand and support you. hugs!
I’m so pleased you were able to share you story here Dyane. I know postpartum bipolar happens to a lot of women but so many aren’t aware that its a possibility. You are helping others by sharing your own story without shame.
Cristi, you rock! I’ll always be grateful to you for giving me the opportunity to share what happened to me. I can’t wait to wear my beautiful butterfly tank with pride and wearing it will remind me of your generosity and compassion! I should have bought 3 of them as I’ll wear mine out quickly! 🙂 Seriously, thanks from the bottom of my heart. I’ll never forget this day.
Cristi, I visited your website for the first time yesterday and am blown away by you. THANK YOU and keep it up. Forever grateful!!!
OH goodness, aren’t you sweet. You can do this, i promise.
Thank you! I’m longing for the day when I believe that, know it, etc. Hard to stay positive and not keep thinking this is as good as it gets and all the what ifs…(what if I relapse, what if I never get well, what if I damage my son, what if my husband leaves me, what if I lose my job, what if I can’t be a mommy)….they loom all the time and bring me down. but then I pick myself up! Gets SO tiring, physically, mentally and spiritually. thank you thank you thank you…..
Dyane. Your story helped me see the truth about myself. I am manic and I think I’ve had bipolar for a long time. would love to Skype or meet you some day. Heading to Dr’s today for assessment and diagnosis. God bless you for sharing your story, researching and exposing this. I had no idea
Leah, thanks so much for your comment. It truly made my day to hear from you, and I’m glad my story helped a little bit. I hope with all my heart that the doctor’s appointment went well!
No matter what, plase remember you will get better! Don’t give up on pursuing a treatment plan that works for you (which includes a good doctor!) and that takes time – be kind to yourself and surround yourself with supportive people as much as you can. Don’t be afraid to ask for help – you have enough going on a mom. My thoughts are with you!
(((hugs)))),
Dyane
Thank you for sharing your story. This is such an important topic. I suffer from postpartum anxiety with major insomnia issues. My mother has bipolar disorder and I often feared this was my “break.” I got screened for bipolar and I don’t have it, but I’m thankful for my psychiatrst who saw the potential there. Thank you again, this will help so many women.
So terrific that you were screened. I love hearing that.
I wish that I couldn’t identify with this.
I honestly believe that screening is the key and education (since you have a history it should have been taken very seriously and dealt with aggressively)
Mania/hypomania is a hard thing to pick up on like you said.
I was diagnosed bipolar after PPD. It is far more common than we think it is and we need to shed MORE light on this topic…so that women suffering from PPD can get on the right path. I suffered far too long.
More of these heroic stories please 😉
Thank you for sharing xo
You are so right on Kim. As I said this happened to me too and I know of others of us. Its just something we don’t realize can happen. And doctors HAVE to screen for it wherever and whenever they can. Its an ongoing this as you know so just one 6-week postpartum screening is not going to cut it. Hugs to you!
Thank you so much Kimberly! I wish you couldn’t identify with my story either! Your comment really says it all – you truly get it. Hopefully in our llifetime there will be universal mental health screening for pregnant and postpartum women. Have you signed the current petition asking our government to enact universal mental health screening for women? Even if we don’t get the 100,000 signatures by the April 4th deadline needed for a meeting with officials, it will help to have as many signatures as possible. Here’s the link, and once again, a huge thank you for your comment! https://petitions.whitehouse.gov/petition/every-mother-every-time-universal-mental-health-screening-every-pregnant-and-postpartum-woman/rG1jLyYj
I’m Canadian 😉
But I still root for you ‘Muricans 😉
I was excited to be able to write a piece for a BP magazine on this very issue. It is so important because it gets overlooked.
Hi again, Kimberly I’ve subscribed to BP for years now and I didn’t spot your article about postpartum bipolar disorder – do you mind sharing the year/issue here? I’d love to buy a copy! Thanks so much, Dyane
What is BP? Do tell. Is it something you all recommend I be receiving and reading? Thank you and hugs.
Hi again! 🙂 BP Is Bipolar Magazine and has been around for a while now. It’s the best magazine out there that focuses on bipolar-related issues! Their tagline is “Hope and harmony for people with bipolar”. They have a great blog too on their website. http://www.bphope.com Take good care, & thanks for asking about the magazine, ramsmommy! ((hugs)) from Dyane
Hi Genevieve & thanks so much for your comment! Yes, we have much in common with our both being diagnosed with bipolar one postpartum, and it sounds like you may have experienced hypergraphia as well. That’s fantastic you are writing a book, and I hope there’s an English version I could buy!
I’d love to connect with you and possibly interview you for my book if you are interested. I would also like to read your blog (if it’s in English! 😉 and I hope to hear from you. Thanks & take care, Dyane Harwood (Please feel welcome to contact me at dyane@baymoon.com)
Hi Dyane,
I’ll surely contact you. I would be happy to participate in an interview for you book 🙂 My blog is all in French and so will be my book. But I will probably have it translated. You can try to use google translate to read my blog even though the translation is not great…
http://www.post-partum-bipolaire.me
Thank you Dyane! Your story is so similar to mine! It’s encouraging to find out that someone else went through postpartum bipolar disorder like me. I had been diagnosed with bipolar disorder type one five weeks after the birth of my first child. I experienced mania for the first time right after the birth and psychosis as well. I was also writing a lot since so many thoughts were coming to my mind. I was hospitalized for a week. Fortunately, the mood stabilizer worked very well for me and I got better relatively fast. There was no history of bipolar disorder in my family so it was quite a “surprise” to get that diagnosis. I am now sharing my story on a French blog (I am a French Canadian) and in a process of writing a book about it.
Great article. Thanks for putting more awareness into the world about this. While the hospital staff was preoccupied, your pediatrician did catch this though. And you were resourceful enough to find warmline support. There is alot of information out now about the risk factors for perinatal mood disorders with a personal / prior episode of mental illness/depression/anxiety/BiP or if BiP or other mental illness is in your family history, But we all need to do more. It’s definetly on my radar screen and I feel so glad to be able to help my clients with developing an awareness and integrating a plan about caring/managing their mental health as part of their birth plan for managing their pregnancy birth and postpartum times. Great article!
Thank you so much for your kind words! Yes, I am fortunate my pediatrician recognized postpartum mania & that I was eventually able to track down the postpartum support line. I am so glad we’ve connected via Facebook. Your clients are lucky to have someone like you in their corner! I look forward to keeping in touch with you down the line regarding my book “Birth of a New Brain – Healing from Postpartum Bipolar” and if you come across any studies you think I’d be interested in, please send them my way. take care, dear Kathy!
ntil I was diagnosed with Type II Bipolar after the birth of my second child. Before that, I’d always had what I thought was the world’s worst case of insomnia, battled bouts of depression (always with some stressor that totally made sense), and, in college, started having anxiety attacks. I dealt with depression and anxiety attacks during both pregnancies, but was treated and was fine after my son’s birth. However, the first nine months of my daughter’s life was a nightmare. I existed in a mixed mood state that left me feeling completely incompetent as a mother and our household in chaos. After a nearly 3 hour long intake appointment, I was diagnosed, and within 48 hours of taking my first doses of a mood stabilizer, I was a completely different person. 7 years, a fair amount of therapy, and proper meds/dosages later, it’s under control and I know that while it’s part of me, it doesn’t define me. I’m now a divorced single mom raising both kids on my own and trying to figure out how to go back to work after stepping away from my career path 12 years ago. And, sadly, my first-born has been disagnosed with Type II and ADD – fortunately, when he started showing signs of both at age 3 and 4, I knew enough to aggressively pursue diagnosis and treatment. It’s a challlenge and some days are certainly better than others. But, I work hard to keep myself healthy and do everything I can to make sure he has every opportunity to stay healthy and thrive. I swear someday I’m going to write the book about out experiences . . . until then, I want to thank you so much for sharing this. Just knowing you aren’t alone is, sometimes, the most helpful thing.
Dear Carrie, thank you so much for sharing what you’ve been through. You sound like an amazing person and a caring, loving mom. I love love LOVE how you write “I know that while it’s a part of me, it doesn’t define me.” I couldn’t agree with you more on that point!
You have been through so much, but your strength and commitment to taking care of your family shines through your words. I hope you do write a book, and I’ll be one of the first to buy it! Take care & I wish you the absolute best! Dyane
Great to see this post retweeted – thanks Cristi! Also there will be a free webinar next week that you & others might be interested in – here are the details:
Postpartum Management of Bipolar Disorder: Challenges and Opportunities
Date: November 25, 2014
Time: 12:00pm EST
Presenter: Dr. Verinder Sharma – Professor of Psychiatry, Western University, Canada
Overview
Correct diagnosis and appropriate treatment of bipolar disorder continue to pose challenges in the postpartum period, despite the common knowledge that childbirth is a potent trigger for bipolar mood episodes. This webinar discusses the importance of identifying women at risk of first-onset or recurrence of bipolar mood episodes, and the role of optimal pharmacotherapy in the prophylactic and acute treatment of mood and psychotic episodes in the postpartum period. There will also be a discussion of management of the disorder in women who are breastfeeding.
Educational Objectives
At the end of this presentation, participants will be able to:
1. Identify the challenges in diagnosing bipolar disorder in the postpartum period
2. Describe the prophylactic and acute treatment of postpartum bipolar mood episodes.
3. Discuss the management of bipolar disorder in lactating women.
Registration
This webinar is free and open to all interested participants. Please register for this ISBD webinar on November 25, 2014 at 12:00 PM EST (US) at:
https://attendee.gotowebinar.com/register/6136276899004177153
After registering, you will receive a confirmation email containing information about joining the webinar. Should you have any questions, please email oldsj@upmc.edu
Dyane — some of your story hits so close to home. Reading about your mania, the hypergraphia (my new word of the day), hospitalizations and more remind me I am not alone in what I have been through. As you probably know by now from reading my blog, I received a bipolar diagnosis after having postpartum psychosis, and I am still trying to piece it all together. I had mental/emotional traumas prior to pregnancy that I am sure were in play, as well as genetics. I hope in time and through connecting with other women and reaching out to professionals I can fully recover. How cool that you contacted a doctor/author and she responded. I have lived in silence for too long.
Update, 2016: I’m now a Huffington Post blogger and my article about postpartum bipolar (also referred to as bipolar, peripartum onset) was published last month: http://www.huffingtonpost.com/dyane-leshinharwood/postpartum-bipolar-disorder-the-invisible-postpartum-mood-disorder_b_9419484.html#comments
I didnt find out I was bipolar until just recently at nearly 35. My first symptoms began 10 years ago after the birth of my 3rd child who was born extremely premature at 26 weeks gestation. When she finally was able to come home from the NICU 3 months later it was time for my husband to deploy to Afghanistan. I just assumed I had to be super mom from there on out and became extremely manic: sweeping and mopping my floors every day sometimes twice, nursing while typing, cleaning nonstop, getting 3 hrs of sleep and feeling as though I overslept, losing 70 lbs in 6 months and worst of all cheating on my amazing husband through online relationships. I felt as though I could concur the world and needed no one to help me do it. My husband came home and took my bizarre behavior like a punch to the gutt, leading him to divorce me and take my kids from me. Almost 10 years later I finally hear you have PTSD and Bipolar 1 disorder which almost simultaneously sent me into a rage and self loathing. Even though I have remarried, all I can think about is how I ruined my marriage, his my children and I’s lives. We were very happy and had been percieved as the perfect couple/family, and frankly we were. My disorder ravaged that happiness and I am just realizing how much responsibility I failed to have over it. Its going on 9 years since he divorced me and I had to move back home without my children, clear across the country. 9 years since I’ve seen them…. how awful am I to have ruined something I held so dear.
YOU did not ruin it. You had an illness that is difficult to understand and diagnose. That isn’t your fault. If you need to be angry, be angry at the illness. Forgive yourself though, because we don’t know what we do not know. You are not guilty. An illness is guilty. I’m so sorry. I hope that maybe you can make amends with your then husband and amends with yourself. Counseling may help you get through it. You can’t control if your ex husband ever understands, but you can express your pain and ask for forgiveness. I am sending you so much peace.