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.