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    Bipolar and pregnancy

    How was your pregnancy while being bipolar?
    How was it after labour? Did you end up having postpartum depression?


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    Common types of depressive disorders


    Healthcare providers name depression types according to symptoms and causes. These episodes often have no obvious cause. In some people, they can linger much longer than in others for no clear reason.

    Types of depression include:

    Major depressive disorder (MDD): Major depression (clinical depression) has intense or overwhelming symptoms that last longer than two weeks. These symptoms interfere with everyday life.

    Bipolar depression: People with bipolar disorder have alternating periods of low mood and extremely high-energy (manic) periods. During the low period, they may have depression symptoms such as feeling sad or hopeless or lacking energy.

    Perinatal and postpartum depression: “Perinatal” means around birth. Many people refer to this type as postpartum depression. Perinatal depression can occur during pregnancy and up to one year after having a baby. Symptoms go beyond “the baby blues,” which causes minor sadness, worry or stress.

    Persistent depressive disorder (PDD): PDD is also known as dysthymia. Symptoms of PDD are less severe than major depression. But people experience PDD symptoms for two years or longer.

    Premenstrual dysphoric disorder (PMDD): Premenstrual dysphoric disorder is a severe form of premenstrual disorder (PMS). It affects women in the days or weeks leading up to their menstrual period.

    Psychotic depression: People with psychotic depression have severe depressive symptoms and delusions or hallucinations. Delusions are beliefs in things that are not based in reality, while hallucinations involve seeing, hearing, or feeling touched by things that aren’t actually there.

    Seasonal affective disorder (SAD): Seasonal depression, or seasonal affective disorder, usually starts in late fall and early winter. It often goes away during the spring and summer.

    You can refer to this:

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    From Hopelessness to Well-Being: Finding Meaning

    Part 1 of 2 “I’m so tired of waking up feeling bad and scared. Every day I wonder why I had this baby when the planet is collapsing around us and everything feels upside down.”

    This was the start of a therapy session with a postpartum mama trying to make sense out of her day.

    Another recently told me, “My husband and I have wanted a baby more than anything in the world. Now, we’re no longer so sure that this would be the right thing for us to do, given the state of the world. I mean, it’s crazy out there. What will the world be like for them?”

    Noticing this trend of hopelessness in response to perilous realities and the litany of environmental, political, social, and medical and mental healthcare crises, I can’t help but wonder about the contagious and ubiquitous impact this shared despair has on each and every one of our psyches and spirits. We are all craving some degree of emotional restoration, reassurance, grounding, predictability – to soothe our collective anxious souls. Our regulatory behaviors don’t feel sufficient at the moment, leading to overloaded nervous systems which, in some cases, morph into a perpetual state of apprehension. Things we have all relied on for comfort or a respite from our worries feel inadequate in response to the severity of restlessness and alarm permeating the air. Our go-to resources for relief are running out of steam.

    All humans function best when we have answers, or a plan, or a direction. When we have a purpose, a design, or an intention.

    In today’s uncertain world, we have more questions than solutions which is a breeding ground for relentless anxiety. Add that to the already vulnerable environment of a new mom and dad, and things can quickly escalate to extraordinary and unprecedented levels of distress. The issues parents raise today cannot be dismissed as “just anxiety.” They are thoughtful and unsettled concerns about the known and unknown variables that have never before confronted young families. Parents are being forced to make decisions that most of us could never have dreamt would urgently be placed in front of them. Research is showing us that COVID-19 is having detrimental effects on maternal mental wellbeing on top of the 1 out of 7 women who experience postpartum mood and anxiety disorders prior to the pandemic. (Chen, Li, Xiong, & Zheng, 2022).

    As therapists, we find ourselves sitting in the mess with them, hoping our clarity can help them navigate this uncharted territory, along with our own anxieties which we quietly tuck into the background. When our professional resilience feels unsteady, when we wonder if we are “enough” or whether our clients’ have anything to gain from our presence during turbulent times – I turn inward.

    My personal journey always directs me to Viktor Frankl, neurologist, psychiatrist and Holocaust survivor, for guidance. I recall the teachings from his book, Man’s Search for Meaning, as he reminds us that the primary and fundamental force which motivates people during difficult times – especially related to trauma and perceived purposelessness – is to find meaning.

    Quite a huge undertaking to ask of overwhelmed, weary and dispirited souls. Still, Frankl maintains it is this task to find meaning which serves to decrease feelings of despair and fuels motivation and our capacity for joy. Finding meaning, he elaborates, is accomplished through various means:

    1) Purposeful work or creation (creative endeavors, projects that keep you focused, excited and working toward a goal).

    2) Experiencing truth, beauty and love, by reaching beyond yourself and helping/connecting with others.

    3) Suffering. This is hard. The very first step is to accept that it is there. Pushing away any uncomfortable emotion or sensation usually makes it stronger and more present. Accepting that you are suffering does not mean indulging or wallowing in it. It means identifying it so you can address it and take care of yourself.

    Finding meaning through suffering is perhaps our most challenging act of courage and introspection and represents a potential pathway to well-being. It is up to each of us, to reflect on and actualize this in a way that is unique to ourself, our own narrative, and our own skill set.

    When my father’s health was rapidly declining, I remember asking my mother, a holocaust survivor, how she does it, day after day and throughout the night, attending to his every need, with sparse and woefully inadequate help. I asked her how she gets up every morning, after being up half the night, only to face the same emotionally-charged yet tedious caregiving role. She said, “This is what I’m supposed to do now. It’s not easy, but he needs me to do this. It’s hard, but it feels important. I am determined to make this part of our journ

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    From Hopelessness to Well-Being: Finding Meaning

    Part 2 of 2 ey as comfortable as possible.” She never once complained. She had, I am certain, found meaning to her suffering.

    As a therapist, I feel privileged to sit with suffering. I feel deeply honored to be trusted to the extent that someone feels safe enough to unpack moments or years of raw experience and emotion in my presence. My greatest task in this work is to help them find meaning to their suffering. First, they can vent, they can rant, and they can unload the hard emotions. And they should, perhaps. Eventually, though, we all need to find our way through the chaos and acquaint ourselves to unfamiliar and profound feelings.

    We need to sit with and reorient the suffering and name it something else. Something that makes sense to us. Something that we can embrace with less anguish, less shame, less internal conflict. Sometimes, finding meaning in our suffering is simply changing perspective, changing the language, perceiving it differently. Because at the end of the day, any and all suffering can be consuming if we lose the ability to find joy and meaning. Suffering without meaning, brings us closer and closer to despair. Finding meaning in our suffering, bring us closer to our authentic selves, with love and compassion.

    As a postpartum specialist, I offer the following thoughts to parents who seek meaning to their daily task of navigating the bumpy postpartum months and beyond…

    When you struggle with uncomfortable feelings, keep these thoughts is mind:

    1) You will not always feel this way.

    2) You will feel like yourself again.

    3) This commitment to parenthood is hard and rewarding,

    not always at the same time.

    4) Savor moments of joy and accomplishment. Feel them. Write them down. Remember them. Refer back to them in your mind when you need grounding.

    5) Pay attention to your relationship. If it is an ongoing source of support, lean into it often. If it is not, figure out what you both need to do to help it feel more supportive.

    6) These are indeed hard times. Find a safe person to talk about how you are feeling.

    7) Try to stick with a routine. This will help you focus on the present and limit the temptation to ruminate.

    8) Take a break from news and social media. Give your brain a rest from overstimulation and worry over things you cannot control.

    9) Breathe. In and out. Slowly. It brings more oxygen to your brain and helps ease the “fight-flight-freeze” response which can calm your anxiety response.

    10) Stay connected. Socialize with friends or reach out to your community, advocate for a cause, take some action to help you engage in meaningful interactions.


    What I Wish I Had Known About Postpartum Depression

    Part 1 of 2 I was 22 years old while wearing a pregnancy glow and preparing for my magical natural birth. A doula created my belly cast to save the shape forever. I wrote a letter to my unborn child. I prepared her room with Care Bear decorations because my favorite lullaby came from that cartoon. I traveled to another city for appointments because that was the location of the nearest midwife. I practiced breathing and had a birth plan. I did lots of prenatal yoga. During the birthing process, incense filled the room as my family thought I was sleeping through contractions. There were lots of lovely moments. However, during labor, I found myself screaming “GET OUT!!!” to both my daughter and my mother-in-law. One of the nurses was holding the door to my room shut as my mother-in-law was pushing back with a video camera; I didn’t want to be filmed.

    That primal scream continued internally as I went home with my newborn baby. And when I say home, I mean my mother-in-law’s home. Without being made aware of the plan, my daughter’s grandmother invited over tons of people that I had never met. They all wanted to hold my baby. I just wanted to rest quietly between breast feeding. I was totally overwhelmed and condemned for not being sociable and for being overwhelmed. The situation was out of my control. My mother told me that my hormones were out of whack because of the pregnancy. That was her response to our disagreements; that I wasn’t thinking clearly because my hormones were “off”.

    My situation was stressful. I didn’t have stability in my relationship or finances. This definitely added to my #PostpartumDepression . There are a lot of new mothers that are similarly in difficult situations but even with the perfect home life, postpartum depression happens. Fatigue is definitely a contributing factor. It’s funny that moms expect themselves to be fully functional while waking up every 2 to 3 hours during the night. We don’t expect ourselves to function like that on a day to day basis; why do we pressure ourselves after creating and birthing a whole human being? Also, my mom was right in that my hormones were “off”; levels of estrogen and progesterone drop significantly after birth. This is a true part of pregnancy but it is an invalidating statement that dismisses the real need for support and treatment. Postpartum depression is common and treatable.

    Postpartum Depression by the Numbers

    1 in 10 women (after giving birth)
    Approximately 600,000 U.S. women per year
    Lasts 6 to 12 months
    50% of women affected are not diagnosed by a professional

    Symptoms of postpartum depression include depressed mood, mood swings, excessive crying, difficulty bonding with your baby, withdrawing from family and friends, loss of appetite or eating more than usual, inability to sleep (insomnia) or sleeping too much, overwhelming fatigue or loss of energy, reduced interest and pleasure in activities you used to enjoy, intense irritability and anger, fear that you’re not a good mother, hopelessness, feelings of worthlessness, shame, guilt or inadequacy, diminished ability to think clearly, concentrate or make decisions, restlessness, severe anxiety and panic attacks, thoughts of harming yourself or your baby, and /or recurrent thoughts of death or suicide.

    There is also an experience with collective symptoms called “the baby blues”. It is different than postpartum depression.

    The baby blues doesn’t last as long and is not as intense as postpartum depression. The baby blues affects 50 to 75% of mothers after delivery. The baby blues usually subsides after 2 weeks without treatment. Symptoms include: mood swings, anxiety, sadness, irritability, feeling overwhelmed, crying, reduced concentration, appetite problems, and trouble sleeping.

    What to do if you think someone may be struggling with postpartum depression: I moved in with my mom and stepdad about a month or so after my daughter’s birth. I remember one day being so fatigued that I didn’t want to go on a trip to visit my stepdad’s family. I didn’t want to get out of bed before 10am. He was very offended that I “didn’t want to see his family”. That response just packed in the stress, guilt, shame, and depression. An alternative response could have been of concern: to ask why do you think you are so tired? Was it waking up throughout the night? Or something more? Encourage the mother to share her experience with her doctor. Help the mother with tasks. Support her to rest and have space as she needs while not isolating. Any negative reinforcement may feel magnified through the lens of the depressed mother. Try to give as much positive reinforcement as possible. Share more positive feedback than negative.

    What to do if

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    What I Wish I Had Known About Postpartum Depression

    Part 2 of 2 you think you may be struggling with postpartum depression: Do a reality check by assessing your situation, body changes, and sleep pattern. The reality is that you are going through a difficult time and deserve grace and self-care. This self-care could include: napping with baby, not over expecting of yourself, not allowing others to devalue you, telling your pediatrician or gynecologist and considering/taking their advice, knowing that you are not a bad person for the struggle, and know that you are not a lesser mother for the struggle.

    Let’s normalize the conversation and help our mothers get through this tough time.


    How do people with bipolar disorder navigate pregnancy?

    I have bipolar 1. I want to marry and have children, but I'm scared of
    1. Whether my psychiatrist will agree to change or take me off my meds while trying/pregnant. I'm on lithium and ziprasidone (geodon). Both cause harm to the fetus. My psychiatrist never agrees with me whenever I point out the side effects of my medications. She always says my symptoms must be due to something else. I think she may have the same response when I tell her I want to go off my meds to have a kid.
    2. Postpartum psychosis
    3. How to avoid sleep loss while taking care of a baby. For me, sleep loss inevitably leads to a manic episode
    I'm still figuring out if having bipolar disorder is a good enough reason to not have kids even if you really want them. If it's really bad then I'd have to change my priorities and marry someone who doesn't want kids either or already has kids and doesn't want any more.
    Is there anyone out there who's had a bipolar diagnosis before having kids and it turned out alright? I'd really like to know.
    If someone is child free by choice because of bipolar I would also like to know about it.
    Thank you. #Pregnancy #baby #Child #Parenting

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    Mental Health and Awareness Campaigns

    Part 1 of 2 There certainly are a lot of mental health campaigns going on. There’s one or more in every month. Most of these are “awareness” days, which is a little bit confusing. People who already have the assorted disorders are already aware of them, as are probably their families and perhaps their friends.

    When it comes to awareness, though, most non-affected people (or people who don’t realize they are affected) find out about them through TV commercials – during Men’s Health Month, in ads for medications, or from organizations like the Wounded Warriors Project. There may be local events, too, but I haven’t seen any in my area. I don’t even see much of anything on my Facebook timeline, even though my friends list contains a lot of people with mental health concerns. I note that there isn’t a Women’s Mental Health Month, even though most people who receive treatment for mental illnesses are women. (There are many, many special days not related to mental health that I knew nothing of until I started to research this post, such as World Animal Road Accident Awareness Day, Insect Repellent Awareness Day, and even Spider-Man Day.)

    Here’s what I did find.


    Mental Wellness Month


    Children’s Mental Health Week

    International Boost Self-Esteem Month

    National School Counseling Week

    National Eating Disorders Week


    Self-Harm Awareness Month

    Brain Injury Awareness Month

    World Bipolar Day (which I had never heard of, despite being bipolar myself)


    National Stress Awareness Month

    National Counseling Awareness Month


    Mental Health Awareness Month

    National Maternal Depression Month

    National Borderline Personality Disorder Awareness Month

    Tourette Awareness Month (May into June)

    Children’s Mental Health Awareness Week


    PTSD Awareness Month

    Men’s Mental Health Month


    International Self-Care Day

    BIPOC (or Minority) Mental Health Month


    National Grief Awareness Day


    World Suicide Prevention Day (and National Week and Month)


    World Mental Health Day

    National Depression and Mental Health Screening Month

    ADHD Awareness Week

    OCD Awareness Week


    National Family Caregivers Month

    International Stress Awareness Week

    International Survivors of Suicide Day


    International Day of Persons With Disabilities

    National Stress-Free Family Holidays Month

    So, how are people made aware of most of these various disorders? By people wearing different colors of ribbons that correspond to them. The idea, I guess, is to prompt people to ask, “What is that silver ribbon for?” and to be told, “It’s for Borderline Personality Disorder Awareness.” If the person inquires further, it’s a chance to educate them, but most people don’t ask at all or ask only what the color means.

    There are only a couple of colored ribbons that everyone knows the meaning of – yellow and pink. The yellow ribbon campaign was started in 1979 to show support for persons held hostage in Iran, but now means support for the Armed Forces. The pink ribbon for the Breast Cancer Awareness campaign started in 1991 and is probably the most successful ribbon awareness symbol there is.

    Here are the colors of various ribbons and what #MentalHealth concerns they are intended to promote awareness of.

    Peach – Invisible Illness

    Yellow – Suicide Prevention

    Periwinkle blue – Anorexia Nervosa

    Teal – Agoraphobia, Anxiety Disorders, Dissociative Identity Disorder, OCD, Tourette Syndrome, Stress Disorders, Social Anxiety Disorder, PTSD, Panic Disorder

    Green – Mental Health, Bipolar Disorder, Major Depressive Disorder

    Lime green – Mood Disorders, Psychosis, Depression, Mental Illness, Postpartum Depression, Childhood Depression, Maternal Mental Health

    Purple – Binge Eating Disorder, Bulimia Nervosa, Eating Disorders, Caregiver Appreciation

    Purple and Teal – Suicide, Survivors of Suicide, Family Members of Suicide

    Gray – Personality Disorders

    Orange – ADHD, ADD, Self-Harm

    Silver – Borderline Personality Disorder

    So now you know what color ribbon to wear and what month to wear it in. I hope that if you do, people will ask about it and allow you to expand on what it means. I don’t expect that, however. Almost no one has ever asked me about my semicolon tattoo for Suicide Prevention and Awareness. (I occasionally get to explain it if I point it out to them.)

    Probably the most effective reminders are t-shirts that ident


    More Blessing Than Curse: Why I’m Thankful for My Bipolar Medication

    There was a time I thought my bipolar meds were more of a curse than a blessing.

    Side effects like headaches and weight gain.

    Dependence on a healthcare system that could be compromised by greed and politics.

    I had a lot of resentment about the hand that fed me. I wanted to get healthy enough that I wouldn’t need my medication. I wanted to have a family and be able to breastfeed my children, which the medication made unsafe.

    So I got connected to doctors who emphasized the natural healing of the body: holistic psychiatrist, naturopath, chiropractor, biofeedback specialist. I really thought I could change my reliance on medication to keep myself stable and accomplish it through other means.

    I was wrong.

    Healing my gut worked wonders, but the labor did not. Preparing nourishing foods helped me lose a lot of weight, feel terrific and wean off the mood stabilizer. The cost? A massive monthly bill for food and supplements, plus many hours in the kitchen and on the pot.

    For a while it was worth it, but cooking everything I ate and taking it everywhere I went took its toll. My husband wanted to be supportive, but he also didn’t want to eat or pay for strange foods for the rest of his life. And even though I was able to come completely off my meds for a little while, I needed to add back a low dose again a couple months later.

    Then we got pregnant.

    I had always dreamed of being a mom, but as soon as I found out we were expecting, I was terrified. Suddenly I understood why people chose abortion. I questioned if I could even handle being pregnant, if I was too sick. The holistic psychiatrist told me to come off the medication to avoid harm to my baby, especially in the first trimester. I made it 7 months without them before I experienced psychosis on vacation and had to be hospitalized.

    I didn’t fully stabilize until after my daughter was born, so my husband had to care for a tiny infant and a very ill wife. I needed the medication then too for postpartum depression. I had to surrender my desire to breastfeed; my milk stayed with me her first year, but the medicine made it unsafe for her to drink.

    To add to our difficulties, our daughter couldn’t tolerate infant formula, and we tried them all. We searched for the cleanest ingredients and even ordered from Germany. When that didn’t work, we scoured the Tennessee Valley for breastmilk donations and my eyes were opened to how many mothers needed food for their babies. Sometimes we had to do enemas at 4 am when she would wake up screaming because she couldn’t poop. But she made it, and we made it, and by the time she was 8 months old we had regular donations to keep her full.

    In the years following her birth I kept dreaming. I wanted to add to our family and hoped for a better experience a second time around. I had received a second diagnosis of post-traumatic stress disorder, and the time came to focus our attention there. I did intensive therapy for a couple years, which reduced my nightmares and restored mental clarity. But the low dose of medication was no longer working. It took another couple of breaks and hospitalizations for me to let go.

    Today my life is different than I thought it would be. I’ve made my peace with being mom to one incredible 4-year-old and taking two medications every night. I still incorporate gut-healing foods into my daily routine, and I think they keep us healthier than we would otherwise be. Staying stable on a therapeutic dose enabled me to go back to a career in teaching, which I otherwise would not have been able to do. Giving up and letting go are not the same. I don’t regret my dreams or what we attempted. I had to let go of what I wanted to take hold of what is, to be filled with gratitude for the family I have. Now I can receive my medication with open hands, not as a curse, but as a blessing on an abundant life.

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    Relationship triggers

    I’ve had depression and general anxiety for 7 yrs now. It started as postpartum depression. I’ve been on meds and many different kinds of therapy.
    My marriage broke right when my depression started. My ex n I still have bad relationship. He triggers my depression and anxiety. I get panic attacks when you I’m around him. My last suicide attempt was because of him. I avoid him. I’d like to get rid of him from my life but we co parent my son.
    I had to sacrifice so my son can grown up with both parents. It’s been hard.

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