Wanting to start a family...

...but I have worries about me. I am bipolar and am looking at starting the journey very soon, but my concern is if I can't be on my meds, how I am going to react in the long run. It's there any one else that has had this concern? And what was the overall consensus and result? It is my only real worry at this point. Wanting to be mentally healthy for my child and husband during the whole process.

Not to worry, I will be having a conversation with my Dr as well.

I have those worries as well with dissociation. I'm not at that point now in my life. Good luck. I wish you well.

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Thanks. It will be an interesting process, but I think I can definitely get through the hardships with all the support I will have. An adventure in the making, that is for sure.

Do you know other older women in your life who are bipolar and "examples" you could talk to? I know one of my employers was when I was working with her and she was going through her college daughter learning she was bipolar too. My employer was a fine mother (had a grown son too) and I felt blessed to be able to "watch" the family interact and deal with that crisis, etc. and learned a great deal.

I went through pregnancy on lamictal before they found it caused cleft palate. That part was fine.

What I wish I had done was make the decision not to breastfeed earlier. Baby was born sleepy, wouldn't latch, I had to pump and supplement with finger feeding, I got mastitis, it was a nightmare. And I couldn't fall asleep once she was up in the night. I spun into PPD.

Once I stopped breastfeeding, started taking benzos again, I felt so much better it wasn't even funny.

I bought in so hard into breast is best so the guilt associated with this decision was incredible. But having a healthy mum that can participate and enjoy baby's life is so much better in the long run. My daughter is 7, she was supplemented with formula after one month and exclusively formula fed at 4.5 months, she turned out just fine.

There must be something you can take during pregnancy, may not be as effective as current regime but better than nothing. Consider not breastfeeding and returning to original drugs after birth, the newborn period is hard. Also consider one child only, then you don't have to manage a kid with weak meds while pregnant.

Good luck

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There are a lot of us that are bipolar and are parents as well. I have a 10 year old son and I'm able to parent effectively, especially since I am on medication. Even when I wasn't though, my husband was able to shield my son from some of the more extreme behaviors I've had. Just remember, you can be a great parent as long as you work at it. Look to support groups and your partner for help. You don't have to do it all on your own.

There are lots of options for you....

• going off meds permanently
• going off meds before and during pregnancy only
• going off meds for first three months of pregnancy
• returning to meds as soon as you give birth
• change to medications that are safer during pregnancy
• increasing other coping strategies while off meds (therapy or more frequent therapy)

Chances are though, that you will not be able to breastfeed if you are on medication.

If I were pregnant, I would take vitamin D3 2,000 I.U. and NAC (N-Acetyl Cysteine) 1200 mg daily. NAC + D3 will increase astrocyte glutathione, which in turn will increases neural glutathione concentrations. In pregnancy, astrocyte glutathione production would also protect the baby from oxidative stress.

Vitamin D3 is pregnancy category A and NAC is pregnancy category B. What medications are you currently on? You can google the pregnancy category of the medications you currently take... here are the category definitions:

• Pregnancy category A: Adequate and well-controlled human studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).
• Pregnancy category B: Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.
• Pregnancy category C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
• Pregnancy category D: There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
• Pregnancy category X: Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.

I'm also wanting to start a family but will wait a couple years. Hopefully I'll be completely off the meds.

I never heard that lamictal caused cleft palate. My MD's switched me to it for pregnancy because it was considered safer. (My kiddo isn't even 1 yet, so it was recent). Contemplating pregnancy #2 on lamictal, so any info you have would be helpful. I put a lot of faith in the pregnancy registry study so I felt okay about it at the time.

I absolutely agree with your advice about breastfeeding. Bottle feeding turned out to be a wonderful decision.

Best,
EJ

Lamotrigine is category C, lithium can be safe in low doses, and NAC is safe at any recommened dose. I don't see any reason why one would need to go entirely off meds. There isn't really ever a right time to have a baby, so just have one.

Some of these things, vitamin C, D3, E, and folic acid for instance, should be taken regardless as they're beneficial to the baby. The pharmaceutical industry has trained doctors to think that only prescription drugs can treat illness, but this is far from the truth. Many options are available, consult a board certified psychiatrist who is educated in complementary medicine.

Luckily, my p doc is board certified, and is amazingly awesome. I will be seeing him soon to talk meds. We found out we were pregnant recently, and will be seeing a slew of drs. right of the bat because of multiple concerns physically. I have had 2 miscarriages in the past. I just don't want my meds to be another factor I have to really worry about. I know everyone will take care of me, but the ultimate worry is still there.

Congratulations! The best thing you can do for your baby right now is to start taking a prenatal multivitamin. Whichever prenatal vitamin you choose, it should contain iodine and at least of 700 I.U. of vitamin D3. These two ingredients are the easiest way to discern if a prenatal multivitamin is high quality or junk, I would not take any prenatal that doesn't meet these two standards. Folate (folic acid) is very important as well...

Folic acid | March of Dimes
Vitamins and minerals during pregnancy | March of Dimes

This is one of the ones I would recommend, Walgreens keeps it in stock:

SimplyOne Prenatal | SuperNutrition
SuperNutrition - SimplyOne Prenatal | Walgreens

I was in the pregnancy registry study and read the results when they were published. The way I read the results was that there was a higher association with cleft palate with lamictal, not huge but statistically significant.

Ultimately it is up to you. Cleft palate is a manageable birth defect. My daughter being born somewhat sleepy, hard to feed, and slow to regain birth weight - was hard for me not to blame on the drugs and brought on the guilt big time.

On hindsight seven years later I see that there's no clear causation between drugs and early weight gain problems with my child. Even if there were drug related issues, they did not have any impact beyond toddler hood.

Of course those of us with issues with guilt and self worth (ie: everyone with bipolar) might find the early childhood years can be extremely challenging. Imagine thinking that any relatively common childhood problem is linked to your condition somehow or the drugs you took to manage it. And you're sleep deprived, which makes everything worse, and who has time for CBT to fix these thought distortions? Also infancy is a time when complete strangers and your entire extended family feel qualified to tell you how to run your life and parent your child. For those that are indecisive and have cognitive fog (ie: those with depressive symptoms with bipolar), this can be all too much.

I struggled so hard and knowing what I know now, I might look to transfer to drugs I would feel more comfortable with. I would not do pregnancy with lamictal again (then again, I don't plan to do pregnancy again, I can't do early childhood).

Yes this is critical. The other part of the lamictal pregnancy study showed that if you are taking a drug with statistically significant increased risk of birth defects in pregnancy, a mega-dose of folic acid can help mitigate the risk. I believe dose is at least 3x amount in OTC prenatal vitamins. In USA there is a prescription formulation of folic acid that helps in this case (also supposed to assist with elevating mood, doesn’t do a great job of that IMHO). This formulation is not available in Canada and can only be replaced with an expensive fistful of OTC folic acid supplements daily.

If you choose to take lamictal in pregnancy a mega-dose of folic acid with it is gold standard treatment, ask your doctor.

I did not read all the other posts. I think most are about medications. I have two children and haven't been prego in 8 years so I don't know about the meds now. I do know that being pregnant really put me on a roller coaster ride. Both times, even before I knew I was pregnant I had serious episodes of mood issues. The second time I ended up in outpatient and lost my job because I couldn't get myself there. IMO, aside from meds, the best thing you can do is build up support and an emergency plan beforehand. Research the effects of pregnancy and share the info with all your loved ones. I'd also recommend journaling before hand about your disorder, about your dreams to be a mother and about stability. Hopefully you won't need to look back on those writings, but I think they could help if you hit any turbulence during the nine months, or the year or so afterward. Best of luck with a bitty baby!!! . Motherhood is wonderful!

I like to think I'm a good mom. All the doctors think so. I dealt my son a ****** hand. Pdd , mood disorder and ADHD. I doubt he'll ever be functional enough to hold a full time job but that doesn't mean he can't have a happy, healthy life. I wasn't DX as bipolar when I decided to have a child but I knew I most likely had bipolar or at least I was mentally ****ed as well as my husband. We had decided we'd just be proactive. My sons pdoc said if everyone was scared of their genes then there would be no children. We had two options not have a child or get them help when needed. She feels we picked the best options.

I don't know if you work but if it was me I would spend my whole pregnancy unmedicated in partial hospitalization.

Being bipolar and female leaves one with a lot harder decisions to make than being bipolar and male. I myself am female and the whole, work, meds, career, life balance can be nervewracking.

There are medications you can take while pregnant/nursing. I took an anti-depressant after my babies were born. They didn't work for me. I nursed my last until 14 months, and starting on meds that I couldn't take prior. It's been about 4 months now and I am not "normal" yet. I felt a lot of guilt over stopping nursing, but I strongly believe I needed to go on medication that was stronger, and also that nursing helped with the depression. Don't know which I believe more. I miss nursing greatly. It's a battle. Talk to your doctor, get help before you make any decisions. Congrats on embarking on this wonderful journey!

I talked with my pdoc. He felt it best if I could manage it, which I agree, to be off my meds. If we believe I need it, I could stay on a low dosage of Lamictal. My OB agreed that it would be the best course if necessary and just take a little more of the Folic acid.

It has been a week since we weaned me off my meds, and so far I feel as if I am doing well. I am not wholly surprised, but I did not expect it to be this easy especially since the last time I did not have my meds, it was more of a disaster. Situation is everything, I guess.

But, I am keeping in very close contact with my pdoc and T to make sure everything is okay. Regular appointments and check-ins. I am taking my vitamins and doing what I can to eat right and stuff. My pdoc also said he would like to help me be able to breast feed as well, if my moods allow it after delivery. So, wishing all things go well so far. Only getting started with a long ways to go, but things are off to a much more promising start than before.

And yes, he did say there were some medications I could take, but there are some medications I cannot take because they will make my moods dangerous. It was a mutual agreement with an lengthy discussion about what I wanted and him going over the medications in detail with me about whether they were safe or not - for both nursing and pregnancy. I am confident in my decision, but we are all wary and keeping a close eye on everything in the process.

That's great. I wish you the best. I did much the same as you. I really found nursing enjoyable, and if it weren't for winter here, I wouldn't have stopped at 14 months. I have read that many mothers experience joy in nursing. Some don't though. I have friends who it just didn't work out for, and that's ok too.

I'm bipolar, now age 51, in my 20's I gave birth to my two wonderful children. And I breastfed both of them. They are now in their 20's and doing wonderfully well in life. I stayed in therapy/on meds while my husband and I were raising the kids, and I took them to therapists whenever there seemed to be issues that needed professional attention (for example, my daughter had a severe, unexplainable fear of fire when she was young - play therapy helped her immensely).

Congrats! I went through my pregnancy on a low dose of Lamictal (tried to go med free and crashed). I also took Deplin which is high dose folate which helps also with mood. I decided not to breast feed so I could resume my med cocktail. It was a really good decision, in my case.

You can do this!

EJ

Hey, I have two little guys and I am about to try for another one. I wasn't diagnosed yet with my first so no meds. For my second I went off all meds and since one if those meds was Abilify which was truly awful for me I immediately felt soooo much better (Abilify is category B tho if you liked it). So second preg no meds, breastfed for a year through an episode. Probably should have just quit sooner and gotten on meds but well I had to journey my own way I guess. So now I'm gearing up for baby number three and I almost thought I couldn't because I decided it was not responsible or feasible for me to go off my Lamictal and parent my two boys. But I talked to my OBs about it and they were like no prob. They sent me for preconceptual counseling with the perinatalogists and they were like this is no big deal at all. They said based on the newest info I have no more reason to worry than anybody else. The cleft lip thing is old. So I was overjoyed to get the chance to be pregnant again and add to our family. I am actually weaning off my klonopin as we speak because I do want to do it without my klon. But they actually told me it was better for me to use it sometimes if I needed it than to get all stressed out.

So anyway that is the deal with my meds. Sleep is the next big problem. The sleep dep made me manic. So next time DH knows he is on night duty. We have to get me sleep. Real sleep. I don't know how this will work with breast feeding. If I decide to do it at all on the Lami , I won't do it exclusively. I don't think it is a good idea nor is it necessary to out that much stress on me.

Now the just handling kids part. Support is a good thing. I actually don't have a lot. Difficult family not in town kinda thing. But I am now feeling the burn of having two cuz my baby is a toddler and so I found a preschool I love, I finally found babysitters I love, I have friends to lean on. I may hire a mother's helper when the next one is here. We shall see. With my first I really immerses myself totally. I never left him, never delegated. He was a sensitive guy but it was me too ya know. Now I am ready to let myself have a little more space. I need it so I can keep myself together.

But don't despair. Us Bipolars can be great mamas! I have never loved being anything more.

Wow what a loaded question! First, congrats to you & best wishes for your hopes & dreams to come true! BPD'S M/O is that there's no way to predict how your life will be, on or off meds.you can't plan your day around an unexpected mood swing or manic episode, but you can sometimes get a feel when the tides are about to turn. You can also learn ways to self-soothe, talk yourself down, (but sometimes that doesn't work ). I like to give my loved ones fair warning when I'm having a bad day. They know my condition and most of the time they give me my space for awhile or they'll help out a little more and try not to trigger me. It helps to have a plan in place like you would a fire drill......know the nearest exits & get to safety as soon as possible. Just having your family learn about bpd is a big plus. The only thing that makes this awful thing worse is lack of understanding. Knowledge is power.