Does bipolar affect women differently? Expand Bipolar disorder affects men and women in roughly equal numbers, but there are gender differences in the ways that the illness manifests itself. Women with the disorder tend to have more depressive and fewer manic episodes and are more likely to have bipolar II. They also appear to be more prone than men to rapid-cycling. Some research suggests this might be connected to abnormal thyroid levels as such imbalances are more common in women than men. Other associated conditions that are seen more often in women with bipolar than men include anxiety, migraines, obesity and panic disorders. Hormones are suspected of playing a significant role in bipolar disorder in women, evidenced by the mood swings often experienced in connection with menstruation, perimenopause and menopause. It is thought this may be connected to fluctuating levels of oestrogen but research needs to be done to find out how this is implicated and the mechanisms that are involved.
If I want to have a baby what do I need to know? Expand Women with bipolar are at particular risk of having a severe episode of illness such as postpartum psychosis (PP). Bipolar UK has produced a leaflet on this subject. There is also a podcast you can listen to featuring a talk between Psychiatrist Dr Ian Jones and Clare Dolman, (Vice Chair of Bipolar UK) about how bipolar can affect women, particularly during pregnancy and after birth. You can also find more information about postpartum psychosis and how to avoid or cope with it on the APP website where you can find details of a Second Opinion perinatal service. This article contains some more tips and includes a personal account of one mother with bipolar’s successful attempt to avoid having a second PP episode.
Should I come off my medication to have a baby? Expand This can only be decided on an individual basis and preferably with advice from a perinatal psychiatrist taking into account your own personal history. However, it is the case that many contemporary perinatal experts do not regard some medications, notably lithium, as being as harmful to the fetus as previously believed. Thus many women have stayed well on their lithium while pregnant with no ill-effects to the baby. If medication is continued, it is important to monitor mother and baby closely.
What sort of medical help can I expect? Expand There are national guidelines which recognize the special needs of women with bipolar disorder from pre-pregnancy through to postpartum care, such as the NICE ‘Antenatal and Postnatal Mental Health’ Guideline. These guidelines were published in 2007 and is currently being revised. There is also a useful guide to good practice produced by the Royal College of Obstetricians and Gynaecologists in 2011. Unfortunately, the guidelines represent advice on best practice; they are not enforceable in all health authorities but even if they are not being followed in your local area, they provide you with ammunition to argue for a decent standard of care. This is also the reason why Bipolar UK is a member of the Maternal Mental Health Alliance (MMHA) so we can campaign for an end to the current postcode lottery in maternal mental health services.
Second Opinion Perinatal Service Expand The Cardiff University Psychiatry Service (CUPS) offers second opinion or consultation to patients, with the aim of assisting and advising clinicians and their patients in diagnosis and management. Requests for a second opinion must be made by the doctor in charge of the care of an individual’s mental health (Psychiatrist or GP). It is not possible to accept self-referrals. There is no charge for this service (either to the patient or the referring NHS Trust). Dr Ian Jones is happy to see women via this service who have experienced postpartum psychosis or bipolar disorder and require advice regarding treatment or planning further pregnancies. More information can be found by clicking the link below, or by contacting Elizabeth Upadhyay, Clinic Coordinator, on 029 2068 8321 or [email protected]