Bipolar disorder is a neuroprogressive illness and early detection is vital. One of the most potent triggers for a bipolar episode childbirth. Unfortunately, research on postpartum bipolar disorder (PPBD) is scarce, however, a new study published in Psychiatry Research found that nearly 50 per cent of postpartum women had hypomanic symptoms. Hypomania is a symptom of bipolar disorder which can include an elevated mood, irritability, increased activity, decreased need for sleep, grandiosity and racing thoughts.
After Dyane Harwood was diagnosed with PPBD six weeks following childbirth, she couldn’t find any books about it so she wrote her own called, Birth of a New Brain.
"After my PPBD was triggered, I had the bizarre condition of hypergraphia, the extremely strong compulsion to write excessively," Harwood told us. "I started writing within a day of my baby’s birth."
According to the Diagnostic and Statistical Manual of Mental Disorders, “bipolar disorder, peripartum onset" occurs within the first four weeks postpartum, however, many health care practitioners believe it can occur well after after the first month postpartum and symptoms of early hypomania can be precursors to PPBD.
The study took place in China. Researchers surveyed 1022 Chinese women who were no more than one month postpartum. The Hypomania Checklist-32 was used and a score of 14 or higher indicated hypomanic symptoms. Forty-three per cent of women who participated in the study scored 14 or higher.
Though previous studies show the prevalence of postpartum hypomanic symptoms to be somewhere between 9 and 20 per cent, in addition to the current Chinese study is an African study that found half of the women it surveyed also had hypomanic symptoms postpartum. One explanation to the difference in findings could be that many women with PPBD are misdiagnosed with major depressive disorder.
"I was never screened for it," Harwood told us. "I did suspect that something was wrong and I wrote in my book that my intuition kept whispering something was amiss with my brain."
Harwood says she was in denial and didn’t want to believe it was bipolar disorder. She had grown up with a father who had bipolar one disorder and had already witnessed how devastating the mental illness could be.
"At first, I was manic," Harwood told us. "I had very high energy, talked all the time (and I spoke super-quickly at that), and I had pressurized speech in which I said words very forcefully and in a weird, affected way. I was barely sleeping and I had grandiose thoughts such as I’m going to write my book right now although I just arrived home with a newborn!"
Harwood's mania grew worse and she admitted herself to the local hospital’s behavioral health unit.
"The staff observed me and then I met with the chief psychiatrist," Harwood told us. "He was the person who sat down with me and told me I had bipolar disorder, postpartum onset. I stayed there four days. I had no idea my struggle with postpartum bipolar had only just begun."
Over a six-year period, Harwood was placed on a variety of medications, met with numerous psychiatrists and therapists, and had multiple hospitalizations.
"If I could’ve gone to a mother and baby unit instead of a psych ward, it would’ve been so helpful," Harwood told us. "I couldn’t stand being away from my baby and toddler. And of course, if I had antenatal screening for a family history of bipolar disorder, it could’ve been life-changing. I believe if I had received guidance on how to prevent or lessen the onset of my childbirth-triggered bipolar disorder, it would’ve made an enormously positive difference in my life and in my children’s lives."
Patricia Tomasi is a mom, maternal mental health advocate, journalist, and speaker. She writes regularly for the Huffington Post Canada, focusing primarily on maternal mental health after suffering from severe postpartum anxiety twice. You can find her Huffington Post biography here. Patricia is also a Patient Expert Advisor for the North American-based, Maternal Mental Health Research Collective and is the founder of the online peer support group - Facebook Postpartum Depression & Anxiety Support Group - with over 1500 members worldwide. Blog: www.patriciatomasiblog.wordpress.com