Prenant Mom Suffering from Severe Mania

Dear A., DO get a second opinion. My midwife advised me to stay on antidepressants when I became pregnant with my first. I'm not aware if there's newer research on the effect of psychological drugs on a fetus. But she emphasized the importance of my own health and stability for the sake of my baby. At that time there was no data on how antidepressants could interact with the health an development of the baby. I hope you find what you need.
Peace and blessings!

*HUGS* I don't have any advice because I had all my kids before my bipolar diagnosis, I just wanted to say "hang in there" you are going to make it!

I wanted a third baby, but I was too afraid and my husband got fixed. I regret it now sometimes. I hope you find someone who can help you. I think I have heard that some medications are okay.

Jenn

I agree with the pernatologist recommendation. There is also a perinatology group at Swedish Hospital, which is closer to you.

I am so sorry you are having so much trouble. My mother is bipolar so I understand what you are talking about. I would call your ob and have them set aside a consultaion for the specific purpose of talking about your bipolar meds. I would also see if you could have your normal doctor in on the conversation, if posible. Also if your ob has not worked with someone with bipolar before I would ask them for a recommendation to another doctor if they do not seem like they are willing to take the time with you. What ever you do remember that you have to take care of you inorder to take care of your baby, even if that means taking some meds. Good luck with the pregnancy.

Sorry, I'm a little late in responding. You should talk to a pharmacist about the meds you were taking and pregnancy. They can figure out the half lifes and know more about what is safe during pregnancy.

My allergist prescribed an antibiotic for strep and looked it up in the book, she determined that if I took it at bedtime, it would be okay to pump and dump once during the night before my son needed to nurse in the morning. Well, I asked the pharmacist when I got it filled and found out that the half life was more like 2 days, not 8 hours. I had to be very persistent with my allergist in trying to get a different antibiotic. She was still sure that the one she prescribed would be safe after 8 hours.

The pharacist can work out the mathematics on the packaging of the meds and help you understand what will be safer for you and the baby.

Good luck to you,
D.

Hi sweets,

I am going to keep this short and simple. Your OB should never be too busy for you, he is at your service when it is your turn so make sure you get what you want from him. Do you really want to trust your health to someone who doesn't take and make the time for your health/life?

Also, have you ever heard of Bach Flower Remedies? They were invented by a Doctor and here is a link
http://www.bachflower.com/

They are all natural healing flowers and should really help you. For you bipolar you might also want to go and see a Naturpathic Doctor.

Blessings......

A.,
Perinatoligists or maternal-fetal medicine specialist are out there. If you call Legacy Emanuel and ask for Maternal-Fetal Medicine, Dr. Merrill (or others in his group). There are groups of Docs out there who specialize in "high risk" pregnancies. High risk covers all sorts of situations, when issues are presenting for mother specifically, baby specifically or both. I think you should consider going straight to the pros in your situation. I had placental seperation in 2 of my 3 pregnancies. I also had other meds that had to be managed during pregnancy. It feels so good to have confidence in you Doctor! These doctors are pros, used to dealing with all sorts of complicated and challenging situations so you would just be one of the crowd. High level professionals with vast experience in maternal-fetal medicine. You need and deserve a supportive capible medical team who can address your needs.

There were many good suggestions. I saw the one about Legacy Eman. if your insurance is not covered there you might try NW Perinatal Center ###-###-#### they are located next to Providence St. Vincent and have a very good team, lots of Dr's there. They may also make a recommendation for mental health care person that specializes in pregnancy and mood disorders.

That said, I too had been stable for years, but pregnancy & the flux of hormones can throw us in either direction, with no notice. Upon discussing this at my week 12 appointment we decided it was in the best interest of the baby to keep me on my med and as stable as possible. Our health affects the health of the baby. There are meds that are safer than others to take while pregnant. Get into someone new as soon as possible, waiting only drags out your emotions and affects the baby inside you. The sooner you get stable again the sooner you will be able to enjoy being pregnant.

I would feel bad if I didn't add this side note. While I do take natural remedies on occasion, while NOT pregnant, there have not been studied for safety on our unborn children. While there are many good natural products out there, there are also natural products that can be lethal. Please use caution if you go this route.
Also remember with mood disorders it is so important to have a support team, they can assist you and see your mood changes usually before we notice them.

I hope you get the help you need and deserve. Happy pregnancy to you.

A.,
All my heart goes out to you, I am 37 weeks preggo as well, I was diganosed bipolar 13 years ago I have been off meds for 7 years. This pregnancy is my 5th, and so far the worst. I struggle to stay in control, I can deal with the mania is the depressive part that scares me, you cant take the lithum while preggo, but I hear paxil is ok. I work with my OBGYN and my bi polar disorder, it is a hard subjuect to breach but remember it is for the health of you and your baby, tell your OB outright in the begining of your appointment, I need to talk to you and I need you to take the time to listen. I really hope that it goes well and if your doc is not willing to discuss and assist you get a different one. The problem is that with each doctor you will get a different opinion. Taking anything during pregnancy can put your baby at risk,even tylenol, but you also need to look at your emotional state, it can put your baby at risk as well, sometimes it is picking the lesser of 2 evils. Please keep us all up todate on what goes on, on of the best things you can get right now is support:)) Best of luck

A.,

Here is a website that may have some resources. http://www.babybluesconnection.org/ There is also a book called Mother's Milk by Thomas W. Hale that lists the latest research on medication and pregnacy and lactation. I think you should seek out a health care provider with whom you feel confident can address your situation. Have you tried accupuncture, exercise, and other natural things to try to manage the symptomsuntil you can get clear answers on medication? I had an insomnia episode part partum and it wasn't fun. I wish I had been more persistant with seeking the appropriate health care provider earlier before it got so bad.

C.

Hi A.,

My sister is bipolar also and she had stopped taking meds before she got pregnant. She found a way to balance her own body through exercise (yoga specifically) and a good diet (removing a few things she found out she was allergic to and eating pretty healthy.) I know she takes some supplements too, like fish oils (though be careful which ones you take while pregnant - I suggest Carlson's or Nordic Natural's, since they're high quality and mercury free). I'm not sure what else she takes though.

Personally I suggest that you see a Naturopath doctor. They might be able to offer you something that you will help you balance your body out, and is safe to take while you're pregnant. Everyone's body chemistry is different, but they may have a good plan for you, since they've probably handled this kind of situation many times before. If you're not familiar with Naturopathy, it's not all tree-hugger type stuff. I was raised very conservative minded and finally switched to a Naturopathic doctor for myself and my sons about 4 years ago, and I have never been happier with my medical care. Honestly, I've found them to be highly more educated about the human body than regular MD's (who seem to just tend to follow a textbook, rather than figuring new stuff out.) Just to note, not all insurance companies cover Naturopath's, but some do, so check with your insurance company first. Even if they don't, I highly suggest at least giving it a try. It will be worth it!

I hope you find the answer that you're looking for. Good luck!

There are absolutely things you can take during pregnancy. I'm not sure how to get in touch with one of these doctors, but, the Mother and Infant Care Clinic at UW hospital specializes in high risk pregnancies and may be able to point you in the right direction.

Good luck, and good for you for looking for help now.

Do you work with a psychiatrist? Have him work with you OB to find a medicine that you can take that is safe for the baby. And then tell the OB that you have been manic. You are going to crash eventually and that is going to be very, very dangerous for the baby. Work out (now!) a plan for what is going to happen when that happens. Shame on your OB for not thinking ahead for what happens when you went off the meds.

But the most important thing to do is talk to whomever you psych meds from. Begin your talk counseling again. It will help you get through this.

I will be thinking of you.

Ditto the the perinatal clinic at Swedish - they deal with high risk pregnancies - they are great - I used them Rheumatoid arthritis - you can use medication while pregnant they can go over your options - at the very least they should get you something to help you sleep - and sleep is oh so important.

I recommend you do that healthy mom means healthy baby. It is important to choose for your health.

Good luck to you! Take care of yourself.

Hi A.~
First of all let me say commend you on the sacrifice you've made for your child going off your meds completely & for so long. I know it is very difficult to do. I have depression & severe anxiety. I also live with chronic pain. I went off all my meds when I got pg also. I was put back on an antidepressant (zoloft) one that never really worked too well for me. At 12 weeks. At which time I was in my 2nd trimester. I had a rough pregnancy.
I started having contractions & was put on medication & bed rest for that at 23 weeks. Let me tell you that medication called terbuliline (it's a bronchodilator used for asthma also) anyway I don't know if you know much about it. But for me it was awful! Talk about feeling manic! It makes your heart race, can't sit still, sleep or relax! But you are on bed rest! It was awful!! I really feel for you!! I was already having a lot of trouble sleeping & relaxing due to anxiety.
Anyway~ There are definitely things you can take. Something that are safer than others. There are doctors that know more about these things. You could talk to a psychiatrist. Just about your meds. You should be able to call around to different OB offices & find out some info. Your OB should give you more time than he is.
Your mental health is EXTREMELY important during your pg. It worries me that he isn't more concerned. And he should also want to talk to you about what meds to put you on after you give birth. You may be at a higher risk for PPD. My OB put me on Lexapro after I gave birth & also gave me ativan & ambien. I also breastfed for 2 years!!

Good luck! I'm sending you many positive thoughts & energy! I really do understand. It has been on of my fears in having a second baby with all I went through the first time. Hang in there.
You have made it this far & should be given a huge MOMS ROCK star for that!!

Be Blessed!
K. }ii{

You absolutely need to talk to your OB about this - ASAP! And if he starts acting like he's in a hurry, you can politely tell him that the 5 minutes that it'll take to answer your questions may make the difference between you having a healthy pregnancy and baby, or not. He’s your doctor - that’s his JOB. And if you’re still really worried about his schedule, when you make your next appointment tell whoever you talk to that you will need a few extra minutes of the doctor’s time to talk about this and he should plan for it.

As far as what drugs are safe to take during pregnancy and which ones are not, there are some that you absolutely cannot take. However, there are some that they don't recommend taking but the benefits to you may far outweigh the “possible” risks to the baby so you can take them - but only with supervision. Bipolar disorder is a serious condition that needs to be monitored and if you think you’re feeling the effects from it, you probably need medication. Your OB needs to help you with this. Now, if he says that he’s only there to treat your pregnancy you may need to see your primary care doctor about this.... and if you don’t have a primary care doctor you need to tell him that so his office can help you locate one.

Long story short is: don’t let this go untreated - it won’t go away on it’s own. And if you try to ignore it or treat yourself, you may end up hurting yourself or your baby and have to deal with the effects for the rest of your life. Those aren’t odds I think anyone would want to play.

Good luck!!!!!!

PS - Also (and I hope this isn’t the case...), if your doctor ends up being a total a-hole about this situation - switch doctors!!! There are a TON of OB’s out there, most of which would want to help you deal with this. Not to mention, if he doesn’t care now, how do you think he’ll act towards you during your delivery?

The first thing you want to do is find someone who takes you seriously and will take the time with you.

Two HUGE suggestions that will make a big difference in your life. #1 - Find a good midwife - some of them specialize in Naturopathic medicine. Midwives actually spend TIME with you - unlike medical doctors. They are just as trained - I had two problem pregnancies in a row mainly because of my age (over 40) -and I wouldn't trade my midwife for ANYONE!!! The doctors have 25 patients delivering at once and NEVER give you the time you need - especially not in delivery according to my experience. Naturopathic medicine can be used regardless of whether pregnant or not. There are great remedies for depression. I was diagnosed as bi-polar in 1988 and now no longer am.

#2 - Acupuncture does WONDERS for depression. Did you know food allergies can also cause depression??? It caused depression and anxiety attacks. A Systemic Candida problem (MDs don't believe in it but it's a real problem) can cause terrific mood swings - terribly up and downs for years. Acupuncture helps relieve bad muscular memories stored in your body - can release them. The first time I had acupuncture I cried for the whole hour, because so much got released.

A., There are psychiatrists who specialize in pregnancy AND mental heath issues. I was in a similar situation. My doctor was able to discuss the pro's and con's of mediations and make sure both mommy and baby are doing well. In addition, she served as an advocate between my OBGYN and pediatrian as needed. If you need a referral, please let me know and I will be happy to provide her information (she is located in Beaverton, OR).

Thanks,
J.

This is one of the things I hate about traditional ob/gyn practices -- when everyone is in such a HURRY and they act like YOU are inconveniencing THEM. Excuse me, YOU are the pregnant MOM! You deserve someone who will focus on you. This was the major difference between the obstetrician I used with my first pregnancy, who was okay, but always in a hurry, and the midwife at Puget Sound Midwives and Birth Center. Can you believe, they ALWAYS set aside ONE FULL HOUR for your appointments? And they said, that time is yours to discuss anything YOU want to discuss. We understand that having a baby affects every part of your life and we are here to help you manage that change. So in my appointments we talked about relationship stuff just as much as my physical symptoms.

I wonder if it would help you to write down, or better, type up, a thorough list of your questions. THen when he bustles in, hand him the list. That way, you won't be intimidated out of getting what you need, because it will be already written down. Write at the top, "Questions/Advice needed about my pregnancy:"

i really think you need a different doctor. When you are in the room with your doctor your health concerns should be their first priority and you should not feel uncomfortable taking the doctor's time and asking about your problems.

This is even more critical for you since you have more complicated situation. My OB doctor is extremely busy and it is so hard to get appointments and sometimes you have to wait for a long time in the waiting room to see her (chronically late/overextended) but without exception, EVERY time she came into my room, she sat down, looked me in the eye, asked me how i was and if i had any problems, then listened and responded to them.

It is common for doctors to have different opinions on this type of stuff b/c there aren't a lot of studies- pregnant women don't want to be guinea pigs for medicines. You need a doctor who will look at your condition and concerns and explain the options and risks to you so together you make the best decision for your health and your baby.

i know finding doctors can be difficult but i really think in your case it is very important that you find a doctor who provides holistic care for YOU and your baby during the pregnancy.

good luck!

Hi A.,

I'm so sorry that you are suffering like this. Your issues are out of the scope of practice of a nurse practitioner and maybe even the OB that you are seeing. It would be best to consult with the high-rish perinatal group - I think that someone mentioned Swedish already - they are very helpful. It would also be best to work with a psychiatrist - Rex Gentry is one that specializes is mental health particularly related to pregnancy. I know that he is difficult to get into but if you get a referral through a doctor, sometimes they can get you in for crisis intervention which it seems like you are headed for.

At any rate, a psychiatrist should be the one managing your meds - OB's are not trained in mental health. It is best to work as a team approach.

I would be very leary of trying anything that you have not discussed with the psychiatrist and OB. If all else fails, going into the emergency room will get you into the system faster - even if you don't feel that you are "that bad" yet. You really don't want to wait until you need to be taken in an ambulance.

Best of luck -

C.

I had a friend in your exact situation. She did end up taking meds I think at a very low dosage, I think. But, you should ask your psychologist. Also, most meds will say not during pregnancy, but at a low dosage, it may not hurt the child, especially after a period of time. I would really talk to your psych. The good thing is, after the child is born you can go right back on the meds to balance things out. Good luck!

It is safe to take Shaklee's brand of fish oil, called OmegaGuard. People with your challenges have found it helpful, and no reason to avoid in pregnancy. If you are interested, check out my website www.shaklee.net/sampleshc. I would be happy to help you.

It is very important that you talk to your OB about this. If you are not comfortable with your current OB, or feel like he is always in a big hurry, then I would find a new one. Also, shouldn't your doctor also be aware of the situation due to your prior use of medications, etc.? Isn't that why we will fill out the medical history form? Can't your nurse practitioner communicate with your doctor? Especially, since you are asking for help/meds? Why hasn't your nurse practioner taken the next step to help you? Sorry, I guess I have more questions than answers! I hope some of my thoughts help you. Good luck, S.

A., i see that you're already working on a resolution but i just wanted to say, i'm a bipolar mom and i just had my second daughter on the 1st of july. i was treated with 150 and then 200 mg of lamictal during my pregnancy and did well on it. i had my ups and downs, but made it out alive. i was not medicated with my first daughter, and it nearly landed me in the psych ward, so i feel your pain. i wish you the best of luck, personal message me if you need to vent!