Monday, November 18, 2013

Bipolar and Pregnant? (Part2)



For many years, bipolar women were told not to get pregnant, but in the last decade or so, medical progress has made pregnancy an option, which is particularly good news because the highest percent of bipolar women in the United States are in their childbearing years. There are nearly 4.5 million of them.

If you become pregnant by accident and are bipolar, don't drop or change the dosage of your bipolar medication without the advice of an ob-gyn and a psychiatrist. If, however, you plan your pregnancy, discuss with your docs whether you need to adjust your medications, and the medication dosage, perhaps beginning six months before getting pregnant and continuing for three months after giving birth. This is important in part because some bipolar meds can cause birth defects.

In addition, pregnancy may lower the effectiveness of bipolar medications and so increase the chances of bipolar episodes. Unfortunately, not a lot is known about optimal dosages of bipolar meds for pregnant women, but you can discuss the issue with a qualified doctor.

A bipolar pregnant woman whose doctor has adjusted her bipolar meds should, of course, eat healthily, and get enough rest and exercise. She should not smoke, drink alcohol, or take recreational drugs, even if tempted in order to manipulate her own sense of stability and well being. Talk therapy may provide especially welcome support. If she becomes depressed, she and her doctor need to address this issue immediately, because severe depression in a pregnant woman can have a negative impact on the child she is carrying.

If you find electroconvulsive therapy (ECT) works for you, your doctor can help you decide whether to continue it during pregnancy and what, if any, adjustments to make if you do.

There are many ways to be bipolar, and no formula fits every bipolar woman who wants to become pregnant or who has given birth. Almost everyone needs a support system of family, friends, colleagues, and medical professionals, but for a bipolar woman who is pregnant or has recently given birth, this is especially critical.

She may find that she can't cope and needs live-in help or needs to consult a psychiatrist, ideally a perinatal psychiatrist, and perhaps to enter a psychiatric facility, ideally a perinatal psychiatric unit. (Perinatal refers to a few weeks before and after giving birth.) Plans should be in place before she becomes pregnant not only for the pregnancy but also for her life as a new mom. Some areas now have perinatal psychiatrists and even perinatal psychiatric units.

As more and more is known about pregnancy and bipolar disorder, pregnancy should become an increasingly viable option for bipolar women.

Monday, November 4, 2013

Hypomania as Bipolar Lite




Hypomania is a sense of increased well-being that lasts for several days or more and is related to bipolar disorder but is less intense and disruptive.

The word hypomania combines hypo, which is a familiar prefix when used in hypochondria and hypodermic but is perhaps puzzling attached to mania.

Moreover, hypo can be confused with the prefix hyper, which means overly (as in hyperactive), the opposite of hypo, which means under or less than as in hypoallergenic (less likely to trigger allergies than a non-hypoallergenic item).

On the positive side, hypomanic people may enjoy a sense of well-being and competence and be more creative and energetic than usual. On the other hand, they can be irritable and easily annoyed. They also can be more competitive, which may or may not be a good thing depending on whether they are in a situation generally accepted as competitive or are, for instance, competing aggressively with their spouse or boss. Another risk with hypomania may be that it lowers inhibitions and sometimes triggers risky behaviors involving drugs, sex, and even shopping.

For bipolar people, hypomania can devolve into mania or depression. A therapist may be able to suggest strategies for dealing most effectively with hypomania in bipolar patients. Some people, however, enjoy hypomania and do not want any treatment that will bring them down.

The disadvantages and risks of hypomania seem to be offset for some creative people by the boost it gives to their talents. Stephen Fry, who is bipolar, asked numerous bipolar people if they would give up being bipolar if offered the opportunity. None said they would. This may be in part because of hypomanic periods of enhanced accomplishment.

Hypomania does not necessarily occur naturally. It may a side effect of pharmaceutical drugs or steroid therapy, for example. It may also be triggered by stress or exhaustion. And in teenagers, hypomania may be the first indication of bipolar disorder.

In his book The Hypomanic Edge, John Gartner claims that hypomania is a quality of temperament rather than a mental illness. He sees it as a benefit to civilization that has given us some of our most productive people, from Christopher Columbus to Bill Clinton. His theory does not appear to have won converts in the community of mental health experts, and he focuses only on men to illustrate his theory, which may raise question in some minds about his own mental state.

Ideally, the first time anyone experiences hypomania, she or he will see a psychotherapist for diagnosis and advice.  

Hypomania as Bipolar Lite



Hypomania is a sense of increased well-being that lasts for several days or more and is related to bipolar disorder but is less intense and disruptive. 

The word hypomania combines hypo, which is a familiar prefix when used in hypochondria and hypodermic but is perhaps puzzling attached to mania. Moreover, hypo can be confused with the prefix hyper, which means overly (as in hyperactive), the opposite of hypo, which means under or less than as in hypoallergenic (less likely to trigger allergies than a non-hypoallergenic item).

On the positive side, hypomanic people may enjoy a sense of well-being and competence and may be more creative and energetic than usual. On the other hand, they can be irritable and easily annoyed. They also can be more competitive, which may or may not be a good thing depending on whether they are in a situation generally accepted as competitive or are, for instance, competing aggressively with their coworkers or boss. Another risk with hypomania may be that it lowers inhibitions and sometimes triggers risky behaviors involving drugs, sex, and even shopping.

For bipolar people, hypomania can devolve into mania or depression. A therapist may be able to suggest strategies for dealing most effectively with hypomania in bipolar patients. Some patients, however, enjoy hypomania and do not want any treatment that will bring them down.

The disadvantages and risks of hypomania seem to be offset for some creative people by the boost it gives to their talents. Stephen Fry, who is bipolar, asked numerous bipolar people if they would give up being bipolar if offered the opportunity. None said they would. This may be in part because of hypomanic periods of enhanced accomplishment.

Hypomania does not necessarily occur naturally. It may a side effect of pharmaceutical drugs or steroid therapy, for example. It may also be triggered by stress or exhaustion. And in teenagers, hypomania may be the first indication of bipolar disorder.

In his book The Hypomanic Edge, John Gartner claims that hypomania is a quality of temperament rather than a mental illness. He sees it as a benefit to civilization that has given us some of our most productive people, from Christopher Columbus to Bill Clinton. His theory does not appear to have won converts in the community of mental health experts, and he focuses only on men to illustrate his theory, which may raise question in some minds about his own mental state.

Ideally, the first time anyone experiences hypomania, she or he will see a psychotherapist for diagnosis and advice.