client with bipolar

syncreo · 08-16-2006, 12:21 PM

Hi,
Does anyone have experience supporting a woman who experiences bipolar disorder? I currently have a client with this diagnosis and from what i can find there are some real concerns in the postpartum period. . She has changed her medication as she was worried about the effects on the baby and at this point the medication isn't working for her. She doesn't really have any other options with the medication but I have heard that perhaps fish oil can improve symptoms. Once she has the baby she will have to continue on these meds as once again there are concerns with the others meds and breastfeeding.

Just wondering what others have found in their experiences and if there is anything else I should be aware of for her pregnancy or labour.

While I am at it I also have another client who experiences Anxiety attacks - any experience with this? I have previously supported a client with this diagnosis but would love some further insight.

Thanks.
Shawna

jesscardona · 08-16-2006, 12:34 PM

It really depends what meds she's on, and what her doctor said if she could continue taking some of those meds while preg. or after preg.

Birth Beginnings · 08-16-2006, 01:37 PM

I just had a client with bipolar. Her doctor actually advised her to terminate the pregnancy because they were in the midst of changing her meds when she found out she was pregnant. She felt wonderful while pregnant, had no episodes, she was amazed. She had a great delivery, however the docotr fractured the babies arm while trying to rush the shoulders to get to another birth. Breastfeeding went well, and she was doing extremelywell. She had many resources set up for help. She had her psychiatrist, home health care worker, family doctor, and family close by. She did amazingly well, her had a few bad days nearing her sixth week, but just feeling unattached to the baby, which really scared her. She was not on meds during her pregnancy, and still had not resume them at six weeks. She wanted to hold off if she stayed well.

As for the meds she was told varying things. The psychiatrist said she could not take them while breastfeeding. Mother Risk told her she could but there were no studies to support it being safe in the amounts she required. Dr. Jack Newman said it would be fine.

I found it didn't affect her labour although she was fine throughout her pregnancy. What I did find was that she wanted a lot of reassurance of what is normal postpartum and to hear of my experiences as a young single mom.

That was my experience, I don't know if it helps at all.

jesscardona · 08-16-2006, 01:45 PM

OMG!! I can't believe that!! that the doctor told her to terminate!!

I am glad she didn't, I would I found me someone else..
Im sorry but I would of sued that doctor!!! then for braking the babies arm!
oh no! this is to upsetting.

Im glad she was able to do fine with/out the meds.

syncreo · 08-16-2006, 01:55 PM

Michelle,
Thanks, hearing another experience was what I was looking for. I know that of course every woman is individual but I wanted to hear some personal stories beyond the research I found when I googled the topic. It is nice to know that everything went well for your client and I think my client.
Her meds are sort of a nonissue because she has already made a decision about it and isn't going to change her mind.

Thanks.
Shawna

jesscardona · 08-16-2006, 02:01 PM

The reason I also asked was b/c I worked for a while at a psych. office and I learned so much, I've always worked in a doctor's office or something in a medical field, anyways, but I've always liked mental health.. and b/c Im also on meds. b/c I have migraine headaches, and I have to get off these meds to get preg. (which is a pain) but I can only stay on one of them, and on the Blood pressure med. and I did get migraines during my preg.

heathenmamaof5 · 08-16-2006, 02:19 PM

For the anxiety mama could try Bach Flower Remedies. Some of my mom's have had great luck with this.

As for the meds, I can't get over how oblivious some of the Doc's are! Prozac is one drug that HAS been researched during pregnancy. The only thing they noticed was small babies at birth, BUT most of those moms were smokers so I don't worry so much about that. The other thing that can happen is that the babe gets sensitized to the med. So if mom is taking Prozac her children may not get the releif that others get. If you look at benefit vs. risk of a med sometimes it IS indicated during pg and the first year post-partum.

Also the doc's freak if your bf and on any meds. When the psychiatrist said I couldn't bf and take meds (remember I have a TON of auto-immune disorders) I basically said, "then I won't take the meds. I AM going to bf this kid for at least two years." That took care of that, he prescribed the meds and my kids are just fine.

Yes, you do have to give these mama's extra support. Especially in the pp period. It's easy for them to become depressed and not know it until they start having all these weird thoughts running around in their head.

I'd trust what Dr Newman says on this subject. Also try Tom Hale's website. He does "medications in mothers milk".

Good Luck!!!

jesscardona · 08-16-2006, 02:21 PM

I WOULD STAY AWAY FROM PROZAC while preg.!!!

but that's just my

heathenmamaof5 · 08-16-2006, 02:25 PM

Why Jessica? I thorouly researched durin my pg with Linz and then while pg with the twins. Is there new info out that I don't know about? Yes there were risks, but if you look at benefit vs risk you'll get better rest on the med and will eat and take care of your home and family. If a mom becomes suicidal that is more of a risk to mama's family. You know depressed people sometimes have a cumpulsion to drive their car off a cliff or into a tree.

Just my

J

jesscardona · 08-16-2006, 02:29 PM

oh no, Im just saying its based on person to person I was once on that med.
and it was the worst thing I could of ever been on, it screwed up everything for me.. for some people it works wonders for some it doesn't..
I tried others and it has worked fine..

heathenmamaof5 · 08-16-2006, 03:32 PM

Well, if mom was on prozac previously then her doc knows it works. Right?

Shawna, what drugs are we fousing on? There are different kinds of depression and anxiety and anti-psychotic meds out there. Sometimes they put them on a cocktail and it works well.

I just had a thought, are wer talking about Lithium? That's a med that's for someone that has EXTEME up's and down's. If this is the case this mom is going to need lots and lots and lots of support. I wonder if a Bach Flower Remedy would ease her symtoms. Hmmmm...

syncreo · 08-17-2006, 12:33 PM

Hi,
Jill, before getting pg she was on Lithium and it worked for her but now she is on Zyprexa (which isn't working for her). She is not comfortable taking lithium while pg or bf and I can see why - it is quite risky. She seems content to stay on the meds that aren't working.
She already recognizes that she is at huge risk for ppd after baby comes and that is part of the reason she has hired me. I guess I want to know what other things I could be doing for her besides setting her up with referrals and supports. I also want to know if I should be aware of anything in particular during her labour - my instinct tells me she just needs what most women in labour need support, reasurrance etc but am I missing something?

Thanks.
Shawna

heathenmamaof5 · 08-17-2006, 02:08 PM

Shawna, it sounds like you have realistic expectations of this mama's childbearing year. I have to admit that I would recomend she back to her psychiatrist and suggest a different med. Do you have access to Medications in Mother's Milk by Tom Hale? Or could mama go to his web site? I'knoe most here might not agree, but I'm wondering if prozac would be good for her. Another thing is that most psychiatric drugs take 4-6 weeks to kick in. Has it been that long (for Zyprexa)?

The Post-Partum husband is a great book. She and you and partner could read it during her pregnancy. It's a quick read and has some great suggestions for the care of mama. Another book that really helped me was Postpartum Survival Guide by Dunnewold and Sannford, here's one more Post partum depression and anxiety: A self help guide for mathers-I've never read this one so have no idea what their thoughts on the subject are. But ALAce recommends it, so I assume it's more family freindly it's by The Pacific Post Partum Support Society.

Another thing she might want to consider is asking female family members if they know of anyone on mama's side of the family having pp issues. I say this because I had symptoms of pp psychosis with my second (we thought it my bizarre behavior was totally normal-talk about denial!) When the symptoms started to return during Linzey's pregnancy and I insisted the OB do something, my mom and Aunt said, "oh yeah, pp depression runs on our side of the family. Didn't you know that Aunt Sue and Aunt Millie were instituationlized after some of their births?" I was like What!?! No one had thought to tell us kids (all the cousins were having babies) about this??? Geez!!! The thing is it's not something to be ashamed of. It's a chemical inbalance in the brain and it's not our fault! Sorry went off on a tangent. I guess when I talk of it I get all worked up and emotional.

Please, Please, Please ask any questions of me and AllDoula's that you need to. That's why we're here, right? I'm here for you girl! My cell is a Metro PCS so all calls are free if you ever want to talk. (916)613-5210

syncreo · 08-18-2006, 09:08 AM

Wow Jill - thanks for the resources. Very helpful and I will recommend the books to her and see if I can get my hands on them as well. Her mom works in a book store so she can pretty much get any book she wants.

I do have access to Medications in Mother's Milk and will look up her meds and other possibilites.

Thanks for sharing both the resources and your personal experience - I appreciate your candidness. I will keep asking questions as they arise.

Cheers,
Shawna