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Postpartum Management of Bipolar Disorder

mariskameldrum

This is one of the most useful things I have read regarding bipolar and pregnancy/childbirth. I wish I had read this before the birth of my first baby and highly recommend it to anyone who is pregnant or considering becoming pregnant. It’s possible to have a baby and not become unwell – but it takes preparation and having a support team at the ready.

Kitt O'Malley

International Society Bipolar Disorder

This morning I participated in a webinar sponsored by The International Society for Bipolar Disorders entitled, Postpartum Management of Bipolar Disorder: Challenges and Opportunities, led by Dr. Verinder Sharma. Bipolar disorder is commonly misdiagnosed as major depressive disorder, just as postpartum bipolar disorder is misdiagnosed as postpartum depressive disorder. Misdiagnosis of bipolar disorder has serious consequences. Reproductive events such as the birth of a child can trigger manic, hypomanic and mixed symptoms.

Studies vary as to the effect of pregnancy on bipolar disorder. For some women, pregnancy is associated with an improvement in symptoms. Childbirth and the postpartum period is a potent trigger of episodes of bipolar disorder. Psychiatric hospitalizations exponential rise during the one month postpartum period. Risk factors include being unmarried, perinatal death, and C-section. Both biological and psychosocial factors play a role. Later in life, menopause is associated with increased rapid cycling and more clinical visits…

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Uncategorized

I’m not on drugs… I’m having a manic episode

mariskameldrum

Eighteen years ago, my mum took me to our local doctor, concerned about my sudden strange behaviour since finishing my final high school exams.  Taking one look at me, his first reaction was to tell Mum that I was obviously under the influence of drugs.

When she told him she didn’t think I would take drugs (which I never have) – he made a sarcastic remark about parents like her having “no idea at all.”

Three days later, after ordering brain scans, CAT scans and a battery of other medical tests, the local hospital concluded I was having my first acute manic  episode.

This incident sprung to mind today as I read an article in the Shepparton News about HeadSpace – Australia’s youth mental health foundation – running courses in country Victoria next month to help parents identify and intervene early with the mental health needs of their children.

As Headspace says to parents and carers on their website: “Recognising signs is the first step toward getting [your children] help.”

I couldn’t agree more.

If it wasn’t for my parents and then boyfriend (now my loving husband!) – my local GP may have dismissed the signs of my first manic episode as a teenager experimenting with drugs.  It was my parents who told him of my family history of Bipolar Disorder and the incredible stress I’d been under the weeks prior during Year 12 exams.

As parents, we are our children’s advocates:  if they start wheezing, we take them to the Doctor.  If they are struggling at school, we book a time to speak to their teacher.  So why wouldn’t we be on the lookout for signs that they are struggling with depression, anxiety or displaying other out of character behaviours.

Nobody knows our children better than us.  And we need to be aware of the symptoms of mental illness and take them seriously.

Parents in Shepparton know this better than most.  Despite the idyllic setting, this regional centre has some of the highest rates of youth suicide in Victoria.  They have learnt that mental illness is the hidden killer.

Mariska xx

Check out Headspace’s excellent mental health resources for parents and youth at www.headspace.org.au

 

Motherhood, Pregnancy, Uncategorized

Have my meds affected my kids?

mariskameldrum

seroquelOn Tuesday night, my kids raced to the front door to greet a special visitor.  Her name was Ameka and rather than dinner, she had come to spend two hours interviewing the kids and I.  By ‘interview’ I don’t mean the journalistic kind… rather, she was there as part of a new research project into the effects on children aged 1-5 of taking anti-psychotic medication during pregnancy.

I’ve shared before about how – after a horrific experience following the birth of my first baby – I decided to go on Seroquel in the latter stages of my subsequent two pregnancies.  This wasn’t an easy decision. Before I fell pregnant the second time I went to see  one of the world’s leading specialists in women’s mental health – trying to find out more information about possible effects of anti-psychotic medication on unborn babies.

Unfortunately, at that time (five years ago) there wasn’t much research to reassure me that it was safe or not. In fact, the specialist I saw was embarking on a world-first study into the effects of Anti-Psychotic Medication on babies.  At the time, they had a database of 25 babies (all healthy!) whose development they were tracking from birth to 12 months.

Knowing how desperately needed this research was, I readily agreed to participate in the study.  The phone calls and visits continued until my each child turned one.

I must admit, I was a little disappointed when our time in the study ended. as they learn to walk, talk and really start showing their true personality. Surely studying babies only until they turned one wasn’t giving the researchers the full picture?

So I was pleased to receive a phone call last month, letting me know that Ameka, a medical student, was joining the team and continuing the research up until the age of five –  as part of her thesis.  I readily agreed for her to interview my younger two kids (now aged three and five) and I.

So that’s how we found ourselves last night, watching my youngest son (a real clown!) hopping around the room on one foot, building towers out of blocks, drawing different shapes and doing puzzles.  Watching his younger siblings pass their tests with flying colours, my high achieving oldest son hovered by… confused as to why this special guest wasn’t interested in testing him.

As she left, I couldn’t help but ask Ameka, “So… do the kids seem ok to you?”  I’ve never had any cause to doubt that they are perfectly ok. But somehow, having a medical professional agree that the medication hasn’t hampered their development at all was… reassuring.

I might have bipolar disorder.  But like any mum out there, I want the best for my children.  My prayer is that years down the track, when  other women with bipolar are preparing for pregnancy, ground-breaking research like this will mean they can be assured that looking after their own health will not harm the ones they love best.

 

 

 

Depression, Despair, Embarrassment, Motherhood, Motivation, Uncategorized

Brains or beauty: why should I have to choose?

mariskameldrum

This morning, getting ready to have my morning shower, I averted my eyes from the scales – and my reflection in the mirror.  A few days earlier, I had been shocked to see the numbers on the scale had gone up… again.

After having lost a stack of weight in the past couple of years, I’ve been struggling to stop the kilos piling back on since having to increase my medications after an episode of depression last year.

Not only that, but one of the medication, Epilim, is having another awful side-effect – causing my hair to fall out… not a great feeling for a woman.  Every time I run my hands through my hair, precious strands float away.

Like many people who have been on anti-psychotic or mood-stabilizing medications before, I know that weight gain is a well-documented side effect.  But the hair thing came as a nasty surprise.

Asking my psychiatrist about it at our next appointment, she talked me through my (very few) alternative options.  One of the drugs she suggested came with no risk of weight gain or hair loss.  “Great!” I thought.  Until she mentioned that if I noticed a rash appearing while I was taking it, I needed to get straight to a Doctor – as  it could be fatal.

Unwilling to take the risk of dying – no matter how small the odds – I’ve decided to stay on the same medications for now.  After all, they are keeping me well and after experiencing my first bout of depression, I have no desire to go back there.  I’ll just up the exercise and start eating a little healthier (which isn’t a bad thing I guess!).

Still, as a woman, I must admit that it annoys me that I have to (literally) make the decision between my brain and my beauty.

Having noticed friends facing similar weight-gain issues, I’m betting that the pharmaceutical company that manages to create a mood-stabilizing or anti-psychotic drug without this self-esteem blowing side-effect will have many satisfied customers.

What are your expriences with medication and side-effects?  What steps have you taken to counter them?  We’d love to hear from you!

Depression, Forgiveness, Motherhood, Motivation, Uncategorized

Approaching the New Year like a set of monkey bars

mariskameldrum

I’m one of those people who love to celebrate New Year’s Eve.   This year, house-sitting my parent’s small farm, we decided to invite two other families with young kids around to bring in the New Year with us.

After enjoying a barbeque dinner and games of backyard cricket and footy, we tucked the kids into bed and sat around chatting, enjoying a glass of wine and waiting to see the fireworks when the clock struck midnight.

When one of the other women suggested we take turns to say our highlight for 2013, my husband Nathan and I glanced at each other.  I don’t think either of us would say that 2013 was a great year for our family.  With business troubles and my struggles with anxiety and depression, this year has been a tough one for both of us.

Yet, sitting there, listening to others talk about their highlights (new babies, houses sold and bought etc.) I recalled something C.S Lewis once said:  ‘Getting over a painful experience is much like crossing monkey bars. You have to let go at some point in order to move forward.’

This quote stuck in my mind because it reminded me of our four-year-old daughter, who loves the monkey bars but is too scared to let go with one hand to reach for the next bar.  Instead, she hangs there until, eventually, she drops.

With this in mind, my New Years resolution for 2014 is to let go of the past and start moving forward again.

Having a whole new year ahead of me feels like opening a brand new journal… crisp, new pages ready to be written upon.  And so, instead of dwelling on the past (see my post Unforgiveness: Don’t let it corrode you) I am going to look forward to the many wonderful things awaiting me this year.

Sure, our life is bound to have ups and downs and be far from perfect.  But perfect would be boring right?

Have you made a New Year’s resolution?  I would love to hear it!

Anger, Depression, Despair, Hope, Motivation, Uncategorized

When you can’t say it with words

mariskameldrum

Tonight, browsing the internet, I came across a wonderful blog, with incredible images drawn by someone with bipolar disorder.

Somehow, with a simple image or two and very few words, the blog’s author managed to conjure up some of the emotions that many of us go through.

And so, in the spirit of her blog – I’m going to say no more and simply show you some of her pictures.  If you’d like to see more, I’d encourage you to take the time to visit her blog.

Photo: http://bipolarcodex.wordpress.com/
Photo: http://bipolarcodex.wordpress.com/
Photo of woman with bipolar disorder saying she needs help
Photo: http://bipolarcodex.wordpress.com/
Picture of manic woman
Photo: http://bipolarcodex.wordpress.com

Thank you to http://bipolarcodex.wordpress.com/ for sharing these photos with us.

picture of Mariska Meldrum after finishing 5km charity run
Embarrassment, Motherhood, Motivation, Uncategorized

Aghhhh! What happened to my body?

mariskameldrum
picture of Mariska Meldrum after finishing 5km charity run
Successfully completing my first ever 5km charity run (3rd from right)

I guarantee I’m not the only woman out there who has looked in the mirror at my post-partum body and despaired.  Gone is the smooth firm tummy – replaced with a wobbly stomach streaked with stretch-marks or a C-section scar.

I naively thought that the 21 kilograms I packed on while blissfully pregnant with my first son would magically ‘melt away’ after his birth.  I vaguely remembered reading somewhere that breastfeeding was equivalent to running a marathon everyday.

Unfortunately, after becoming acutely unwell after my son’s birth, I was admitted to a psychiatric hospital and put onto heavy doses of anti-psychotics and mood-stabilisers.

When I finally came home from hospital six weeks later, I curiously stepped on the scales and was devastated to find myself only 2 kilos lighter than when I was 9 months pregnant.  And my son had weighed 3.7 kilos!

Six years and two more babies later, I finally lost the last of all that ‘baby weight’ (although I’m not sure I can blame it on the baby….)

As a woman with bipolar disorder, losing weight has never been easy for me.  Staying well has always been my priority, so I’ve had to put up with the weight gain which is a side effect of the anti-psychotic and mood stabilizing medications I take.

To successfully lose 21 kilograms, while remaining on my medication, took me six years of healthy eating and exercise.

After what my body and mind had been through, I was determined not to go on the latest ‘milkshake’ diet and starve it of nutrients – but to nourish it with fresh, nutritious food.

With three preschoolers around, it became even more important to me that they see their mum exercising and eating healthily.  I didn’t have the option of going to a gym during the day, but discovered I loved exercising with the kids outdoors.

An exercise class for mums got me running for the first time since high school – with my two and four year olds in the pram acting as my coaches, urging me to ‘keep running mummy – don’t stop!’

I still struggle with my eating habits (especially when I’m around chips…), but I’ve learnt that it is possible to be on medication and lose weight….slowly, but surely.

Has motherhood or medication caused you to struggle with your weight?   I’d love to hear your comments or stories.

Developing an action plan, Pregnancy, Uncategorized

Stay in control: be armed with an action plan!

mariskameldrum

Many things about bipolar disorder seem out of our control.  We can’t dictate when depression will hit us out of the blue, or when we’ll be left picking up the pieces in the aftermath of a manic episode.

Still, there are some things that we can control.  And for those of us who are mums (or mums-to-be), with little ones depending on us, this is music to our ears.

Nearly six years ago, I was pregnant with my second child and terrified that things would go pear-shaped, like they did after my first son’s birth.

Trying to wrestle back some sense of control, I sat at the computer and wrote a Bipolar Action Plan.

This focused on manic episodes (the hallmark of my condition) and outlined a number of things – such as signs that I was becoming unwell, usual medications, contact details for my GP, psychiatrist and psychologist, and a list of the people I wanted to act as my ‘support crew’ during any future episode.

As a mum, the thought that I may not be in a state to care for, or see, my young children was terrifying.  Writing down instructions for their care, as well as that of our dog and house, was somehow soothing to my anxious brain.

For those who don’t already have a Bipolar Action Plan, I would highly recommend putting one together.  If you’re not sure where to start, why not adapt this sample one – based on the plan I put together: Bipolar Action Plan (sample). 

 Was the Bipolar Action Plan useful? I’d love to hear your feedback or suggested improvements!