I have talked with my OB/Gyn about pregnancy and lithium (and/or other medications for bipolar disorder). She has extensive experience with women with mood disorders being pregnant and giving birth. She agreed that with my history (very short relapse time and every relapse is worse than the previous one), going off all meds, even just for the 1st trimester is not an option.
I have talked with a nationally-recognized psychiatrist working with women with mood disorders before, during, and after pregnancy. She agreed that going off all meds is not an option. She said that lithium is probably the best choice, although Lamictal is an option. I will visit her again during pregnancy (should this happen) and especially towards the end as we work to avoid postpartum psychosis.
I have talked with my psychiatrist. She has experience with women with depression before, during, and after pregnancy. She referred me to the specialist, but the specialist agreed that she is more than qualified to be my primary mental health caregiver during pregnancy.
Pregnancy and lithium don't mix.
This comment especially pushed my buttons and possibly not why you would expect. I was diagnosed with bipolar disorder when I was 23 years old. After trying numerous medications, I found a certain amount of relief of symptoms when I was taking lithium. It had some side effects that were bearable. I didn't care for all of the blood tests that I had to have on a regular basis, but I appreciated that they were being done. Numerous body functions were tested.
I was 23 years old and I wasn't ready to get married. I was sexually active, but I was conflicted about it because of my upbringing. Of course, this didn't stop me from having sex! I had a cervical cap, but then traded it in for The Pill because it helped with cramps, but mostly because I was terrified of getting pregnant. I was not just terrified because I was unmarried, but because my doctor had told me that lithium would cause such extensive birth defects that I would have no choice but to terminate the pregnancy. He said that the only way for me to have a child--ever--would be through adoption. That's a hard pill to swallow when you're 23.
Not long after that, I fired my doctor, quit taking the meds and tried to hang on to my sanity. I managed to make it through the manic periods without completely destroying my life. Except that my debt was high, my credit was shot, my relationships were ruined or strained, my career was nonexistent, all of the usual things. Apparently, none of these were evident enough for anyone to suspect that I was ever manic. And like I said, I was in denial. Depression, on the other hand was something that I knew I struggled with and got finally help for about 7 years ago.
11 years after my original diagnosis, my primary care physician referred me to a psychiatrist. We had tried all of the typical antidepressants and nothing had really helped. I still had "anxiety." So, the psychiatrist worked with me and asked questions and watched me and after a particularly bad manic episode, even I knew that I wasn't just anxious. The psychiatrist amended her diagnosis of depression and anxiety to bipolar disorder. She had known about the original diagnosis, but I'd also told her that the original doc was a jerk and a quack. I stand by those statements, although sometimes, a blind squirrel will find a nut.
In fairness, I had been in denial and the condition is such that if you're not actively manic when you go in and you don't report it to your doctor, they won't get it. Well, my doctors at least, because they're not psychic.
So, pregnancy. I fell in love with an amazing man. I somehow tricked him into marrying me. After 7 years together we realized that parenthood was something we wanted to pursue. The research now is different. I blogged about what I found.
And now the rubber hits the road. Or, the rubbers hit the road. Wish us luck!
