Bipolar disorder during Pregnancy

ichhori team

Bipolar disorder during pregnancy is risky for mother and baby. Learn symptoms, treatment options, and how to manage it safely before and after birth.

Bipolar disorder doesn’t stop when you get pregnant. And if you ignore it? Things can spiral fast — for you and your baby.

The mood swings. The meds. The pressure to stay “stable.” It’s a lot. But the good news? There are ways to manage bipolar disorder safely during pregnancy — without putting either of you at serious risk.

What Is Bipolar Disorder?

Bipolar disorder = extreme highs (mania) and crushing lows (depression). It’s a chemical imbalance in the brain — not a personality flaw.

There are two major types:

  • Bipolar I: Full manic episodes, often with psychosis
  • Bipolar II: Hypomania (milder highs) + major depression

Both types can flare during pregnancy, especially if meds are stopped suddenly or if sleep patterns change (which they will).

What Makes Pregnancy Risky for Bipolar Patients?

  • Hormone shifts can trigger episodes
  • Lack of sleep worsens symptoms fast
  • Stopping meds suddenly increases relapse risk
  • Stress, physical strain, and birth trauma can all cause mood crashes

If left unmanaged, bipolar disorder during pregnancy can lead to:

  • Severe depression or suicidal thoughts
  • Manic episodes with risky behaviour
  • Missed prenatal care
  • Poor nutrition or self-care
  • Postpartum psychosis (in severe cases)

Stats That Matter

  • 23% of bipolar women relapse during pregnancy if unmedicated (JAMA Psychiatry)
  • That number jumps to 66% postpartum without care
  • 1 in 5 bipolar pregnancies involve psychiatric hospitalisation (NIH)
  • Women with untreated bipolar disorder are 4x more likely to experience postpartum psychosis
  • Medicated patients are up to 60% less likely to relapse during pregnancy (Lancet, 2023)

Should You Stay on Medication?

This is a huge question. And the answer isn’t “yes or no.” It’s “what’s safest for you and your baby.”

Some bipolar meds can increase risk of birth defects — especially mood stabilisers like valproate or lithium. But going off meds cold turkey? That’s worse for many women.

Options to discuss with your doctor:

  • Lamotrigine — often preferred in pregnancy
  • Antipsychotics — some are safer than others
  • Avoid valproate — linked to neural tube defects
  • Never stop meds without tapering

Always work with a psychiatrist who understands pregnancy. Regular OBs may not know enough about psychiatric drug safety.

Other Ways to Stay Stable

Medication is key. But it’s not the only thing that helps:

  • Stick to a sleep schedule — no matter what
  • Avoid major stress triggers (including toxic people)
  • Eat on time, hydrate, take prenatal vitamins
  • Therapy — CBT, DBT, or even just a support group
  • Daily check-ins — journal or mood tracker
  • Involve your partner or family in your plan

Read more about managing mental health during pregnancy

What About Labour and Postpartum?

Plan early. Talk to your care team about:

  • Labour support — who will help you stay calm and safe?
  • Postpartum plan — what happens if you crash emotionally?
  • Safe meds for breastfeeding (if you choose to)
  • Emergency contacts if you hit a manic or depressive episode

The first 6 weeks after birth are the riskiest for bipolar relapse. You need a solid plan in place before delivery.

FAQs

Can I have a healthy pregnancy with bipolar disorder?

Yes — but it takes planning, support, and usually medication.

Is it safe to take bipolar meds while pregnant?

Some are safe. Some aren’t. Never make changes without your psychiatrist.

What’s the risk of postpartum psychosis?

Higher if you’ve had mania before. Planning early reduces the risk.

Can bipolar disorder affect the baby?

Yes — if unmanaged. Stress, poor care, or substance misuse can hurt the baby’s development.

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