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Like so many other bipolar women, Angeline was told she could never fall pregnant. But she did – twice. Here she shares all she's learned.
You brought home the pharmacy-bought test and did what needed to be done on that little plastic stick. You wait, and, as if by magic, two blue lines appear. You know, without any hesitation or compunction, that nothing will ever be the same in your life again. Ever, ever again.
Once the realization of pregnancy and the long nine months that lie ahead finally sink in, most women are filled with elation, pride, anticipation, surprise and a bit of fear. And she cannot wait to allow everyone willing (or even unwilling) to celebrate in her good fortune.
For others however, the thought of bringing a little bundle into the world is one so fearsome that many opt out without even doing the necessary research. For women like me, it's thoughts plagued by the horror of what bipolar disorder can be like during pregnancy.
'My psychiatrist was there to guide me through'
I was diagnosed with Bipolar II sometime after my mother died about 20 years ago. With rigorous treatment and strict use of the cocktails of medications, I was in a good frame of mind – most of the time.
Even science is not perfect, and there were many times when I lapsed into deep pits of depression and had my mind filled with suicidal thoughts, but you always manage to creep back – slowly - for your friends and loved ones.
When I turned 33, my boyfriend and I discovered that I was pregnant despite my being on the pill for many years. I immediately called my gynaecologist who had no idea how to treat a patient with bipolar. My medical advice came from my psychiatrist, who suggested that I not stop taking any of my medication during the first trimester but to scale down on the mood stabilizers, which prevent hypomania.
During this pregnancy, I stayed on all my medications. What was very challenging was to differentiate between what I considered depression and a manic episode with one that was purely pregnancy-hormone driven. My psychiatrist was there to guide me through the whole nine-month period, and I’m proud to say that my beautiful son was born in 2007. There were no birth defects whatsoever.
'I was one of those lucky ones'
A massive relief given that articles I had read stated that as recently as a decade ago, doctors advised women with bipolar disorder not to have children. The medications were considered dangerous to the foetus as many of the drugs could cause birth defects.
There was also the chance that should a bipolar pregnant woman decide to stop taking her medication during pregnancy, she could relapse into a manic or depressive state postpartum with a rate believed to be as high as between 50 and 70 per cent.
I was one of those lucky ones – but there is a warning at the end of this tale that should be carefully heeded.
My husband and I fell pregnant in June 2011, and because of the strong concoction of drugs I was on, both my gynaecologist (who had finally come to the party with some knowledge about pregnant woman with bipolar) and my psychiatrist decided that for the first trimester, I should stop my medication altogether and see how I felt.
If I couldn’t cope they would suggest some other course of treatment.
I’ll admit that it was touch and go at first, with my husband bearing the brunt of most of my mood swings, but we attributed these to the levels of HGC in my system.
Also see: 'I wanted to throw him against the wall': Local mom shares scary experience of postpartum depression
'I had never experienced such joy'
The second trimester, began and I mentioned to my husband that I actually felt better emotionally and psychologically than I had in years and that I was not going back on my medication.
Needless to say he was wary, as he had seen the best and the worst side to my bipolar. He also became my sounding board when I felt a little down and told me that if he saw the signs of mania or depression surfacing at any time, I would have to promise to go back on my meds. I pinky-promised.
I still remember having a conversation with my aunt in her pool at the prime of my pregnancy that I had never experienced such joy – pure and unadulterated - without the use of chemicals.
I also started throwing the idea around that maybe the HGC hormones in a pregnant women’s body balances out the chemical imbalance in the brain that causes bipolar disorder. I have yet to find any written evidence to support my theory, except that I lived through it.
My second son was born in February 2012. There were also no birth defects from more than 20 years of chemicals in my system used to make my behaviour 'normal' and 'acceptable'.
'Baby blues hit me like a loaded runaway steam train'
There was one major hitch – and this is the one that I mentioned you pay great attention to – whether it was the pregnancy hormones that release endorphins and dopamine into your brain for the nine months while a little life is growing inside you – you will fall HARD if you don’t start your medications after the birth.
The blues are bad enough without you sitting in a hole waiting to die while your little baby needs you. This was my fault – as is the fault of many who suffer from this illness – once you feel better you stop taking the medication. It just doesn’t work like that. It’s a lifelong process that can be managed and lived with.
My baby blues hit me like a loaded runaway steam train – I was in tears all the time, I literally hated my baby and even at one really low point thought of harming him. This thought broke my heart and I realized that I was so far gone that I had to do something quickly.
Don't miss: Maternal Mental Health: A Parent24/7 podcast series
'I was too proud to ask for help'
I was not coping without my medication. And I was too proud to ask for help – from my husband, my mom, my friends and other family members.
I believed that as a mother I had to cope without chemicals, come what may. That’s bull! If you have bipolar, you need all the help you can get, especially during the postpartum time. My gorgeous husband picked up the phone one day and called my doctor who immediately got me treated.
It was like a breath of fresh air had filled my lungs.
Today, I religiously stick to my regimen of medication, but still experience some mood swings (don’t we all) and some episodes of mania and depression. I’ve just learned how to manage it better.
Also I have two cherubic boys who need their mommy, and I will never let them down again.
Find support
If you suspect you might need help, or you know someone who is struggling, immediately contact the following organisations for advice and support:
The South African Depression and Anxiety Group (SADAG): 011 234 4837
SADAG has a WhatsApp counselling line that operates from 9am to 4pm: 076 882 2775
Gauteng Mental Health Society: 011 984 4038
SA Federation For Mental Health: 011 781 1852
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