August 27, 2005

Postpartum Depression in Bipolar Disorder

Postpartum depression is a disorder that 1 in 10 mothers will have to deal with during or after pregnancy. Having a prior history of depression increases this risk, whether it be unipolar depression, or bipolar depression. Those with bipolar disorder appear to be at an even higher risk of developing postpartum depression than those with unipolar depression.

One study examined 2,340 women who went to Massachusetts General Hospital between the years of 1996 and 1999. Of these women, 1,814 of them filled out a mood disorder questionnaire while in their second trimester. Using these results women were able to be diagnosed with bipolar disorder and a score of 16 or more on the Epidemiologic Studies Depression Scale was used to diagnose unipolar depression. The average age of all the women in this study (both with depression and without) was 32.5 years old, for 61% of them it was their first child.

"In the second trimester, the prevalence of depression was about 52% among women with a history of bipolar disorder, about 34% among those with a history of unipolar depression, and about 8% among women with no history of a mood disorder.... At the sixth week post partum, the prevalence of depression was 50% among women with a history of bipolar disorder, about 32% among women with a history of unipolar depression, and about 6% among women with no history of mood disorders" (Zoler, 2005).

The effects of lithium on children via breast milk was also looked at. There were minimal traces of lithium in breast milk and 9 out of 10 children showed no negative affects from the lithium. The one baby that did have a negative reaction only had elevated levels of TSH and the levels went back to a normal range after 2 weeks of the child not being exposed to lithium. TSH is thyroid stimulating hormone, having too much or too little can have negative effects on your body. Babies of lithium-treated mothers should "be monitored by serum assays of TSH, blood urea nitrogen, and serum creatinine every 6-8 weeks during breastfeeding" (Zoler, 2005). In most cases, lithium does not have a detrimental effect on children via breast milk.

Original Source: Bipolar history boosts depression in pregnancy; women with a history of unipolar depression or bipolar disorder are at increased depression risk. Philadelphia Bureau Family Practice News. August 1, 2005. By Mitchel L. Zoler.

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