Bipolar Disorder Daily News Blog

Madness, medication and motherhood

Salon.com has a good article written by a woman who has bipolar disorder and is thinking of having children... "I want a child, but I am terrified of going off my meds -- and of birth defects. Do I dare trust this body to create another one?"

"But for me, the question of how to be pregnant occurs simultaneously with the will I or won't I, the why and the whether. At the age of eighteen (around the same time the last batch of recently hatched Magicadas had gone underground to nourish themselves with the juice of trees), I was diagnosed with bipolar disorder. Ever since, I've been taking medication to prevent a relapse into the whirling circus of psychosis and mania, where, among other things, my mother was disguised as Madonna sending me messages through her videos, and wearing shoes meant you walked on souls (soles). This medication also prevents another foray into the dead land of depression where the idea of my mother-cum-Madonna seemed like the good old days and putting on shoes took all of the energy I could muster, never mind worrying about trampling spirits. ... I often find myself staring at the drugs in my cupped palm in amazement and wonder: Lexapro, an anti-depressant, is a tiny white bitter-but-blissful tablet; the anti-depressant Wellbutrin is a curvaceously round, pink cheerleader of a pill; and the Stepford-wife sounding mood-stabilizer, Tegretol, is a humble medium-sized pill that looks deceptively like a run-of-the mill aspirin. My marriage to this medical cocktail has been a relatively stable and happy one and pregnancy would require a separation. The most alarming aspect of this separation is the break from Tegretol, that miracle aspirin that keeps my moods, well, stabilized.

According to various studies, if a woman takes Tegretol during the first trimester of pregnancy, there are risks: a 1% risk for neural tube defects, such as spina bifida (versus the .01% risk associated with women not taking Tegretol); an increased risk of heart malformations, cleft lip and stunted growth (particularly in head size); and, bizarrely, a heightened risk of abnormally large spaces between the nose and upper lip. The research is incomplete and hard to come by because there are ethical considerations, more risks, involved with doing research on pregnant women."

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