#FeatureFriday: Dyane Leshin-Harwood on POSTPARTUM BIPOLAR

We’re kicking off our new Feature Friday slot with a great friend of ours and a topic that is her particular field of expertise.

BIPOLAR, PERIPARTUM ONSET (POSTPARTUM BIPOLAR): THE IGNORED PERINATAL  MOOD AND ANXIETY DISORDER by Dyane Leshin-Harwood

I live with a form of severe mental illness that few people know about. It’s called postpartum bipolar (PPBD), or bipolar, peripartum onset as listed in the Diagnostic and Statistical Manual of Mental Disorders, the DSM-5, which is used by psychiatrists everywhere to asses their patients.

This perinatal mood and anxiety disorder (PMAD) is often ignored, dismissed, or misunderstood by both the postpartum and bipolar support and advocacy communities. It’s the only form of bipolar disorder that’s triggered by childbirth, and medical professionals often miss the signs of PPBD when it first manifests in women for a variety of significant
reasons.

I was diagnosed with PPBD in October, 2007, six weeks after my second baby was born. Within twenty-four hours of giving birth I was manic, not depressed. I also had postpartum hypergraphia, a rare condition in which one writes compulsively. This type of nonstop writing was depicted eloquently in the bestselling book “The Midnight Disease: The Drive to Write, Writer’s Block and the Creative Brain” by Dr. Alice W. Flaherty, who eventually revealed she had bipolar disorder after her book was published.

When I was hypergraphic, I typed and wrote hundreds of pages while breastfeeding and talking on the phone when I should’ve been focusing on my baby and resting. I wrote so much that I could barely move my writing arm, and had muscle spasms in my upper back and neck.

Despite being manic, writing up a storm and being in physical pain during those postpartum weeks, my mood disorder was undetected by the numerous medical professionals I interacted with on behalf of my baby girl. My postpartum mania was mistaken for a mother’s joy of having a healthy newborn. It’s hard for me now to believe that my obviously bizarre hypergraphia was overlooked, but it was! My poor baby Marilla didn’t gain enough weight because I was writing so much and not breastfeeding her
enough.

While chances of a mother having postpartum bipolar disorder are relatively low (with one’s family history of mental health playing a key role) it’s important to know this peripartum mood disorder can affect any mother. A 2008 United States study  found that 29 out of 1000 women were affected by postpartum bipolar disorder. (Vesga-López O, Blanco C, Keynes K, Olfson, M, Grant BF, Hasin DS).

Here’s what postpartum bipolar/PPBD is not:

PPBD is NOT postpartum depression (PPD or PND) or antenatal (during
pregnancy) depression.

PPBD is NOT postpartum obsessive disorder.

PPBD is NOT postpartum anxiety, postpartum panic, or postpartum
post-traumatic stress disorder/PTSD.

PPBD is NOT postpartum psychosis (PPP).

It’s important to note that postpartum psychosis and postpartum bipolar disorder often manifest together; however, postpartum bipolar disorder is not always accompanied by postpartum psychosis.  To reiterate, the two mental illnesses PPP and PPBD are not always one and the same.

Unfortunately medical experts, websites, and articles often misinform the public about the correct definitions of PPP and PPBD.  Moreover, most of the time postpartum bipolar disorder is omitted from lists of perinatal mood and anxiety disorders (PMAD’s) on high-traffic postpartum mood disorder and bipolar disorder websites, articles, etc.

Once in a blue moon  I’ll locate a newspaper article that not only mentions postpartum bipolar disorder, but it gets the facts right. An 2013 article was published by CTVNews titled “Baby Pinks? Postpartum Euphoria Can Be As Dangerous as Baby Blues“.

This article contains an interview with Maya Hammer, a Toronto based psychotherapist specializing in postpartum mental health. In reference to postpartum mania, Hammer remarked, “In many women, the condition eventually clears up. But for others, it’s the beginning of a long battle with postpartum bipolar disorder.”

Yes, “long battle” is an excellent way to put it. I’ve suffered with postpartum bipolar disorder since 2007 and until there’s a cure, my battle shall continue. I hope in the future there will be more mainstream articles published with such accurate information.

In the DSM-5, long considered to be the “Holy Bible” of psychiatrists, there’s a postpartum onset “specifier” with bipolar disorder. There is nomention of psychosis in the section explaining the postpartum onset of bipolar disorder. Postpartum psychosis has its own section.

I’ve been asked why it’s important to publicize this particular mood disorder. The fact that many psychiatrists aren’t clear about the definition of postpartum bipolar disorder is a major reason why I’m sharing my story. I’m not the only one who has suffered with postpartum bipolar, but I’ve felt that way since I was diagnosed.

While there is currently a great deal of media attention given to postpartum depression, my postpartum mood disorder remains virtually unheard of, and I’m dedicated to bringing attention to this PMAD. There are eight perinatal mood and anxiety disorders: postpartum depression, antenatal depression, postpartum psychosis, postpartum anxiety, postpartum
OCD, postpartum PTSD, postpartum panic disorder, and of course, postpartum bipolar, and every PMAD counts!

It’s imperative that doctors and other caregivers assess women for not only postpartum depression but also hypomanic or manic symptoms following childbirth, and for pregnant women to get comprehensive mental health screening as well.

Everyone who suffers with any kind of chronic, stigmatized illness deserves a chance to find others who share her experience. By connecting with women who understand our mood disorder firsthand, we may not find a magic cure, but we can benefit greatly from support, empathy, and hope. By recognizing the existence of postpartum bipolar disorder, both postpartum and bipolar organizations would not only educate the public but help bring together women who have felt so alone while living with this mental illness.

Women like me.

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For more information please visit:

Postpartum Support International (PSI) Website:
http://www.postpartum.net/learn-more/bipolar-mood-disorders/

BIO:
Dyane Leshin-Harwood, B.A. is the founder of the Depression and Bipolar Support
Alliance (DBSA) of Santa Cruz County, California. She facilitates free support groups for mothers with mood disorders. Dyane is an active member of the International Society of Bipolar Disorders, The Marcé  Society for Perinatal Mental Health and Postpartum Support International. She is the author of “Birth of a New Brain – Healing from Postpartum Bipolar
Disorder” to be published by Post Hill Press, 2017 with a foreword by Dr. Walker Karraa.  Visit Dyane’s blog at www.proudlybipolar.wordpress.com and on Twitter: @birthofnewbrain