Mothering with Bipolar Disorder

Mothering with Bipolar Disorder
Telling my family I decided to stay off of medication was a difficult conversation.
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I have Bipolar Disorder. I rarely hear this subject being discussed when it comes to the cycle of conceiving and delivering. However, I'm grateful, grateful, grateful I made it through it. I know there are taboo's wrapped around mental illness—even with the most evolved people. I think there's an uncomfortable state people feel when talking about it. They don't want to offend or they just don't know much on the subject.

Denying the illness is the number one symptom of Bipolar Disorder. After my diagnosis at the age of 18 in 1992 I’ve come to accept this illness. This took years of belly flops, learning experiences, psychiatric hospital visits, flimsy jobs, and straining the most important relationships with friends and family. “The lost years” as my father calls them affectionately in his own, compassionate, way. I don’t entirely agree with his assessment. If the years were lost I hadn’t learned from them and I would have to start over from square one. I finally arrived to the conclusion that Bipolar can be one hairy beast. But, if I’m proactive I can lead a normal, healthy life.

In my husband’s North African culture their method of talking about it is not talking about it. But, we’ve been married for nine years and I like to talk a lot. I mean a lot! One of our conversations led to talking about having kids.

When my husband and I decided to conceive a child I had to make a hard decision. Do I go off of medication when conceiving to protect the future fetus? Or do I stay on medication to protect myself from a psychotic break or suicidal thoughts and actions? My psychiatrist tried to talk me into staying on medication. I had pressure from concerned family members to stay on medication, too.

Telling my family I decided to stay off of medication was a difficult conversation. I remember that concerned look on my mom as she looked sick to her stomach, “It’s not a good idea. You haven’t been off of medication in 15 years. This is a crazy idea.”

I was absolutely terrified of bringing a child into the world as an unhealthy baby. But, I had never felt more certain of a decision. This future child deserved to enter the world with all the health in the world I could offer her. 

It was extremely difficult to differentiate between the symptoms of Bipolar Disorder or the hormones growing the baby.  Everybody around me boasts how amazing I was during pregnancy, except for one husband.  He spends the most time with me, so I trust his opinion. He’s not willing to go through another pregnancy. This best explains how I really was during my pregnancy.

I remember missing the part of my mind that edited speech when I was pregnant. Maybe it was the hormones that circumvented logic. I remember one dark night around bedtime. We had neighbors that were having the conflict of the universe. They were suspected of being gang members. They were so loud that I opened up the door on our second level apartment balcony. I looked down at their apartment on the first floor, a little to the left, and yelled, “Shut the f*** up or I’m calling the cops!”

My husband couldn’t believe this, “Do you want to get us killed?”

My Ob-Gyn had amazing advice during my pregnancy. However, I should have listened to the doctor more about the risks of Postpartum depression once I became pregnant. My doctor explained to me that half to two-thirds of women with Bipolar Disorder suffer with depression right after delivery. I was stubborn and didn't believe it. Who made that study? How could they study the entire population? This was just one study.

I even had a prenatal yoga instructor tell me since my pregnancy was so easy (no vomiting), be prepared to “think you’re still pregnant long after the delivery”, in other words... be delusional.  She said she saw this with a lot with people who had such an easy pregnancy.

A huge case of denial engulfed me even after my delivery. I wanted to breastfeed so desperately for my child. For her health, for her well being, to be aligned with Mother Nature's true course. If I went back on medication right away I couldn't breastfeed. Period. I wanted to tough it out for my beautiful daughter. But, reality set in. After she hit her 6-week marker, I was at Cedars Sinai Emergency Room for anxiety. I remember the emergency room physician explaining that the hormones were exiting my body and it's time to get back on medication.

Minutes later a kind, compassionate nurse came into my room. We cried together. She explained when she stopped breastfeeding it felt like a death in the family. She comforted me until I got back to normal. The baby was sleeping the whole time. My husband didn't know what to do but to stroke my back. This did the trick and comforted me even more.

Some time passed, I just assumed, since I was on medication, I would be okay. I didn't feel like myself and figured it was all the hard work it took to care for a newborn. My psychiatrist had a good, long talk with my husband and explained I will need a full night’s sleep or I will become manic.  My husband completely stepped up to the job and pitched in above and beyond my expectations with taking care of our newborn in the wee hours of the night.

But, still, I knew I was "going to the dark side". This is what I call entering a depression. I took a trip back home to Virginia with my daughter. My dad, the one always in my corner throughout my life, offered to pay for me to get a second opinion from my psychiatrist back home. We had a great therapy session.  I explained to her I felt like I was still pregnant.  I, intellectually, understood I wasn’t pregnant, but I “thought” I was pregnant. I knew I wasn’t but I looked down at my huge belly and couldn’t help but “feel pregnant”. I explained I felt muted.  She looked at my prescription and look at me with shock, "Carla, this prescription is like water. It's totally wrong!" she whispered in a worried tone. I thought I would be just fine after this.

However, my therapist could tell I was depressed from my symptoms; fatigue, trouble reaching goals, feelings of unworthiness. The worst part was when thinking my family was better off if I was out the picture. I had suicidal thoughts.  My motto for suicidal thoughts is “Just give it a few years”. This wards off any physical choices and gives myself time to heal.  Plus, I knew I’ve been through this before and I would make it through the storm.

But, admittedly, this time it was the deepest depression I’d ever felt. I felt angry. I felt sad. I felt like I could never get back to my old self. I felt low. I felt hopeless. My gorgeous daughter, growing everyday, didn’t deserve a sick mother.  I was doing everything in my power to be healthy, but to no avail I was sick. Really sick. Really depressed.

It got so bad I looked unkempt and couldn’t stop overeating. The thought of losing the 60 pounds of baby weight was a fantasy. I felt it would never happen. What’s the point? I didn’t feel like socializing with friends. I felt so fat and didn’t even recognize my reflection in the mirror. This sounds shallow but it’s the depression talking.

Guilt engulfed me. How could I put my family through this?  Will I permanently damage my daughter?  Everybody kept telling me how crucial the first three years were. Would she soak up my negativity? Would she have depression as an adult? What should I do?

The worst part was when I had to check into a psychiatric hospital in Southern California;. My husband’s mother and father were visiting from North Africa. I felt so ashamed to put them through this. But, the suicidal thoughts were getting more and more intense. It was a blessing that my mother-in-law took care of my daughter while I was trying to heal in the hospital.

I knew being proactive was the only thing I had up on Bipolar Disorder.  When I checked in the hospital it kept me safe. One patient explained the psychiatric hospital as “not six feet under and not jail”.  But it felt awful.  I felt anger and rage because the nurses wouldn’t give me my medication due to legalities the first 24 hours.  But, I knew I was in the right place. I stayed for three or four days ‘til I calmed down and the suicidal thoughts exited me. I refused to let my daughter, even though she was only two, soak up my negativity.

The saddest part of the hospitalization was when I was leaving. I saw an eight-year-old boy with a hospital bracelet and a bag. It felt hauntingly sad. What if my daughter is destined to have the same fate? I would be responsible.

Fast forward two years.  By some miracle of the universe she is a well-adjusted, spunky, gorgeous four year-old girl. As the tallest girl in her class she is a sweetheart, eager to learn, and always asking to play with her friends.

Those two years weren’t the easiest. I was wobbling off and on as depressed and then healthy again. Relapsing ain’t a day at the park. It got bad. I accused my husband of cheating on me because I felt so low about myself. He took it like a champ. He had to explain over and over he would never do that and how much he loved me. I asked him how he put up with the depression for so many years. He told me he knew I would be back one day.

It turns out some friends from my daughter’s preschool were gossiping about the custodian of the preschool. They mentioned she looked like a pedophile and didn’t like the way she stared at the kids.  After one night of lost sleep over worrying about this possible pedophile I knew I needed more help.  None of the other mothers were losing sleep. Therapy was great in helping understand some of the anxiety about the custodian. But, I understood I had to ask for more help.  The gossip about the custodian was my breaking point. I thought it was real and it wasn’t. Somehow, I got so sick I was taking things out on my husband and daughter.

This is when I finally told my psychiatrist I’m willing to take another pill. Abilify did wonders for my brain. After a few days I, literally, felt like my old self. I shudder to think why I didn’t just do this three or four years prior.  I was stuck on the fact that I could just take the same medication I always took. But, the truth of the matter is that my pregnancy vastly changed my brain chemistry.  Or maybe I built up a resistance to the Tegretol and Wellbutrin I had been taking for nineteen years.  It’s probably a combination of both. 

Sure, it took a few weeks to tweak the Abilify to find the exact, right dosage. But, It turned out five milligrams did the trick.  I was new. I could write again. I could paint. I could sing. I could feel pleasure in eating. I could look at my husband in his eyes and trust him. I didn’t feel pregnant. I felt like me. I distinctly remember the pleasure of laughing, deeply laughing.

When I look back at my choices over the past 5 years I learned a lot. The problem wasn’t my brain chemistry. The problem was me. I was stubborn to change in my prescriptions. I was holding on to the old me before I become pregnant.  This happens with people without Bipolar. It’s interesting that it happened to me through my illness.

Finally, with focus on raising my daughter, my goals couldn't be more clear. Mothering with Bipolar can be a bit of a maze. I cannot compare myself to other moms. I just can’t. I’m not the same. Some mothers can raise four kids with ease. Having one gorgeous, amazing daughter has been a challenge for me. It’s hard to take care of another and myself. But, as she ages it becomes easier. My husband and I get an unspoken pang of jealousy when we see parents pregnant with their second and third children. My husband always wanted a large family. He comes from a family of 12 kids. Literally, it was a mourning process for him to decide on not having any more kids.

But, when I’m healthy I look at the positive. I just can’t help it. I’ve never been more grateful to just be me. The gratitude cannot be measured. I wake up everyday and feel thankful for being alive, vibrant, and healthy again.  What a great thing to pass on to my daughter. 



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