Perinatal mental illnesses

Bipolar disorder

<aside> <img src="/icons/info-alternate_green.svg" alt="/icons/info-alternate_green.svg" width="40px" /> Bipolar disorder during the perinatal period, which includes pregnancy and the postpartum period, poses significant challenges due to the high risk of mood episode recurrence and the complexities of treatment. Women with bipolar disorder are particularly vulnerable to new-onset or relapsed mood disorders during this time.

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• Prevalence and Risk
• Screening and Diagnosis
• Relapse and Recurrence
• Treatment Considerations

Psychosis

<aside> <img src="/icons/info-alternate_green.svg" alt="/icons/info-alternate_green.svg" width="40px" /> Postnatal psychosis is a severe but treatable psychiatric condition that affects new mothers, typically within the first month after childbirth. It is characterised by symptoms such as cognitive impairment and disorganised behaviour. The condition is rare but life-threatening, affecting approximately 1 to 2 per 1000 new mothers. It is strongly associated with pre-existing bipolar disorder and a family history of bipolar disorder.

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Signs and Symptoms

• Early Symptoms

• Psychotic Symptoms

• Behavioural Changes

• Mood Disturbances

• Cognitive Impairment

• Risk of Harm

<aside> <img src="/icons/shield_green.svg" alt="/icons/shield_green.svg" width="40px" /> Preventive Interventions Preventive measures focus on identifying women at risk, early recognition through screening, and preventive drug therapy. Mood stabilisers, antipsychotic drugs, and hormone therapy may be beneficial in preventing psychotic episodes in high-risk women (Essali et al., 2013).

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<aside> <img src="/icons/pill_green.svg" alt="/icons/pill_green.svg" width="40px" /> Management and Treatment Treatment options include inpatient care, antipsychotic medications, and electroconvulsive therapy (ECT). Lithium has been found to be highly effective for both acute and maintenance treatment of postpartum psychosis (Bergink et al., 2016).

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Patient Experience

• Traumatic Experiences

• Social and Emotional Isolation

• Importance of Support Systems

• Altered State of Mind

• Challenges in Mother-Infant Bonding

• Healthcare Experiences

<aside> <img src="/icons/info-alternate_green.svg" alt="/icons/info-alternate_green.svg" width="40px" /> Bipolar Disorder and Postnatal Psychosis

• Women with a history of bipolar disorder are at a significantly higher risk of developing postnatal psychosis. The onset of postnatal psychosis is often seen as an overt presentation of bipolar disorder, triggered by the physiological changes following childbirth (Sit et al., 2006).
• Sleep disruption, common in the postpartum period, can trigger manic episodes in women with bipolar disorder. Those with a history of mania triggered by sleep loss are at a higher risk of experiencing postpartum psychosis (Lewis et al., 2018).
• A family history of bipolar disorder significantly increases the risk of postpartum psychosis (Jones et al., 2007).
• The risk of postnatal psychosis is notably higher in women with first-degree relatives (such as parents or siblings) who have bipolar disorder (Di Florio et al., 2013). </aside>

For more information on postpartum psychosis, visit Action on Postpartum Psychosis

Depression