Q:  Will Pregnancy Increase My Risk of BP

My mother Has bipolar disorder type I.  I am 30 years old do not have this disease.  My husband and I would like to have children.  Will having a child increase my risk of developing this disease?  I ask this because my mother says she developed bipolar disorder due to my birth when she was age 19.

 

Dear Beth -- 
Will pregnancy increase your risk?  Frankly, I've never seen a mood expert say that outright.  Based on my experience talking with patients, I'd say that there's no question that pregnancy, and the hormonal changes that follow pregnancy in particular, can trigger major mood events.  In my patients' stories this hormonal event seems often to have been the beginning of more serious symptoms.   However, what your risk is depends on how many individuals in your family have been affected, and how closely related to you they are.  Here's a little essay, based on an expert's article, on this topic. 

I would caution you not to arrive at any major conclusions based on a simple question you ask, as though my answer represents a simple response -- this whole area of a woman's life is simply too complex to boil down to a simple question/answer thing.  I would want someone who knows this area An OB with good endocrinology experience, or better, a good psychiatrist with extensive experience with mood disorders in pregnancy and post-partum; there is a woman in Portland,OR for example, whose kids joke that she ought to be called a "gynechiatrist" -- somebody like that is who you want, to sit and talk with several times to evaluate what this question really means in your personal life story.  Lee Cohen at Harvard is a well-known expert; his office might even be able to recommend a similar specialist in your area.  

I guess all that means that yes, I think there's some risk in pregnancy for you, but I would say that about any woman who has a family history yet hasn't had symptoms yet; beyond that the question is how this should be integrated into your decision making.  There's a maxim from wise internist:  "it's as important to know who the patient is who has the disease, as what disease the patient has", which I'm trying to apply here, if you follow all that.  

Dr. Phelps

 
Published February, 2002