Bipolar Disorders Case Study

may be linked to medications used during pregnancy. It is speculated that there are a multitude of health risks to the fetus if an expecting mother is prescribed antidepressants for Major Depressive Disorders. It is also hypothesized that there may be long-term effects to the child after birth if the mother of the child was taking antidepressants during her pregnancy. Postnatal psychological effects may be due to the onset of the drugs during pregnancy, and there may be a link between a child’s physical and psychological state once born, due to the drugs, but is not correlated to women that have used antidepressants before pregnancy. Results identify that there are many negative effects of antidepressants use during pregnancy.

Bipolar disorder is a manic-depressive lifelong illness in the brain that causes shifts in mood, energy, activity, and the ability to carry out normal tasks, but efficient treatment helps people to manage these complications and normalize their daily lives. This illness is a very serious mental disease affecting about 2.6 percent of adults in the United States that has the power to cause risky behavior and even suicidal tendencies if not treated (www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml). It is more common in older teens and young adults, but it affects children as young as six years old. It affects men and women, all races, ethnic groups, and socioeconomic classes equally but women experience more periods of depression than

Despite the physical changes that a woman is to expect during her pregnancy, a major concern that requires attention is a period of expected feelings of depression that a woman may encounter known as baby blues. Although normal, and expected baby blues can lead into post partum depression that involves a myriad of emotions and mood swings. If not addressed postpartum depression can lead to a more severe form of baby blues known in the clinical world as postpartum non-psychotic depression that requires professional intervention. The therapeutic goal during this time is to prevent the new mother from committing suicide where she poses a danger to both herself and her newborn.

People from the age of early 20s and 50 are mainly affected by this disorder. Children are not affected by it. If you have a family member that has a bipolar disorder you are at risk of having the disorder.

“Postpartum depression affects 10% to 20% of women after delivery, regardless of maternal age, race, parity, socioeconomic status, or level of education”.( Consise) Postpartum depression is a major depression episode that occurs after childbirth affecting not only the mother but also the child and family members. After the delivery of the placenta extending for about six weeks this is considered as as the postpartum period. This a critical period for the mother and new born physiological and psychological because the woman’s body is returning to a non-pregnant state in which hormones, sleep parttters, emotions and relationship are changing. Therefore, up to 80% of mothers experience the "baby blues during the first week in which

Midwives, obstetricians and gynecologists are often the central medical caregivers for women and as such they are likely to be the first or only medical providers to identify, refer and coordinate a plan of care for women who have mood disorders. Early detection, intervention, treatment in conjunction with individualized care is imperative and greatly reduces the risk of adverse effects for the mother, infant and family. However fifty percent of women with these disorders are never diagnosed because many symptoms of mood disorders overlap with the symptoms of pregnancy and often are overlooked (Center on the Developing Child at Harvard University, 2009). If left untreated these women can continue to have symptoms, sometimes for many

As stated in the article "Bipolar Disorder: Myths and Facts", for a treatment plan, "an individual cannot just snap out of [bipolar disorder]". As with other conditions, treatment for bipolar disorder may need to be changed or modified if a woman is pregnant or planning to become pregnant because of the complications that medications can cause for the fetus ("Bipolar Disorder Health Center"). A "combination of medication, therapy, lifestyle changes, and social support" is recommended for the treatment of bipolar disorder (Smith and Segal). For the medication part of a treatment plan, a few medications that can be used are Lithium, anti-convulsants, anti-psychotics, Symbyax, or Benzodiazepine. Lithium and anti-convulsants are mood stabilizers and they try to prevent the highs and lows of episodes from occurring in an individual. Anti-psychotics can assist people who aren't helped by anti-convulsants or anti-depressants. A downside to this type of medication is the individual may go into a manic episode, but this effect may be halted if taken with a mood stabilizer. Symbyax is a medication that combines an anti-depressant and anti-psychotic together to work as a treatment for depression and mood stabilization ("Bipolar Disorder" Mayoclinic). Several therapies have been used for

In terms of public health and associated concern, in the recent years it has been observed that mental illness has major impact on pregnant women and postpartum period which has become a concern of public health lately. The aspect that associated with pregnancy of women and their mental health that has brought this topic in the forefront is the fact that mental health problems like depression and anxiety have the probability to impact women twice as compared to men. The severity of the situation seen from a global perspective, shows that depression is one of the major reasons of maternal mental illness during the childbearing age of women, which is approximately between the age group of 18 to 40 years. As a result of this to the Global Burden of Disease (GBD) it contributes approximately 7% of the entire GBD for women of all age group (Leham, 2015).

Estimates of the prevalence of postpartum depression range from 13% to 19% (O 'Hara & McCabe, 2013). However, major depressive episodes may go undiagnosed in 65% of pregnant women ( (Ko, Farr, Dietz, & Robbins, 2012). It is important for pregnant women and new mothers to undergo depression screening to be diagnosed and treated early if they are experiencing any symptoms of depression. Depression during pregnancy is associated with a higher risk of inadequate nutrition, poor weight gain, inadequate prenatal care, preterm birth, surgical birth and low birth weight babies (Wirz-Justice, et al., 2011). The newborns have a higher rate of neonatal intensive care admissions and increased risk of cognitive, emotional, and behavioral disorders (Wirz-Justice, et al., 2011).

Most studies found that mental illness was more prevalent among women. This could be associated with the hormonal changes in women during the fertility, pregnancy, and menopausal period. In addition, there was generally higher level of stress in women due to their multitasking responsibilities. Most women, especially for those staying in the urban area have to deal with their job and household duties. In the long run, this creates an unbearable amount of mental burden for the women. The occurrence of mood changes after delivery which is generally known as postpartum blues is common. If the condition becomes severe and lasts longer than expected, it is considered as postpartum depression which has harmful effects on the mother. The physiological

In a recent meta-analysis of 28 articles regarding depression during pregnancy, Gavin et al. found that up to 13% of women experience depressive episodes at some point during pregnancy or within the first year postpartum. The prenatal period is a very important time for the growth of the offspring, therefore a range of exposures can have long-term changes. Not only will it have immediate effects on the fetus, the impact of a woman’s mental state has been found to have lasting effects up to childhood and adolescence (Kinsella, 2013). The mental state of the mother causes a chain of hormones to be released if stressed. Once a mother is stressed, the fetus activities decrease and are less responsive to stimulants. Due to stress hormones, the fetuses have low birth weight and are at a higher risk of preterm delivery. Prenatal depression has been noted to be able to predict the likelihood of postpartum depression from hormones such as low dopamine. Depression during pregnancy negatively affects the development of offspring.

Psychiatric disorders such as bipolar disorder, schizophrenia, anxiety, depression and many others most commonly occur during the reproductive years of women, especially during pregnancy. Recent studies estimate that the range for the prevalence of psychiatric disorders occurring during pregnancy is 14 % to 30.5%.1-3 Untreated psychiatric illnesses are found to be associated with many adverse effects both on maternal health and pregnancy outcome. There is >50% risk for relapse of psychotic disorder during pregnancy and post partum. 4 In addition to that, unfavourable pregnancy outcomes such as low neonatal birth weight, neonatal hypoglycemia, increasing risk for congenital defects, and adverse neurodevelopmental effects can also occur.5 These adverse consequences associated with unmanaged mental disorders lead many patients to remain on pharmacological management using antipsychotics throughout pregnancy.