Worse after pregnancy
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Worse after pregnancy; and the baby? (Christine)

IT IS MY BOYFRIENDS GIRLFRIEND HAS BEEN DIAGNOSED WITH BI POLAR AND IT SEEMS LIKE SHE IS MORE OUT OF CONTROL SINCE SHE HAD HER DAUGHTER 6 MONTHS AGO. BUT MY MAIN CONCERN IS THE BABY. COULD SHE HAVE GOTTEN THE DISORDER FROM HER MOTHER, CAN SHE BE TESTED FOR IT AND AT WHAT AGE?

Dear Christine --
Mmmm, you're in a tough position if your boyfriend's girlfriend is not you.  But it's nice of you to worry about the baby -- I fear that's because you can see how badly the mom (his g.f.) is doing?

I printed your question because it is a good example of something we now recognize: bipolar conditions run a very high risk of worsening after pregnancy, about a 50% chance of so-called "postpartum" depression, much worse than "baby blues".  And there is a definite chance of "postpartum psychosis", where the mom actually looses contact with reality.  She can have thoughts like "I'm such a terrible mother, I shouldn't have this baby; and the baby is too damaged, she'll suffer too much, she should die with me".  People with such thoughts can try to kill themselves and their child.  So if you see some evidence this might be happening, it would be ok to tell somebody about your concern.  Because of the relationship problem, though, that could be really tricky.  Talk over your plans with some other friends or relations before you act -- but if you're really worried, don't delay too long.

To answer your question -- unfortunately, we do not have a genetic test for bipolar disorder.  There's no way to know about that child at this point.  We may someday have such a test, and using it wisely will be very tricky in some cases, maybe like this one.

Dr. Phelps


Published October, 2000

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