In plain words
Bipolar disorder is a condition with episodes of mania or . These are periods of unusually high, fast, or irritable mood, with much less need for sleep. The episodes alternate with periods of depression. It is different from and from alone. Its signs can be missed after birth. A reduced need for sleep and high energy can be mistaken for ordinary new-mother tiredness or excitement. Mania after birth is treated as a medical emergency. Mothers with bipolar disorder have a higher risk of an episode in the weeks after delivery. Sleep loss is one of the strongest known triggers. Clinicians screen by asking about past mood episodes and family history. Care often combines medication and psychotherapy. A psychiatrist or perinatal mental health clinician usually makes that choice.
The deeper version
Bipolar disorder is defined in DSM-5-TR (American Psychiatric Association, 2022) by manic or hypomanic episodes, with or without major depressive episodes. Mood episodes in the postpartum period are common among women with bipolar I and II disorder, and the period carries elevated risk of relapse and of , which is more often associated with bipolar disorder than with unipolar depression. Sleep reduction is proposed as a final common pathway to mania. Wehr's 1987 model holds that sustained sleep loss can precipitate episodes in vulnerable people, and prospective postpartum data are consistent with it. Screening for bipolar history precedes many perinatal medication decisions. Controversy centers on how much weight sleep protection should carry in prevention, and on the reliability of retrospective screening instruments.
Where it comes up
- Sleep deprivation: what it does and how to survive itPostpartum: Your Body
- Postpartum depressionPostpartum: Mind
- Therapy and medication after birth: what the options arePostpartum: Mind
- When to get help, and who to call tonightPostpartum: Mind
What mothers here say about bipolar disorder
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Sources
- American Psychiatric Association — Diagnostic and Statistical Manual of Mental Disorders, fifth edition, text revision (DSM-5-TR), 2022
- Wehr TA — Sleep reduction as a final common pathway in the genesis of mania. American Journal of Psychiatry, 1987