#BipolarBrave: How I Became Comfortable Sharing my Bipolar Diagnosis

This post appeared on the International Bipolar Foundation website, here.

After my postpartum psychotic breakdown in 2008 and my time spent in a mental hospital for it, I was diagnosed with bipolar disorder.

That explained so much. When I returned home, I was elated. I was compelled to explain to everyone who had ever touched my existence that I suffered from bipolar disorder, and that was why I had acted so erratically my entire life.

#bipolarbrave - How I became comfortable sharing my bipolar diagnosis - CassandraStout.com

Clutching my newborn tight with one hand and opening my laptop with the other, I explained to my husband–with rapid, pressured speech due to a lingering manic episode, no less–my desire to email all my old college friends, strangers I had yet to meet, and everyone at church.

“Not all of them need to know, at least not right at this moment,” he said, trying to contain my compulsion. “I understand that you want to share, but explaining your diagnosis to all your old college friends, most of whom you’re not even in touch with, would be counterproductive.”

I bristled, but he continued. “You need to educate yourself about your diagnosis before you begin to share with others, so you know what it means. And, rather than focusing on sharing that you have bipolar disorder with everyone, you need to take care of yourself and our baby.”

That made sense to me. I reluctantly closed my laptop, and looked at my beautiful, fragile infant. He needed a mother who wouldn’t bend to every compulsion that struck her. I didn’t fully understand at that moment that I was compelled to share my diagnosis due to a manic episode. I wasn’t in my right mind; only halfway there.

My husband was right.

After I recovered from the manic episode, I no longer desired to shout, “I have bipolar disorder!” from the rooftops. When it came to my diagnosis, I became closed off. I would no longer spill my darkest secret–that I’d committed myself to a mental hospital and was separated from my 7-day-old baby because I was literally insane. I grew ashamed of my bipolar disorder.

Then I began writing my memoir, Committed, detailing my days spent in the psychiatric ward. I realized the story was compelling, unique, and could help people understand what it’s like to experience a bipolar mixed episode with psychotic features. And I realized that if I ever wanted to publish my work, my dream since I was a little girl, I had to be open with sharing my diagnosis.

A few months after I started writing, I formed a critique group, the Seattle Scribblers, who encouraged me to attend the Pacific Northwest Writers’ Conference in 2012. I pitched my not-yet-completed manuscript to agents and editors.

“After the birth of my son, I suffered a postpartum psychotic episode and committed myself to a mental hospital,” I told them in my elevator pitch. “My memoir, Committed, details the time I spent there while separated from my newborn.”

I explained to the agents and editors that I was grappling with a bipolar diagnosis, and that the mental illness had upended my entire life. I was met with a warm reception by some, but others were completely turned off by the “crazy” person sitting in their midst.

I wasn’t offended. Stigma is real, and I wasn’t going to change their minds about mental illness in the brief moments I had to make an impression.

Now, I have no problem telling people I’ve known even for a few weeks that I have bipolar disorder. When people ask me how I am, I tell them honestly: “I’ve been suffering from a depressive episode lately, but I’ll be okay. I have bipolar disorder, and that’s part of the cycle.”

The diagnosis is no longer shameful for me. It’s just a label that’s a reason behind why I sometimes act unpredictably#bipolarbrave - How I became comfortable sharing my bipolar diagnosis - CassandraStout.com. The explanation comes out naturally. Bipolar disorder is just a part of my life–a big part, to be sure, but it’s not everything.

My husband was right. Not everyone needed to know right then. I had to prioritize my own well-being and that of my infant.

But he was also wrong, in a sense. I had to grow into being genuinely comfortable sharing with my diagnosis eventually. I realized that by being open, I could help other people who might be struggling. So I started my blog, The Bipolar Parent, a comprehensive resource for parents with mental illnesses.

I faced my compulsion and my subsequent shame, conquered them, and never looked back.

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Maternal Bipolar Disorder Significantly Increases Risk for Premature Births

premature
A premature infant lying on a hospital bed just his size. Credit to flickr.com user César Rincon. Used with permission under a Creative Commons license.

Premature babies–infants born before the 37th week of pregnancy–endure a great number of challenges, such as high blood pressure, hypoglycemia, and breathing properly. No one wants their baby to be born early, unless there’s a risk to the mother.

But, unfortunately for mothers with severe bipolar disorder, they may not have a choice. A 2015 study published in the American Journal of Obstetrics and Gynecology showed that mothers with bipolar disorder are twice as likely to give birth prematurely than mothers with no mental illnesses. And a 2010 study published in the Journal of Affective Disorders demonstrated that in Taiwan, the incidence rate of premature births among pregnant women with bipolar disorder was 14.2%, compared to 6.9% of women without mental illnesses. The Taiwan study also included statistics about infants with low birth weights (9.8% vs. 5.7%), and smaller-than-gestational-age babies (22.3% vs. 15.7%).

Unfortunately, premature babies are also 2.7 times more likely than full-term babies to develop bipolar disorder later in life. For a full breakdown of these statistics, including the risk for psychosis and schizophrenia, click here.

But it’s not all bad news. The rates of premature births for bipolar mothers aren’t very high. A 14.2% chance to have a preterm baby means that you have an 85.8% chance to have a full-term baby. That’s pretty good!

So what can you do to prevent preterm births? The risk factors for a premature infant include:

  • Already having had a premature baby. This is a major risk factor.
  • A second pregnancy soon after having a baby.
  • Being pregnant with twins or more.
  • Having uterine or cervix problems.
  • Being overweight or underweight.
  • High blood pressure, stress, diabetes, and some infections.
  • Smoking and substance use.
  • Becoming ill with the flu.

Some of these things you can’t control, like having twins. But others, you can, such as avoiding pregnancy soon after having a baby, stopping substance use, or getting your flu shot. Maintaining a healthy weight during pregnancy also helps, so be sure to exercise and eat a healthy diet.

Final Thoughts

Premature birth can be scary and challenging. But, while the likelihood of giving birth prematurely is increased for bipolar mothers, the overall rate isn’t that high. Follow your obstetrician’s advice. There are some steps you can take in order to hopefully prevent a preterm infant.

Good luck!

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Preemies Have Higher Risk to Develop Bipolar Disorder

Premature infants face a variety of challenges, including gaining weight, hypothermia and hypoglycemia, and possibly respiratory distress syndrome. Yet there’s another challenge for these babies: the risk of developing mental illnesses.

A new study led by Chiara Nosarti, PhD, of the Department of Psychosis Studies in the Institute of Psychiatry at London’s King’s College, demonstrated that babies born preterm have an elevated risk to develop a range of psychiatric conditions later in life, including psychosis, depression, and bipolar disorder, with bipolar being the highest. Past research has shown that preemies may develop schizophrenia as adults, but little had been studied about bipolar disorder and depression.

Bipolar disorder is a mental illness characterized by “highs” (called mania) and “lows” (called depression). These extreme changes in mood are disruptive to the lives of the individuals who suffer from bipolar disorder.

preemie.jpg
A premature baby in a hospital bed, with an adult hand nearby. Credit to flickr.com user César Rincón. Used with permission under a Creative Commons license.

The scientists pooled data from the Swedish Medical Birth Register for all people born between 1973 and 1985 who were living in Sweden in December, 2000, which totaled 1,301,522 people. The researchers concentrated on the week in which these individuals were born, and looked at whether they had been hospitalized for mental conditions including psychosis, bipolar disorder, and drug and alcohol dependencies.

Preemies born between 32 and 36 weeks were 2.7 times more likely to develop bipolar disorder. They were 1.3 times more likely to develop depressive disorders, and 1.6 times more likely to have nonaffective psychosis.

Younger babies were showed an even stronger association to develop psychiatric conditions. Preemies born before 32 weeks were 7.4 more likely to develop bipolar disorder, 2.5 times more likely for psychosis, and 2.9 times more likely for depression. The infants born before 23 weeks were also more than three times more likely to develop an eating disorder.

However, the scientists did not look at other factors that could contribute to the development of mental illnesses, such as socioeconomic factors, ethnicity, or substance abuse. Another limitation to the study is that the researchers only considered hospitalizations, so milder cases of psychiatric conditions were missed.

The scientists hope that their work will shine a light on preterm infants’ struggles, and that mental illnesses such as bipolar disorder can be more easily diagnosed.

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