Here’s a post I was in the middle of typing when pregnant, around March I think, and then never got around to finishing. So I have finished it now. It might be useful for those ladies considering an increased dose of their medication during pregnancy 🙂 I do talk about thoughts of death, paranoia and suicide in the context of adjusting medication so please don’t read on if that could trigger you in any way.
I’m sorry it has been some time since I last posted. I have been surprisingly busy and I find these days my brain can only process one thing at a time.
It has been a nice time. I have done job interviews, unexpected as I am so big now people need a periscope to look around me. I’ve seen friends. I’ve hung out at home with the dog. I’ve helped DH with his studies and even picked up my own books once or twice. The online book thing is going well. I’ve had a TON of appointments at hospital.
And I have not slept. I’ve had my medication upped twice in the last three weeks.
Insomnia is a killer for anyone at the best of times. When you’re lugging round an extra 20 kilo and your lithium levels are falling then it becomes a playground for dark creeping thoughts in the middle of the night.
I was very resistant to my medication being increased the first time round. I’ve got a little one to think of inside me. I am the kind of girl who deals very well with a lithium count of 0.4-0.5ish. I don’t deal well at the higher end of the range. I was therefore pretty upset at the thought of more drugs.
As it turns out it is, of course, fine. Basically the volume of fluid in your body increases, which in turn then decreases the potency (for want of a better word) of the lithium in your blood stream. I was reading at 0.2 which is basically nothing. But, because I was irrational and tired and lacking in hormones, I didn’t make the connection to a dip in lithium altering my perceptions. It wasn’t until I was sat with my psychiatrist that I realised all those thoughts of having a suicide pact with DH so he wouldn’t die before me were not in the normal way of thinking.
Because those thoughts weren’t along the lines of ‘oh, I’m going to kill myself now’, I didn’t think anything of it. I thought it was normal to plan my death, and because I was thinking waaaaay ahead into the future, such as in my sixties and seventies when it might have happened naturally at some point anyway, I didn’t see a problem with it. I created elaborate schemes in my head about euthanasia (legal in The Netherlands), car crashes, train accidents, travelling somewhere where there was a high incidence of plane crashes, so I wouldn’t have to live if DH died before me when I was old.
I also had increased anxiety, and DH retrieved me from the supermarket a couple of times as I couldn’t cope with the amount of people around me. I started, for the first time, to understand what paranoia in bipolar really meant. I was convinced that people walking past me on the street were about to come and do me harm, and that I couldn’t trust the doctors and nurses in the hospital to do what was right for me.
All of it, my psychiatrist assured me, was completely not normal thinking. And all that was because of a dip in my lithium levels.
What was impressive to me was the rapid turnaround in my thought process once they increased my lithium. Eventually I went up to 1000mg per day spread out over five lots of 200mg. It was amazing how much better I started to feel again. What I found as well towards the end of my pregnancy was how high they wanted to keep my lithium count – as high as possible – to avoid any potential psychotic episodes immediately after the birth. I really am a girl who doesn’t do so well on a higher count, so it goes to show how massive the changes in my body were that being around the 0.8 mark was absolutely fine for me in my last month or so.
Throughout all of this, my baby, of course, was completely 100% unaffected by it. They are tough little creatures, babies, designed to survive some pretty extreme conditions. As an expectant mother none of that matters whatsoever so there is no point in trying to reassure yourself in that way!
I have also resolved to not be one of those mothers that dishes out completely useless advice. Unless you’re the one living it, it’s almost impossible to understand what someone is going through, so therefore the only thing to do is emphathise (as a bipolar mum to be you are not alone) and offer a shoulder of support. The only advice I will give is keep an eye on those lithium levels. If you start to suddenly see the sky turning purple with pigs serving champagne, find yourself plumbing the darkest parts of your brain, doom scenarios marching through on a frequent basis at 3am, or even convinced that the old lady in the apartment opposite you has a incredibly sophisticated camera setup just to record your every move with the ultimate aim of taking your baby away (yes, that was me to the last two), then please get to your GP or psychiatrist asap and talk it out. Cortisol is not good for our growing little ones and particularly not for you.
So, to sum up:
– monitor your lithium every week or two weeks, following your doctor’s advice to the letter
– try and sleep as much as possible. Rest during the day. Take it easy. Get someone else to do the hoovering/housework/walk the dog
And that’s it 🙂 Having a successful pregnancy on medication can be done and I am very glad I continued with my lithium.