Mood swings in the postpartum period are very common, and it's completely normal if you experience feelings of joy, sorrow, exhaustion and worry in the days and weeks after giving birth. But if the postpartum emotional highs soar way beyond normal — and the lows hit rock bottom — you may be experiencing bipolar disorder.
Fortunately, with quick diagnosis, there are treatment options available for bipolar disorder during the postpartum period. Read on for more about this condition, including symptoms to look out for.
What is postpartum bipolar disorder?
Bipolar disorder is a mental health condition that can occur at any age and involves two phases, mania, or hypomania (highs), and depression (lows).
There are different types of bipolar disorder, including bipolar I disorder (which means a person has had one or more manic episodes followed by hypomanic or major depressive episodes) and bipolar II disorder (having at at least one major depressive and hypomanic episode without a manic episode).[1]
About 20% of new moms develop postpartum depression, though a smaller portion of this group will have bipolar disorder, a condition that’s commonly misdiagnosed. In fact, a study of 10,000 women who were screened for mental health issues after birth found that of the 14% who screened positive for postpartum depression, almost 23% had bipolar disorder.[2]
Some new moms are diagnosed with bipolar disorder for the first time during the postpartum period, while others who were previously diagnosed may be more likely to relapse, research has found.[3]
In some cases, the first sign of postpartum bipolar disorder may be postpartum psychosis, a rare but serious mental illness that often involves rapid mood swings and hallucinations or delusional beliefs.
Read This Next
What causes postpartum bipolar disorder?
Postpartum mental health conditions may be triggered by dramatic hormonal shifts after birth — and certain women seem to be more susceptible. As for bipolar disorder, individual brain chemistry, as well as physical brain changes and genetic makeup, may play a role.
If you have a history of postpartum depression, postpartum anxiety, postpartum obsessive-compulsive disorder (OCD), or postpartum psychosis, or a personal or family history of bipolar illness or thought disorder, you may be more at risk for developing symptoms of bipolar disorder in the postpartum period.[4]
What are the symptoms of postpartum bipolar disorder?
The symptoms of bipolar disorder appear to be the same whether the episodes occur before, during or after pregnancy. Specific signs of depression and mania include:
- Extreme sadness
- An unusually upbeat, wired attitude
- Irritability, distractibility
- Abnormal talkativeness and/or rapid speech
- Restlessness, tearfulness
- Loss of interest in nearly all activities
- Rash decision-making
- Insomnia or sleeping too much
- Thoughts of suicide
- Symptoms of both mania and depression are often persistent, lasting multiple days in a row rather than just a few hours a day
How can pregnancy and childbirth affect an existing bipolar mood disorder?
If you’ve previously been diagnosed with a bipolar mood disorder, your chances of having a recurrence after giving birth are higher. According to some research, around 36% of women with bipolar disorder will have similar manic and depressive symptoms after the baby is birth.
How does postpartum bipolar disorder differ from bipolar disorder at other times?
While manic and depressive behaviors are the hallmarks of bipolar disorder, for postpartum women, the episodes they experience may be mostly depressive in nature.
Another difference is the difficulty in recognizing and reporting symptoms. If you’re experiencing mania and depression for the first time after giving birth, it can be easy to attribute crying, sleep disruptions and distraction to being a first-time mother, rather than symptoms of a possible bipolar disorder — and the result can delay diagnosis and treatment.[5]
How is postpartum bipolar disorder diagnosed?
While there are no specific tools to diagnose bipolar disorder, a mania screening tool can help clarify your symptoms. Your doctor will likely suggest physical and psychiatric exams, which can include an appointment with a psychiatrist to complete mood charting, a sleep assessment, and answering questions to determine your thoughts and behavior patterns.
Your doctor will likely make an official diagnosis of bipolar disorder if your manic symptoms last longer than four days and are responsible for disrupting your relationships and everyday tasks.
Because bipolar disorder after the birth of a child can appear to mimic severe depression or anxiety, it’s important that your medical history and current condition are carefully evaluated so symptoms aren’t overlooked.
The evaluation will likely include questions such as whether or not you’ve had times of a constant elevated mood, decreased need for sleep, and periods of productivity that go beyond your usual activity.
How is postpartum bipolar disorder treated?
Treatment for bipolar disorder during the postpartum period requires a team effort, including a psychiatrist, therapist and other professional support.
Regular counseling appointments or a therapy program are typically scheduled, and mood-balancing medications may be prescribed. In severe cases, a stay in the hospital may be necessary in order to stabilize mood swings and cognitive behavior therapy (changing patterns of thinking).
While some medications used to treat bipolar disorder are problematic with pregnancy and breastfeeding, and a few can negatively interact with birth control, there are medications that can be used safely by pregnant and nursing moms.
Talking with a doctor who specializes in women’s mental health can help you balance the risks and benefits of taking medications for bipolar disorder. Ignoring symptoms can have a negative impact on you, your pregnancy and your child. Recognizing and treating the disorder quickly and effectively is the best way to protect yourself and your family.
If you or someone you love appears to have developed symptoms of bipolar disorder after giving birth, seek help right away. With swift diagnosis and proper treatment, mood swings can be managed and your health care team can help you make a plan for therapy and other supports.
The following resources offer more information and support if you or someone you know may be suffering from bipolar disorder during the postpartum period:
- Office on Women's Health (800-994-9662)
- Postpartum Support International (800-944-4PPD)
- National Alliance on Mental Illness (800-950-NAMI)
Yes 
No 
Trending On What to Expect
