I have always felt different – I was an odd child next to my friends and I remember having moments of sadness from around age six and thinking I was a bad person. I was emotionally also abused throughout my childhood and sexually abused twice as a child.
So the ingredients were there for a predisposition to serious mental illness and, in particular, bipolar disorder, but I have only ever experienced symptoms of depression and borderline personality disorder, both of which I have also now been diagnosed with. Then when I was pregnant with my second child, psychosis also crept in.
When I had psychosis I lost my insight, so I didn’t realise that what I was thinking was weird and irrational, and therefore did not tell any of my family or caregivers. I used to hover over toilet seats whenever I was out of the house as I was convinced someone was going around infecting the seats with HIV. I thought people were spiking my drinks at work so I was forever tipping away full cups of tea. I constantly washed my hands for fear of contamination. I was living in a silent nightmare.
Once my beautiful boy was born I started to feel even more strange. I was detached not only from my baby but also myself. My mum noticed straight away and said: ‘There’s something wrong with you my girl’. I denied it. I had no idea I was ill. My insight was long gone. My psychosis and delusions worsened. By the time my baby was three months old I was convinced that all the humans had left the planet and aliens had taken their place. That, or I was the intruder on another planet. It was a deeply uncomfortable existence.
Not long after this episode I started to experience auditory hallucinations, something I now know is common with bipolar. I found a glimmer of insight and called my Mum. I told her to get round to me immediately because voices were telling me to kill myself. I was diagnosed with postnatal psychosis and the bipolar diagnosis was missed completely. I was medicated incorrectly and it took me a full year to recover. I had several manic episodes in the following years but I didn’t know that’s what they were. I just thought I’d gone off the rails and was behaving very badly.
It wasn’t until a year after the birth of my third son that I was finally diagnosed with borderline personality disorder (BPD) and then six months later bipolar disorder. Six full years after the initial onset. Even though all the warning signs were there. I was dismissed as a neurotic mother and even laughed at in the GP Surgery. No one took me seriously.
Through my own ongoing research, I have become well aware that many of my experiences happen to a lot of other women. In fact, some of the facts and figures I have discovered are remarkable.
A 2013 study revealed that experience of childhood maltreatment is common among individuals with bipolar disorder; rates in the region of 40–50% are typically reported. What makes it even worse is that on average it takes 10.5 years to receive a correct diagnosis for bipolar in the UK, and before bipolar is diagnosed there is a misdiagnosis of an average of 3.5 times.
The figures for postpartum mental illnesses are also troubling: An estimated 1 in 5 women develop postpartum depression (PPD) and up to half of them may be misdiagnosed if they have unrecognised manic or hypomanic symptoms, according to current evidence. A research review on bipolar postpartum depression suggests anywhere from 21% and 54% of women diagnosed with PPD meet formal diagnostic criteria for bipolar disorder.
It is recommended screening should occur in the first three months postpartum as it may help to differentiate bipolar depression from unipolar depression. That certainly would have helped me.
Undiagnosed and diagnosed, suicidal ideation has been perhaps the most serious aspect of my mental illnesses, and I have come close to taking my life several times. Again, I am not alone: There are findings that show that at least a quarter, and maybe even half of the patients with bipolar, make at least one suicide attempt. Deaths from suicide are much higher in people with bipolar disorder. A study following 2.5 million people in Denmark for four decades showed 8% of the male bipolar patients and 5% of the female patients died by suicide, compared with 0.7% and 0.3% in the general population.
Thankfully, I am now properly medicated on a mood stabiliser and antipsychotic as well as a low dose of antidepressant.
Every woman that has a history of depression should be monitored much more carefully throughout their pregnancy for signs of bipolar disorder. If I had been cared for properly I am certain I wouldn’t have become so seriously ill and I would have recovered more quickly with far less impact on my family and relationships, and my career.
Although I do understand that my symptoms greatly mirrored postpartum psychosis I still think anyone being assessed for that illness needs to also be assessed for bipolar as the two are so similar and it’s currently too easy to get the diagnosis wrong. The healthcare professionals must move with the times and protect the women in their care from this deadly disorder.
Image credit: Freepik
Karly Green is a stay-at-home mother to three children with an avid interest in all things mental health, particularly bipolar and borderline personality disorder as she has recently been diagnosed with both those disorders.
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