Well controlled bipolar disorder can run into double trouble when a woman with the disorder becomes pregnant.

Tough choices need to be made by the patient and treating physician concerning the continued bipolar treatment into and through pregnancy. Often the decision is made to discontinue treatment through pregnancy to avoid any impact that the anti psychotics may have on the fetus.

This opens a Pandora’s box of sorts. I trust this won’t be taken out of context, but there is some evidence that mood swings are not uncommon in women who are pregnant. When a bipolar patient discontinues treatment, even just for the term of the pregnancy, the symptoms of bipolar can return with a vengeance. Seems like kind of a dangerous combination.

Previous studies had indicated that pregnancy had a stabilizing effect on the disorder. This is no longer considered to be true.

Life insurance underwriting of bipolar disorder has made significant strides in the past few years with more and more favorable approvals. I suspect that there might be a tendency, given the possibility for problems during pregnancy, for insurance companies to postpone approvals for women with bipolar until after childbirth.

Bottom line. Risk assessment of this situation is a tough call for both doctor and patient and is something that needs to be considered carefully before and during pregnancy. The potential for bipolar relapse needs to be weighed against the impact of medication on the fetus. A tough call.