Drugs for Bipolar Disorder Thwart Motherhood Dreams

Poet Sherri Levine always wanted to have children, but she has bipolar disorder, which causes extreme mood swings, and her mother had it, too. Should she risk passing it on?

She takes lithium to manage her symptoms. Because of the risk of birth defects, it is not considered safe to take lithium during pregnancy, but she knows from hard experience that within two weeks of stopping her medication, she will become manic. The added stress of fluctuating hormones and her changing body will not help. 

Her doctor told her to let go of the motherhood dream. Her husband, who didn’t want children anyway, agreed, but Sherri was and still is devastated. “I don’t want to be an aunt; I want to be a mother,” she said, fighting tears. 

Why not adopt? Her husband didn’t want children, and she wasn’t sure she could deal with the stress of the adoption process.  

So the choice was made. People don’t understand, she says. If she agreed not to get pregnant, why is she still grieving?

Photo by Alex Green on Pexels.com

I think a lot of us here know the answer to that question. When we close the door on parenting, we lose a dream, the life we had expected to have, the children and grandchildren we might have had, a chance to live like our friends and relatives, and the right to claim a rose on Mother’s Day. It’s what Jody Day calls “disenfranchised grief.” You’re losing something you never had, so our friends and co-workers find it hard to understand.

People don’t talk enough about mental illness and childlessness, Sherri says. We need to get the conversation going. Those living with it need the support not only of a team of doctors well-versed on the conditions, medications, and risks, but supportive friends and families who offer love and acceptance.

In doing a little research, I find most of the attention focused on depression during and after pregnancy, not so much about going into a pregnancy with a diagnosed mental illness, such as bipolar, schizophrenia, or depression. It’s a big deal. Many psychotropic medications can cause birth defects in the developing fetus, but not taking them and leaving the illness untreated can be dangerous for both mother and baby. In some cases, it may be possible to find drugs that are safe, but not always. Sherri has looked at other possibilities, but none would manage her illness as well as lithium does. She couldn’t take the chance.

Over the years, childless people I talked to have mentioned concerns about mental illness as a reason they didn’t have children. It’s not always the woman with the problem. Men can pass on genetic-based illnesses to their children. They may also feel that their illness makes them incapable of being good dads. 

A few things are clear:

  1. It’s not just bipolar disorder. There are risks taking any kind of medication during pregnancy. Bipolar medications are particularly dangerous, but there are some drugs that seem to be a bit safer. Medications for depression and anxiety also may endanger the baby, and stopping them could endanger both mother and child. 
  2. If you take prescription drugs for emotional issues, you need to confer with your mental health professional, OB-gyn, and primary care doctor about the pros and cons of pregnancy. You will need support from your partner, along with a team of people who really understand this stuff. 
  3. Ask them: How dangerous is it for me to continue my meds? How dangerous is it to stop? Is there something else I can take that would be safer? Do you think I can handle the stress of pregnancy and childcare? 
  4. Ask more than one professional. The answers are rarely black and white.

Have you or someone you know struggled with mental illness that became a factor in their decision about having children?  Were you/they concerned about medication and birth defects, passing the illness to their offspring, or being able to cope with the added stress of being parents? Let’s talk about this. Sherri Levine, who wrote about this topic here a few years ago, has offered her email address for people who want to talk privately with her about this. You can reach her at sherrihope68@gmail.com.

Some resources: 

Bipolar and Pregnant by Kristin K. Finn, 2007. This looks very helpful, although Amazon has only used copies.

Bipolar and Pregnant by Katie McDowell, 2017. It’s more of a memoir of a woman who did get pregnant shortly after her bipolar diagnosis. Looks good.

International Bipolar Foundation

Mayo Clinic symptoms and causes of bipolar disorder

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Closing the Door:  Bipolar Disorder and Motherhood 

 Happy Wednesday! Today I offer you an essay by a poet friend who is also childless. This piece previously appeared in an online literary journal called Quiet Storm. As you will see, there are many different ways we can end up not having children. In her note to me, Sherri said that when she told her father she would not be able to have children, he responded, “Get yourself a dog. Dogs are more loyal.” Which they are, but that’s not the point. As always, please feel free to comment.

By Sherri Hope Levine

Sherri Levine I have been grieving over the loss of a dream for many years. The feelings of profound emptiness and sorrow have overwhelmed me. I have always wanted to have a child, and I knew that I would make a wonderful mother. I would break the cycle of critical voices that played a big part of my childhood. Ideally, I would be a loving, nurturing, and accepting parent.

Whenever I see a mother and a child holding hands in the park, or a mother strolling her baby with other mothers, or watch my sister read Harry Potter to her son, I cry out: “Why not me? It’s not fair!” I tell myself to try to move on with my life—to remind myself that I have a loving and supportive partner, family, and friends, that I have a rewarding job teaching English to immigrants and refugees, that I am a passionate and published writer. But is this enough?  Do these things take the place of being a mother? Is this the dream? Is this something I have been dreaming about my whole life?

My mental health has suffered tremendously from bipolar disorder, a chronic mental illness. During my teenage years, I endured severe depression and was hospitalized due to suicide attempts. In my twenties, a psychiatrist prescribed an antidepressant, and I immediately shot into a full blown manic and psychotic episode. I was living with my mother at the time. While in a heightened state, I impulsively packed all my belongings and took the train from New York to San Francisco. While living there, I was reckless and impulsive. I slept with many men, spent most of my money, and I lost a lot of weight. When my dad found out I was calling my grandma in the middle of the night to tell her I was an artist and model, he flew me home.

What I didn’t know is once you are committed to a mental hospital, you cannot leave. I didn’t believe this. I thought for sure after I got stabilized, I could leave. At first, the doctors figured out the right combination of medications, and I got better. But then I became depressed. Why was I still there if I was better? I had a tough time coping in there because I saw many sick patients, a lot worse than me. The only way “out” of there was to write. I found poetry. The staff allowed me to sit in an empty room with a computer. And that is what saved me. That was my escape. The staff recognized that I was well enough to take day passes out of the hospital. They came up with a plan for me to attend classes at a local liberal arts college. I worked closely with some very fine poets. My writing improved, and I became a student there. I even graduated without any of my classmates knowing that at the end of the school day, my ride had been a shuttle that took me to a locked mental facility on the outskirts of town.

After I graduated, my friends had moved away, and my sister had relocated to Seattle.  I wanted to live near her, so I moved to Portland, Oregon. Little by little, things started to improve again. I took my medication, entered a master’s degree program, and got my first job as an English teacher at Portland Community College, where I have taught for almost twenty years. I was finally stable, happy, and productive.

After months of rest and recuperation, I felt strong again.  I was ready to settle down, get married. I married a man twelve years younger than me. Another impulsive decision! Then I found out that he didn’t want children.  He didn’t even like children. I was so upset because I knew if I was stable, I could have children. I did everything I was supposed to do to prepare myself for motherhood.  I took my medication, continued my teaching job, ate well, and exercised vigorously. I remember talking to my doctor about medication and pregnancy.  It was a risk, he said, but I would be monitored carefully. Still, my husband wasn’t interested in having children or having sex. He finally did give in, and we tried to get pregnant for a year, but something was wrong. I didn’t understand why I wasn’t getting pregnant.  By then, my husband had become increasingly withdrawn from me. He stayed at work late, and when he came home, we hardly ever spoke. I was devastated. I wasn’t a mother and my marriage was falling apart. I felt empty.

My husband and I split up. I was alone, without a child. By then, I was in my 40s, and it was too late for me to conceive. I thought about adoption, but I was single, so I knew it would be difficult to raise a child on my own.

Many people can tell you to move on, but it does not help. Letting go is part of the grieving process. Losing someone is the most difficult part of life. I believe that raising a child with a mother who has a chronic mental illness would not be fair to the child or to my family.  It would put a heavy burden on all of us.

I have thought about what it would be like if I did choose to be a mother. I might have to stop taking my medication during the first trimester. This risk could cause me to become manic or depressed. Then, after I gave birth, sleep deprivation could also cause an episode. Who would take care of the baby? My husband who was absent most of the time? My 80-year-old mother? My sister who lives in another city? If I became ill, would I be in the hospital loaded with medication? Would the court take away my child?

Some dreams do not come true. I have had to close the door on the dream of being a mother. It doesn’t mean I don’t still grieve, but the intensity of grieving has waned. I have learned to accept the reality of my situation. I put my efforts into my art and my writing. My work has been published in various journals, and I have been hired to be a poetry editor of a literary magazine. I have a loving partner who has a young son. My friends and family are all around me. I realize that embracing loss is embracing life. As I close the door on my dream, other doors will continue to open.

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Sherri Hope Levine is a poet, artist, and teacher living in Portland, Oregon. She received the Lois Cranston Memorial Poetry Prize and Oregon Poetry Association’s Poet’s First Prize (Poet’s Choice). Her poetry and other writings have appeared in numerous literary magazines, including CALYXThe Timberline ReviewPoet LoreThe Jewish Literary Journal, and Mizmor Anthology. She founded and hosts Head for the Hills—a monthly poetry series and open mic. Her first book, In These Voices, was published in 2018 by The Poetry Box. She escaped the harsh weather of upstate New York and has been soaking in the Oregon rain ever since.

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Do you want to tell your story at the Childless by Marriage blog? I’m looking for personal stories, 500-750 words long, that fit our childless-by-marriage theme. You could write about infertility, second marriages, partners who don’t want children, stepchildren, feeling left out when everyone around you has kids, fear of being childless in old age, birth control, and other related issues. Tell us how you how you came to be childless “by marriage” and how it has affected your life. Or you could write about someone else. We love stories about successful childless women. We do not want to hear about your lovely relationship with your children or how happy you are to be childfree. Not all submissions will be accepted, and all are subject to editing. If interested, email me at sufalick@gmail.com.

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Notice anything different about the blog? Yes, the puppy picture is gone. As I polish the “Best of Childless by Marriage” book–and as WordPress makes changes in the formatting software–it seemed like time. I’m still working on making the header type more visible. What do you think of the new look so far?