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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Childless Suffer ‘Disenfranchised Grief’

On a recent podcast, UK childlessness guru Jody Day and host Kathy Seppi talked about “disenfranchised grief.” We have talked a lot about grief here at Childless by Marriage, but something clicked in me when I heard that.

What is disenfranchised grief? Grief researcher Ken Doka defined it as “Grief that persons experience when they incur a loss that is not or cannot be openly acknowledged, socially sanctioned or publicly mourned.”

Let me put it another way. You have suffered a loss, such as the chance to have children, but other people just don’t get why you’re hurting or acknowledge your right to grieve.

Seppi, whose Chasing Creation podcast focuses on infertility, said disenfranchised grief is “the feeling you have to prove how much it hurts.”

Jody Day, who is also a psychologist, added, “We want people to see our pain.” Grief changes a person, she says. Our lives might look completely the same from the outside, but grief changes how we feel about it from the inside.

At a site called whatsyourgrief.com, Litsa Williams lists 64 situations where people tend not to acknowledge the right to grieve. They include death of an ex, moving to a new place, losing a friend, and death of a dream. Losing the family you had expected to have certainly fits on that list of things we grieve but other people don’t understand why.

Not long ago, I sang at a funeral for my friend’s husband. I found myself in tears. Not only was I sad for her and missing her husband, who was also my friend, but I felt my own losses–my father, my mother, my husband. But most strongly, as I watched my friend’s adult daughter holding onto her, taking care of her, I kept thinking who will be there for me? Once again, I grieved the loss of the children I never had.

The grief is there. I will always be different from all those people at the funeral who have children. It’s not something I could speak of, certainly not that day, and not something that anyone would have thought about when they saw me trying to wipe away tears around my COVID mask.

I don’t look bereaved. You can’t tell from the outside. I’ve got a pretty good life. But still, that thing is there. Aug. 21, on the first anniversary of my father’s death, I posted a picture of him with me and my brother as babies on Facebook. No one will ever post a picture like that of me, and that hurts.

Childless grief is tricky. If you had a baby who died, you could hold a funeral. You could maybe dress in black and avoid society for a while. But grieving for something that never existed, for the lack of something you wanted with all your heart? People will say buck up, you’ve got a good life, look at all the freedom you have and all the money you’ll save. Right?

If you burst into tears at the office . . . well, you feel like you can’t. You mustn’t. And yet we do want people to see that we’re hurting and to offer comfort. Just like when we were little kids and skinned our knees, we want someone to hug us and bandage our wounds, to acknowledge that we are hurt.

With childlessness, it’s like we didn’t get that doll we saw on the TV commercial; what right do we have to cry and carry on? We want to be held. We want someone to stop the bleeding. We want someone to say we didn’t realize how much it hurt. Here is your doll. Now wash your face and we’ll go get ice cream cones. Isn’t that what we want? Of course it is.

You know what? I think it’s okay to express our grief right out loud. I wanted to have a baby. My heart hurts because I never did. Will you hold me and help me feel better? Let’s say it out loud.

COVID be damned, I want to hug all of you.

Please share your thoughts.

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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.