Birth of a New Brain, Interview

I met Dyane Harwood on my website and had the opportunity to read her book and connect with her as a bipolar mom. Her book is an easy, straightforward must read if you have a mood disorder  and have questions about what pregnancy can look like with mental illness. I would also recommend it if you are the partner or caregiver of someone who has mental illness. While I was already diagnosed when I had my children, it brought back a ton of memories of my postpartum experience and gave me the chance to remember it with new knowledge and kinder eyes. I have a link at the bottom of the interview in case you want to put her book in the reference section of your person library. 

This is my first interview, so bear with the format which is limited by my website host. If you read nothing but the interview you will still walk away with a better understanding of mood disorders and pregnancy could look like. 

Why was it important to write your book?
In 2007, after I was diagnosed with postpartum bipolar one, I couldn’t find any
books about the postpartum bipolar disorder (PPBD) experience – there were
books about perinatal mood and anxiety disorders (PMADs) such as postpartum
depression, postpartum psychosis, postpartum anxiety, etc., but there was a
dearth when it came to PPBD. I knew I couldn’t be the only person on the planet
to experience this PMAD!
I had already been a freelance writer before my mood disorder took hold. Like so
many other writers, I wanted to write a book and had felt that way since I was
seven years old. But I had never been sure which genre was the one for me since
I was awful at writing fiction!
After my PPBD was triggered, I had a bizarre condition called hypergraphia.
Hypergraphia is the extremely strong compulsion to write excessively, and I
began doing that within a day of my baby’s birth. I felt the need to start writing
my book right away. It was weird, it was physically painful and it was a
bittersweet beginning of writing a book.

What is Post Partum Bipolar Disorder?
PPBD, at its core, is bipolar one disorder or bipolar two disorder that has classic
bipolar symptoms such as mania, hypomania, or depression during one’s
pregnancy or during the postpartum period. The Diagnostic and Statistical
Manual of Mental Disorders (a.k.a. the DSM-5 which has been called “the bible of
diagnostic criteria” for mental health professionals and researchers) states the
onset of PPBD occurs during the first four weeks postpartum, but that amount of
time is being hotly contested by some brilliant perinatal psychiatrists who believe
the window of onset can last up to six months! The fifth, most current edition of
the DSM-5 calls PPBD “bipolar disorder, peripartum onset.”

What made your experience with Post Partum Bipolar so over the top to those
around you?
I was manic, which usually captures the attention of those close to you since one
acts very differently than usual. In my case, I had typical manic symptoms such
as very high energy, lots of talking (and talking super-quickly at that!), not much
of an ability to sleep, grandiose thoughts (i.e. I’m going to write my book now,
although I just got home with a newborn!) and then the very strange symptom I
mentioned: hypergraphia/excessive writing.

What is your advice for pregnant bipolar moms as they go into their final months
of pregnancy?
Work with at least one (ideally a team) of experienced OBGYN’s and/or midwives
and (if possible) doulas that are experienced in working with pregnant moms who
have bipolar disorder.That’s absolutely essential!
This section refers to pregnant moms who already take bipolar medication. If a
mom has already been diagnosed with bipolar, she needs to do her best to
communicate with her medical team about the medication issue. Have her do as
much research about continuing to take bipolar medication during her pregnancy
as she can, and enlist trusted family/friends to help because that won’t be easy!
If no medication has been taken, research starting bipolar medication when
pregnant. This is a controversial issue for some people, but everyone is different.
It’s absolutely imperative to consult with a professional one trusts and who has
an excellent track record in this area. The reason all of this is so critical is that
pregnant moms with a bipolar diagnosis have a much higher chance of getting postpartum psychosis after giving birth, which can be life threatening. Around
one in five women go on to experience an episode of psychosis following
childbirth.
For women already diagnosed with bipolar disorder, where can they learn more
about Post Partum Depression, Post Partum Panic Disorder, Post Partum
Obsessive Compulsive Disorder, Postpartum Psychosis, and Post Partum Post-
traumatic Stress Disorder?

I suggest two great resources:
Postpartum Support International for all the PMADS
https://www.postpartum.net
PSI Helpline English & Spanish (for non-emergencies) 1-800-944-4773 or text
503-894-9453
Action on Postpartum Psychosis for postpartum psychosis and bipolar disorder
https://www.app-network.org

Do you fear that you have passed this down to your daughters and if so, what do
you tell them?
I worry about it sometimes (and I used to worry about it more when they were
little), but not too much these days, thank God. But since they’re now 12 & 14 and
these are the teen years where bipolar can arise, I watch their behavior closely.
We’ve already had conversations about the possibility they could have bipolar
disorder and they’re well-informed. Craig and I have reassured them a lot over
the years (We’ve said things to them such as “Even if you have bipolar disorder,
we will help you with it!) and they know without a doubt that if we see any signs
of bipolar, we’ll be there for them.

Why do you think you were initially so averse to taking medication to manage
your illness?
For most of the seven years post-diagnosis, I was prescribed a lot of different
meds and most of them gave me awful side effects. The worst “side effect” was
that they didn’t work and one med even made me feel suicidal. I also knew there
were some people who could live med-free. Oh, how I wanted to be one of them! I
admit I was jealous of them. In any case, I didn’t want to have to keep trying
meds that never seemed to work and made me sick.

How long have you been on your current med cocktail and do you feel it is still
working? Do you ever feel apprehensive that an episode is coming on?
I’ve been taking a combination of lithium and the MAOI (monoamine oxidase
inhibitor) tranylcypromine/Parnate since November, 2013. I’m grateful these two
“old-school”medications are still working! I do worry sometimes when life gets
hard or when a crisis will happen that an episode will “get” me, which is why I
keep seeing my therapist (although not as often) as well as my psychiatrist.

Do you have a safety plan and if so what it is?
My safety plan is super-streamlined – I’ll contact my psychiatrist before doing
anything else and go from there. If I have to get hospitalized again, I’ll do it, but
I’ll be honest – it’s a big fear of mine to have to return to a psych ward and I hope
it never comes to that again.

What is your self-care plan for keeping yourself stable?
Taking my medication, keeping in touch with my therapist & psychiatrist,
exercise, getting enough sleep (that has been a challenge the past couple years –
it might have to do with perimenopause I think is happening now!), using my
bright light or getting natural sunlight, and avoiding toxic people/situations as
much as I can. (Easier said than done sometimes!) Also, I can’t believe I almost
forgot to mention my dog Lucy. She’s not a service dog but I consider her my
Emotional Support Animal. Sadly, I can’t have her around other dogs as she’s
aggressive, but she’s like my third child. We even have the same birthday!

Do you attend talk therapy even when you are feeling normal?
Yes. I used to see my therapist Ina on a weekly basis for years and now we talk
every couple weeks, sometimes taking a longer break than that such as now,
during summer.

What can stable Dyane do that you couldn’t enjoy when you were
manic/depressed?
When I’m stable, I can get out of bed and function!

Reading your book, I felt like we became bff’s. I love when I meet someone who is
like me. I have gone to a women’s therapy group with DBSA to connect with
women who have bipolar. It was tremendously important in helping me not feel
alone with this illness. Most days I still feel like the only woman in the world that
has this illness and that I have to keep quiet about it. I know you started a group
for bipolar moms, what was that like and what did you get out of it?
Aww, you made my day! I wish I could move you into my neighborhood! That’s
so awesome you attended the women’s therapy group with DBSA! First of all, I’m
so sorry about how you feel ( i.e. “the only woman in the world”) and believe me, I
totally relate to that feeling, still. The group I started for bipolar moms was
wonderful because I didn’t feel so isolated in having bipolar, and the women were
really cool. (Well, most of the members were a breeze! We had a couple, um,
challenging members, but that’s what happens with most support groups. You
can’t really pick and choose based on personality, especially when it comes to
bipolar disorder.) but it was also really stressful to be in charge.
I wish I could go back and do it again and recruit a few other moms to help me. I
miss the group and I’ve been tempted to start another one, maybe in the fall or
next year, but I wouldn’t go forth with it unless I had at least 2 other moms who
had facilitated peer support groups or had a keen desire to learn how to do it and
keep a commitment like that for at least six months.

What is the most important idea you want everyone to walk away with after
reading your book?
Even when you think life is hopeless, it will get better—no matter
what you do, please don’t give up and ask people to help you!!!!

Where can readers get a copy of your book?
For a free PDF file of my book, readers are welcome to email me:
dyaneleshinharwood@gmail.com

Amazon is the best way to go if you’d like to buy a paperback copy or give one as a
gift. Here’s a link to the book’s page:

https://amzn.to/2YnZhis

Thank you for taking the time to read this interview! 
Mental Melissa