Don't Ask, Don't Tell?

Telling someone you have Bipolar can be a daunting thing to do.  A lot of people who are BP decide not to tell a lot of people.  My mom was DX with BP before I was born and I never knew she was Bipolar until after she passed away (She was stable for 21 years on Tegretol, I was 22 when she passed).   Like my  mother, I decided not to tell many people about my diagnosis.  I didn't want my aunts and extended family to find out, but they did.  So the only people who know I am Bipolar are family and close friends.  Some people know I was sick last summer (Summer of 2008 when I was DX) and some people know I spent some time in the hospital, but they don't know why I was sick or what part of the hospital I was in.  I will not tell any of my employers I am bipolar and my husband's employer does not know either. 

I wish that more people were informed about what Bipolar is and how mental illness affects people.  But there is too much stigma around mental illness, I feel people would misunderstand me as a person.  One woman on a support network I am on (on-line) told me I shouldn't have children or be working with children because I am Bipolar.  She told me if I needed meds to "control" me that I wouldn't be a good parent or a good role model.  I informed her that I need meds to help stabilize my moods, they in no way "control" who I am or what I do. 

I am open to hearing your take on the stigma surrounding mental illness and whether you've chosen to tell people or not. 

My Medications

I take Tegretol (carbamazepine or Epitol) as my main mood stabilizer and Geodon picks up some of the slack that Tegretol misses.  Here is some info on both.

Tegretol is in Category D for pregnancy (There is a risk to the baby, but the benefits may outweigh the risk for some women).  Certain types of defects are increased (especially if Tegretol is taken during the first 3 months of pregnancy) but they are still relatively uncommon. Defects are more common in the babies of women who take Tegretol during the first 4 to 6 weeks of pregnancy.  (Source) With each pregnancy, all women have a 3% to 5% chance of having a baby with a birth defect.   This medication does cross the placenta. In pregnancies exposed to carbamazepine during the first trimester, a number of human studies have shown a 1% risk for neural tube defects. The general population risk for having a baby with a neural tube defect, such as spina bifida, is 0.1% (1/1000 births).  Tegretol is excreted into breast milk. However, the amount of carbamazepine found in infant blood is low and does not seem to build up over time. The American Academy of Pediatrics and the World Health Organization considers the drug to be compatible with breastfeeding.  (Source) The risk appears to be highest when carbamazepine is taken in the first trimester. The use of carbamazepine should therefore be avoided in pregnancy whenever possible, especially in the first trimester. However, when carbamazepine is stopped and reoccurrence of mania occurs, the physician may discuss the need to restart carbamazepine after the first trimester or seek an alternative medication or treatment. (Source)

Geodon is a category C drug for pregnancy.  Geodon (ziprasidone hydrochloride) may not be safe for women who are pregnant. In previous animal studies that looked at the effects of Geodon during pregnancy, Geodon increased the chances of miscarriage and birth defects.  . Pregnancy Category C is given to medicines that have not been studied in pregnant humans but do appear to cause harm to the fetus in animal studies.  It is important to note that animals do not always respond to medicines in the same way that humans do. Therefore, a pregnancy Category C medicine may be given to a pregnant woman if the healthcare provider believes that the benefits to the pregnant woman outweigh any possible risks to the unborn child. (Source)  It is not know if Geodon is passed through breast milk. Because of the potentially serious side effects that could occur in the nursing infant, the manufacturer of Geodon does not recommend that the drug be used in breastfeeding women.


I see my NP on October 5th and we will talk more about my options.  Just from the research I have done, I think I will taper off both meds before starting TTC and then after the first trimester is finished, if I need to, I will go back on a low dose of Tegretol.  Once the baby is born, I will go back on just tegretol and breastfeed.  If my moods start slipping, I will stop breastfeeding and go back on both meds.