How to Recognize Perinatal Bipolar Disorder During Pregnancy

Emma Loker
Published: 06/30/2025 | Updated: 03/31/2026
Authored by: Emma Loker, BSc, PgDip
Edited by: Ashley Pena, LCSW
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Living with a mental health condition, more specifically perinatal bipolar disorder, can feel like carrying an invisible weight. Everyday tasks might seem overwhelming. You might feel like no one would understand if you opened up – or wonder if getting help would even make a difference. You may struggle to recognize the condition altogether. 

If you think you may have perinatal bipolar disorder, you’re not alone. Bipolar disorder affects 2.6% of women in the perinatal period.1 And while this may not sound like a lot, with around 213 million pregnancies globally every year, that’s over 550,000 women. 

Fortunately, support is available. Whether it’s exploring how medication could help, or talking through what therapy might look like for you, support for you does exist. This page is one place to start – it covers:

  • What perinatal bipolar disorder is
  • How perinatal mood disorder can affect pregnancy
  • Signs and symptoms of perinatal bipolar disorder
  • Treatment options for bipolar disorder during pregnancy 
  • Coping strategies for perinatal bipolar disorder
  • Frequently asked questions about perinatal bipolar disorder
  • Support for perinatal bipolar disorder
woman in sweatshirt, looking away in distress with a tear running down her face, thinking about bipolar and pregnancy complications

Key Takeaways

  • What is perinatal bipolar disorder? A mood disorder with depressive episodes and mania/hypomania during pregnancy or postpartum.
  • Perinatal bipolar disorder can begin in pregnancy or within 1 year after birth, with depression plus mania or hypomania.
  • Symptoms may include high energy, less sleep, racing thoughts, risky choices, deep sadness, guilt, or suicidal thoughts.
  • Untreated perinatal mood disorders can affect parent and baby, including pregnancy complications and higher NICU needs.
  • Mission Connection supports moms and families with therapy, psychiatry coordination, coping tools, and multiple outpatient care levels.

Table of Contents

What Is Perinatal Bipolar Disorder?

Perinatal bipolar disorder, also known as postpartum bipolar disorder, is a mental health condition that can appear during pregnancy or within a year of giving birth. Bipolar disorder usually starts in early adulthood, although in people without a history, hormonal changes, sleep deprivation, and psychological stress during pregnancy might trigger the onset of the disorder.2

Approximately 2.6% of women in the perinatal period will experience perinatal bipolar disorder.1 For those with pre-existing bipolar disorder, they may notice their symptoms worsen during pregnancy and the first year after giving birth. 

Understanding Postpartum Bipolar Disorder

Perinatal bipolar disorder manifests as periods of depression and either mania or hypomania in the period during pregnancy or after childbirth. Let’s explore each of these terms in more detail: 

  • Hypomania or Mania: Hypomania and mania are periods of elevated energy levels and heightened mood. Mania is typically the more severe form and can lead to intense symptoms such as delusions and hallucinations. Hypomania is similar but milder than this and doesn’t tend to cause as much disruption to everyday life as manic episodes do. 
  • Depressive Episodes: During a depressive episode, you may feel a prolonged sense of sadness, irritability, and exhaustion, and have intense feelings of guilt and hopelessness. 
  • Mixed Depression and Mania: While it’s more common for those with bipolar disorder to have separate depressive and manic episodes, some may experience both at the same time. 

This condition undoubtedly has a big impact on a person’s life, even before pregnancy. So how might bipolar disorder look for someone who’s pregnant or has recently given birth?  Let’s explore how perinatal mood disorders such as perinatal bipolar disorder can affect pregnancy. 

How Perinatal Mood Disorder Can Affect Pregnancy and After Birth

Perinatal mood disorders, such as depression, anxiety, and bipolar disorder during pregnancy and the postpartum period, can have a significant impact on the health of both the mother and the baby.

The different ways perinatal mood disorders can affect pregnancy include:

Pregnancy Complications

Extended labor, postpartum bleeding, and a higher requirement for aided deliveries are among the potential complications linked to antenatal bipolar disorder.3   

Neonatal Health Issues

Perinatal bipolar disorder can affect the first 28 days of a baby’s life. As such, neonatal intensive care is more likely to be necessary for babies born to women who are experiencing perinatal depression.4

Early Development Difficulties

Sometimes, when a mom experiences perinatal bipolar disorder, it can gently influence her baby’s early development. This might appear as mild behavioral or developmental differences, or a child who feels emotions more deeply as they grow. 

Just like the emotional ups and downs of pregnancy can affect how you feel physically, they can also have lasting effects on both you and your baby if not addressed. It’s helpful to know that when mental health struggles like persistent anxiety or sadness continue through pregnancy, they can sometimes carry on after birth. 

In more serious situations, these feelings may feel overwhelming – and in some parts of the world, untreated mental health conditions during the postpartum period can lead to serious outcomes. 

The encouraging news is that healing is absolutely possible. With the right care, support, and treatment, many moms recover and feel like themselves again. Reaching out for help is a powerful and courageous step. Taking care of your mental health is one of the most meaningful ways you can care for both yourself and your baby.5  

To help you identify if you’re struggling with bipolar disorder in pregnancy, we’ll cover the signs next. 

What Are the Signs of Bipolar Disorder in Pregnancy?

Like any condition, perinatal bipolar disorder tends to show up as a set of signs and symptoms. While the exact set of symptoms may be unique to each person who experiences perinatal depression, there tends to be a framework of symptoms that occur in most people with the condition. Let’s explore these in more depth. 

The following signs are commonly experienced in women with perinatal bipolar disorder:6,7

1. Episodes of Mania and Hypomania

Manic and hypomanic episodes may occur or worsen during pregnancy in those with perinatal bipolar disorder. These may include:

  • Feeling excessively joyful or irritable for no apparent reason is known as an elevated or irritable mood.
  • Having more energy than usual, meaning you feel extremely productive. 
  • Feeling rested even after a few hours of slumber.
  • Speaking rapidly and hopping from one subject to another.
  • Making snap judgments, including excessive spending or dangerous actions.

2. Periods of depression

Depressive episodes also occur in those with bipolar disorder in pregnancy. This can look like: 
  • Persistent sadness, spending most of the day depressed or without hope.
  • Loss of interest in once-pleasurable activities.
  • Feeling worn out despite getting a good amount of rest. 
  • Sleep disorders include excessive or insufficient sleep.
  • Changes in appetite and significant weight gain or reduction associated with this (and unrelated to pregnancy). 
  • Feelings of guilt and worthlessness, or harsh self-criticism.
  • Having trouble concentrating or deciding.
  • Suicidal thoughts. 

3. Symptoms of Psychosis

Those with perinatal bipolar disorder may experience hallucinations or delusions under extreme situations. However, this is not the case for all.  After symptoms have been identified, the next step would naturally be treatment of the disorder.

Treatment Options for Bipolar Disorder During Pregnancy

Pregnancy-related perinatal bipolar disorder management calls for a comprehensive strategy that strikes a balance between the safety of the baby and the mental health of the mother. 

Here are some evidence-based treatment options to help you during this crucial time:

Speak to Your Doctor

One option is to consult a multidisciplinary professional team. A psychiatrist, an obstetrician, and a perinatal mental health professional are on this team. This team can assist in creating a treatment plan that takes the baby’s well-being and mental health requirements into account. To track symptoms and modify therapies as needed, routine consultations are required.8

Get Therapeutic Support

Bipolar symptoms have been successfully managed by psychotherapeutic approaches such as Cognitive Behavioral Therapy (CBT) and Interpersonal and Social Rhythm Therapy (IPSRT). These treatments can support your regular daily routines, enhance already-existing coping mechanisms, and stabilize your mood.9

Medication for Perinatal Bipolar Disorder

Medications are also available to manage the symptoms of perinatal bipolar disorder. However, it’s important to get approval from your doctor before taking certain mood stabilizers, like Valproate, while pregnant. Lamotrigine and other atypical antipsychotics are alternatives that could be considered to be safer solutions. However, to avoid complications, any changes to medication should be performed under close physician care.10   

Medication together with other strategies can be helpful. Coping strategies will be discussed next.

Coping Strategies for Perinatal Bipolar Disorder

We always recommend seeking support from your doctor or a mental health professional as a first line of treatment. However, there are steps you can also take at home to help you manage your symptoms: 

1. Prioritize Sleep

Episodes of perinatal bipolar disorder might be triggered by sleep problems. To encourage proper sleep, set up a relaxing environment and strive for regular sleep routines. Avoiding electronics and caffeine right before bedtime can also be beneficial.

2. Surround Yourself With a Robust Support System

Be in the company of encouraging friends, family, and support groups. Speaking with people who have faced comparable difficulties can provide both practical guidance and emotional support.11

3. Keep Tabs on Warning Signs

To monitor emotional shifts, sleep habits, and possible triggers, keep a mood journal. The probability of full-blown episodes is decreased by prompt intervention made possible by early detection of mood swings.12

4. Create a Postpartum Period Plan

The first month following the baby’s delivery is when the chance of relapse is highest. Together with your healthcare providers, create a postpartum care plan that may involve changing your medication and stepping up your monitoring to maintain stability during this delicate period.5

Frequently Asked Questions

Perinatal bipolar disorder is bipolar disorder that appears during pregnancy or within a year after childbirth. It involves episodes of depression and episodes of mania or hypomania.

Common signs include elevated or irritable mood, more energy, reduced need for sleep, rapid speech, impulsive or risky behavior, and depressive symptoms like hopelessness, exhaustion, or loss of interest.

Yes, perinatal mood disorders can impact both parent and baby. Support and treatment can improve safety, stability, and overall wellbeing during pregnancy and after delivery.

Medication decisions during pregnancy are highly personal and should be made with a qualified medical team. We encourage you to talk with a psychiatrist and OB-GYN to weigh benefits and risks and avoid abrupt changes.

Treatment often includes coordinated medical care, evidence-based therapy such as CBT or Interpersonal and Social Rhythm Therapy, and a plan to protect sleep and reduce relapse risk after delivery. We help match you to the right level of outpatient support for your needs.

Mission Connection: Support for Perinatal Bipolar Disorder for the Whole Family

Mission Connection is committed to providing individuals and families impacted by perinatal bipolar disorder with all-encompassing, empathetic, and culturally sensitive care. By providing moms, partners, and families with the clinical services, community networks, and mental health education they require to flourish, we hope to promote emotional wellness throughout pregnancy and the postpartum period.

The team at Mission Connection has a hotline you can call for confidential support and advice. You’ll find a friendly listening ear at the end of the phone and more information about our treatment center, resources, and services. 

Alternatively, you can get started here, and we’ll be in touch. 

treatment for Perinatal Bipolar Disorder

References

  1. Masters, G. A., Hugunin, J., Xu, L., Ulbricht, C. M., Moore Simas, T. A., Ko, J. Y., & Byatt, N. (2022). Prevalence of Bipolar Disorder in Perinatal Women: A Systematic Review and Meta-Analysis. The Journal of clinical psychiatry, 83(5), 21r14045. https://doi.org/10.4088/JCP.21r14045

  2. Di Florio, A., Forty, L., Gordon-Smith, K., Heron, J., Jones, L., Craddock, N., & Jones, I. (2013). Perinatal episodes across the mood disorder spectrum. JAMA psychiatry, 70(2), 168–175. https://doi.org/10.1001/jamapsychiatry.2013.279

  3. Bitew, T., Hanlon, C., Kebede, E., Honikman, S., & Fekadu, A. (2017). Antenatal depressive symptoms and perinatal complications: a prospective study in rural Ethiopia. BMC psychiatry, 17(1), 301. https://doi.org/10.1186/s12888-017-1462-4

  4. Hermon, N., Wainstock, T., Sheiner, E., Golan, A., & Walfisch, A. (2019). Impact of maternal depression on perinatal outcomes in hospitalized women-a prospective study. Archives of women’s mental health, 22(1), 85–91. https://doi.org/10.1007/s00737-018-0883-5

  5. The Royal Women’s Hospital. (n.d.). Bipolar disorder and pregnancy.  https://www.thewomens.org.au/health-information/pregnancy-and-birth/mental-health-pregnancy/bipolar-disorder-pregnancy

  6. NSW Health (n.d.). Signs and Symptoms of Perinatal Health Issues. https://www.health.nsw.gov.au/mentalhealth/services/parents/dads/Pages/signs.aspx

  7. COPE: Centre of Perinatal Excellence (n.d.). Bipolar disorder in the perinatal period. https://www.cope.org.au/health-professionals/screening-and-assessment-tools/perinatal-mental-health-disorders/bipolar-disorder-in-the-perinatal-period

  8. Uguz F. (2020). Pharmacological prevention of mood episodes in women with bipolar disorder during the perinatal period: A systematic review of current literature. Asian journal of psychiatry, 52, 102145. https://doi.org/10.1016/j.ajp.2020.102145

  9. Wesseloo, R., Kamperman, A. M., Munk-Olsen, T., Pop, V. J. M., Kushner, S. A., & Bergink, V. (2015). Risk of Postpartum Relapse in Bipolar Disorder and Postpartum Psychosis: A Systematic Review and Meta-Analysis. American Journal of Psychiatry, 173(2), 117–127. https://doi.org/10.1176/appi.ajp.2015.15010124

  10. Uguz F. (2020). Pharmacological prevention of mood episodes in women with bipolar disorder during the perinatal period: A systematic review of current literature. Asian journal of psychiatry, 52, 102145. https://doi.org/10.1016/j.ajp.2020.102145

  11. The Cerebral Care Team. (2024, March 28). Bipolar Disorder and Pregnancy: What You Need to Know. Cerebral. https://cerebral.com/blog/bipolar-disorder-and-pregnancy

  12. Purse, M. (2022, May 16). What Is Bipolar Disorder? Verywellmind. https://www.verywellmind.com/bipolar-disorder-overview-378810