Bipolar II postpartum depression: Detection, diagnosis, and treatment. The American journal of psychiatry [Am J Psychiatry] Journal article

Title	Bipolar II postpartum depression: Detection, diagnosis, and treatment.
Author(s)	Sharma V, Burt VK, Ritchie HL
Institution	Department of Psychiatry, University of Western Ontario, London, Canada. vsharma@uwo.ca
Source	Am J Psychiatry 2009 Nov; 166(11):1217-21.
MeSH	Adult Anticonvulsants Antidepressive Agents Bipolar Disorder Breast Feeding Depression, Postpartum Depressive Disorder, Major Diagnosis, Differential Diagnostic and Statistical Manual of Mental Disorders Dibenzothiazepines Female Humans Lactation Lithium Compounds Mass Screening Milk, Human Pregnancy Pregnancy Complications Psychiatric Status Rating Scales Questionnaires
Abstract	Research on postpartum mood disorders has focused primarily on major depressive disorder, bipolar I disorder, and puerperal psychosis and has largely ignored or neglected bipolar II disorder. Hypomanic symptoms are common after delivery but frequently unrecognized. DSM-IV does not consider early postpartum hypomania as a significant diagnostic feature. Although postpartum hypomania may not cause marked impairment in social or occupational functioning, it is often associated with subsequent, often disabling depression. Preliminary evidence suggests that bipolar II depression arising in the postpartum period is often misdiagnosed as unipolar major depressive disorder. The consequences of the misdiagnosis can be particularly serious because of delayed initiation of appropriate treatment and the inappropriate prescription of antidepressants. Moreover, no pharmacological or psychotherapeutic studies of bipolar postpartum depression are available to guide clinical decision making. Also lacking are screening instruments designed specifically for use before or after delivery in women with suspected bipolar depression. It is recommended that the treatment of postpartum bipolar depression follow the same guidelines as the treatment of nonpuerperal bipolar II depression, using medications that are compatible with lactation.
Language	eng
Pub Type(s)	Case Reports Journal Article Research Support, Non-U.S. Gov't
PubMed ID	19884236

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