Things I would never do as a board certified psychiatrist: unplanned pregnancy version

I would never assume an unplanned pregnancy was unwanted. Hopefully this isn’t too surprising, where this really is an issue is in research. Many research articles make the assumption that unplanned pregnancies are unwanted. This has changed in recent years to more inclusive language, but we all need to acknowledge that an unplanned pregnancy can certainly be a disaster and a dream come true or both at the same time and anywhere in between! Not to mention half the pregnancies in the US are unplanned and that was before wide spread restrictions on birth control and abortion access… so the number of unplanned pregnancies is likely to grow.

Women at increased risk for unplanned pregnancies are women with ADHD and Bipolar Disorder. ADHD is a chronic impulse control disorder, whereas bipolar disorder can be an episodic impulse control disorder. Some women actually have both diagnoses, in fact having ADHD may be a risk factor for developing a bipolar disorder. This is something we are still learning about. Up to 30% of people with ADHD go on to develop a bipolar disorder.

There are two types of Bipolar Disorder: Bipolar Disorder and Bipolar 2 Disorder. I used to call Bipolar 2 Disorder the "Diet Coke of bipolar disorder," however I learned at the 2024 International Society for Reproductive Psychiatry Conference in Boston that this is not the case. In fact, women with bipolar 2 disorder might spend as much as 50% of their lives in a depressive episode and may be associated with high risk for unaliving completion in women. So I will no longer be calling bipolar 2 disorder the Diet Coke version. I have yet to come up with an alternative, but I will keep you updated.

What's the difference between the two bipolars? Bipolar disorder has manic episodes, and bipolar 2 disorder has hypomanic episodes. I'll have to do a different post on that soon. :-)

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