More Than a Woman
Emari Dimagiba Lavine
For as long as we've known each other, my husband and I have relished the idea of becoming parents, welcoming everything that comes with it -- the challenges and joys, the unexpected surprises and growth. Two and a half years into our marriage did indeed bring the unexpected, though not in the form of an unplanned pregnancy. With a history of depression, several environmental stressors, and most likely, genetic predisposition, I was hospitalized for presenting my first major manic episode with psychotic features.

The psychotic part describes how much I was out of my mind by certain standards, and not that I was violent or self-abusive in any way. I must have been ramping up over several weeks, with little need for sleep or food. My mind overflowed with rapid, interconnected thoughts, ideas, and raw creative genius. I also had a desperate compulsion to document as much as I could lest I forgot something I might need later. Because writing is the most natural extension of my expression and my understanding, I wrote incessantly -- in my journal, on sticky notes, on scraps of paper, all over my left arm, whatever I could find. Perfectly described, at the risk of sounding arrogant, the manic episode brought me into a heightened and humbling realization that I really am among the best and brightest, and at the same time, very out of control of my own experience.

Like others who are diagnosed with manic depression or bipolar disorder, I was completely oblivious to the sweeping changes in mental states that brought me there. I found myself unable to respond fully or coherently to anyone's frantic, confused questions about what was going on because I didn't have any answers to give them. Instead, I remember feeling in touch with my environment on a special level - through a love for music, dance, rhythm, flow, energy, and well-executed acts of synchronization. As such, I became aware that the moment was unfolding as it should, and I had no worries because my loved ones, my husband in particular, could still act and communicate on my behalf. In my reality, I was just more at peace with myself than everyone else was.

I remember when the doctors and nurses told me about the importance of managing my illness for the rest of my life. I can avoid lapsing into another major manic or depressive state by taking my daily medication along with proper diet and exercise. Not until several months later did I stabilize on my medications and no longer feel fog-headed. Then I became conscious of the implications that bipolar disorder and its indefinite treatment would have for planning our family.

At my next annual gynecological exam, I was determined to know if there was a viable game plan for bipolar women who want to bear children. From a pharmaceuticals manual, the doctor reviewed the fetal risks of my particular medication. She read to me what I already suspected and feared: fetal and newborn consequences resulting from its use during pregnancy include major and minor congenital abnormalities, intrauterine growth retardation, and a number of other defects that I just couldn't keep straight in my head.

Given all that information, I had to ask the doctor what our options were for a viable pregnancy. First off, she emphasized taking folic acid or prenatal vitamins even if we weren't ready to start trying to conceive. It's a matter of preparing the body. Once we decide that we are ready to start trying, she advised me to work with my case manager to gradually wean off the medications over several weeks, prior to conception. Postpartum, the recommendation is to get right back on the regimen of medications as soon as it's safe to do so. For women who are not bipolar, risk of postpartum depression is a common possibility, which makes the risk even greater for those of us who are.

A range of questions is raised when individuals like me, with certain mental health disorders, want to have biological children like "normal" people do. How much of my mental health do I risk by protecting a pregnancy from abnormalities and defects? How much of my own defects will be passed along to our children? Can I still be a competent parent with the emotional and psychological baggage that I carry? Am I not entitled to try and do my best like everyone else?

I see family, friends and colleagues getting pregnant and delivering babies, relatively free from complications, while I try to see into a future that will allow my husband and me to share in the same experience. Some may argue vehemently against my so-called chemical dependency. Others may call into question my true capacity to be a parent. The truth is, living up to our fullest potential requires asking for help along the way, and this is the legacy and the lesson that I most want to leave behind.

Emari Dimagiba Lavine is the result of 16 years of Catholic education. Raised in the San Francisco Bay Area, she is the youngest of four children in a Filipino family. With experience in radio broadcasting, rape prevention education and adolescent reproductive health advocacy, she has devoted her life to increasing interpersonal communication and social understanding about sexuality. She has been writing in a journal since age eight, and appreciates learning about new music. She lives with her husband and three cats in the Twin Cities.

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