New research (Bipolar II postpartum depression: detection, diagnosis, and treatment, by Sharma, Burt & Ritchie) on postpartum mood disorders is beginning to recognize early postpartum hypomania as an important diagnostic marker. It is suggested that postpartum bipolar II depression is often misdiagnosed as unipolar depression. The study also points out that we lack specific screening instruments for women with a history or current bipolar depression during the prenatal or postpartum period.
“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.”
Reference: Am J Psychiatry. 2009 Nov;166(11):1217-21.