Photo: Jana Cruder (@janacruder)
“It was the most wild thing when she told me she stayed on,” Torresani recalls in an interview for the new issue of PEOPLE, on newsstands Friday. “I was like, ‘What do you mean? I have been told the whole time you can’t.’ But you don’t want to place judgment and be like, ‘I’m the mother that wouldn’t do that.’ It was just like, ‘I’m so confused!’ "
Then in March Torresani interviewed aCedars-Sinai specialist in reproductive psychologyfor her mental-health podcast,EmotionAL Support. “And when I explained how I was not on my medication, she was shocked,” the actress says. “It was confusing. You hear so many different stories and theories.”
That’s a problem, say physicians at the intersection of psychiatry and obstetrics, where the stigma of mental illness and the historic neglect of women’s health research can make for an especially dangerous combination.
Mental Health is Not ‘Elective’
“There’s a kind of knee jerk with mental health, more so than with other conditions, to stop meds as if they are elective,” saysDr. Tiffany Moore SimasofUMass Chan Medical School’sLifeline for Moms. “You would never just stop somebody’s diabetes or hypertension meds.”
The fact is, addsDr. Susan Kornsteinof theInstitute for Women’s Healthat Virginia Commonwealth University, the data on the safety of lamotrigine use during pregnancy is “very reassuring.”
“While an early study found that infants exposed to lamotrigine during pregnancy have a small but elevated risk of cleft lip or palate deformity, a number of larger studies since then — and a large meta-analysis — concluded that there is no association between lamotrigine use during pregnancy and birth defects,” Kornstein tells PEOPLE.
And because women with bipolar disorder are a high risk of postpartum psychosis — associated with increased risk of suicide and infanticide — “the conversation needs to change from ‘medication or no medication?’ to ‘treated versus untreated disease’ for these serious mental health conditions,” says Moore Simas.
Her Lifeline4Moms program developed anationwide networkof perinatal psychiatrists who are available to consult with anyone who cares for pregnant, postpartum or lactating women about which mental health medications are safe and appropriate to continue.
Toolkits and appsavailable on the Lifeline4Moms website also offer access to the latest information on medication safety in pregnancy.
“People focus on the risks of medication exposure but it’s important to keep in mind that psychiatric illness itself can cause harmful effects on the fetus,” says Kornstein. “A woman’s psychiatrist should work closely with her obstetrician to manage her medication.”
‘Lucky to Have Resources’
Alessandra Torresani and Sturgis Adams, July 4, 2020.Courtesy Alessandra Torresani
Torresani decided to stay off her medication — “I didn’t want to make a mistake and be that [tiny] percent chance of a problem,” she says — but her second trimester was a reminder that her untreated disease can be terrifying.
But since she knew bipolar would be a challenge, Torresani and her husband Sturgis Adams, 44, a tech-company executive, went into the pregnancy feeling as prepared as they could be. Adams “did his own research, met with doctors and specialists and knew the most important thing was to nurture me,” she says.
Kunal Nayyar and Alessandra Torresani on The Big Bang Theory, 2016.Michael Yarish/CBS/Everett
It worked. Until it didn’t. She suffered three relapses in her second trimester.
‘The Darkest Phase’
“In my darkest stages,” she tells Sher in an upcoming podcast episode, “I got to the point where I was like, ‘I don’t deserve to live.’ "
source: people.com
