Updated 3 October 2026
At a glance
- A meta-analysis of 37 studies describing 5,700 deliveries found an overall postpartum relapse risk of 35% in women with a history of bipolar disorder, postpartum psychosis, or both, and severe postpartum episodes in 17% of those with bipolar disorder (Wesseloo et al., 2016).
- The NHS says postpartum psychosis affects around 1 in 1,000 mothers after giving birth, that symptoms usually start suddenly within the first 2 weeks, and that an existing bipolar disorder diagnosis raises the risk (NHS).
- A pregnancy log for bipolar disorder holds a baseline, weekly sleep, mood, and energy lines, a medicine list as prescribed, a written list of early warning signs, and a one-page summary for each appointment.
- Bipolar Journey is a bipolar tracker that keeps sleep, mood, medicines, flare marks, and care-team notes in one dated history that supports every prenatal and mental health visit.
Pregnancy brings many appointments, several clinicians, and steady changes to sleep. Each of them hears a piece of your story, and a dated record lets all of them start from the same facts: how sleep and mood have run, which medicines you take as prescribed, and what earlier episodes looked like.
This guide covers a baseline, a short weekly log, the care team and appointments, a medicine list and questions for the prescriber, a list of early warning signs with urgent-help steps, the first weeks after birth, and a one-page summary for visits. Decisions about medicines and care stay with your clinicians; the log gives them dated information.
Why a dated record matters during pregnancy and after birth
Pregnancy and the first weeks after birth involve many appointments, several clinicians, and broken sleep. NICE guidance on antenatal and postnatal mental health lists, among the points a mental health professional should discuss when giving detailed advice, the possibility of sudden onset of symptoms in pregnancy and after birth, particularly in the first few weeks after childbirth, with bipolar disorder given as the example (NICE CG192, 1.4.6).
The NHS notes that some medicines for bipolar disorder are not safe to take in pregnancy and advises talking to a doctor if you are pregnant or planning a pregnancy (NHS). It also advises continuing bipolar disorder medicine unless a doctor says to stop, even when you feel better. A conversation with the prescriber goes further with dates: which medicines you take as prescribed, how sleep and mood ran over recent months, and what earlier episodes looked like. For a general starting routine, see How to Start Tracking Sleep and Mood in Bipolar Disorder.
In Bipolar Journey, the Daily check-in records sleep, mood, energy, and medicines in one guided pass, so each week of pregnancy has the same fields. The Flare Tracker marks a day clearly worse than usual, which gives any change a date a clinician can find. Insights can show whether sleep shortened before a worse day across the weeks you logged.
Record a baseline at the first prenatal visit
A baseline is a short description of your usual range, written before pregnancy changes the picture or at the first visit. It gives every later entry something to be compared with.
Bipolar Journey (part of Health Journey Labs) recommends writing the baseline in the same fields you will use each week, so week 6 and week 26 can be compared directly. Add the history of earlier episodes in plain words: the first sign you noticed, how many days it took to build, how long it lasted, who noticed it, and which steps your team took.
Baseline items for the first prenatal visit
The baseline table in Bipolar Journey has six rows, each with what to write and why it helps:
| Baseline item | What to write | Why it helps |
|---|---|---|
| Usual sleep | Bedtime, wake time, and hours on a typical week | Shows which nights count as shorter than your own normal |
| Usual mood range | Words such as lower, steady, higher, or mixed, plus a 0–10 score | Gives later entries a comparison point |
| Usual energy | 0–10 and what a typical day includes | Separates tiredness from a change in drive |
| Earlier episodes | Month, first sign, length, and what the team did | Lets the team match current signs with past ones |
| Current medicines | Names and times as prescribed | Starts the medicine record at visit one |
| Support people | Names, relationship, and who you would call first | Fills in the contact page of the care plan |
Source: Bipolar Journey
In Bipolar Journey, the Daily Journal holds the earlier-episode history as free text, with voice available when typing is hard, so the history is written once and reused at each visit. The Daily check-in then records the same fields from week one. Both sets of entries make the pattern of change visible against your baseline.
What to log each week of pregnancy
The NHS says it is common to feel tired, or even exhausted, during pregnancy, especially in the first 12 weeks (NHS). Tiredness, nausea, back pain, heartburn, and night-time bathroom trips can all interrupt sleep, so a sleep total alone has more than one possible cause. Add a short reason to each wake-up, such as bathroom, discomfort, racing thoughts, or unknown, and the entry carries the information a clinician needs.
Keep the daily set short: sleep, a mood word, energy, and one line on anything unusual. Record the order of changes as well as the values. If sleep shortened first and energy rose two days later, that sequence is useful to the team. Add the week of pregnancy to each weekly summary so entries line up with the prenatal schedule.
Checklist for each week of pregnancy
Each week of pregnancy, Bipolar Journey keeps these six lines:
- Hours slept, bedtime, wake time, and the reason for each wake-up
- Mood word (lower, steady, higher, or mixed) and a 0–10 score
- Energy 0–10 and whether activity matched your usual
- Thought speed, irritability, and spending or plans that felt unusual
- Appetite and nausea, since both change meal and sleep timing
- Events: appointments, stress at home or work, travel, illness
In Bipolar Journey, the Daily check-in covers sleep, mood, energy, and nutrition in a short pass, and custom symptoms add your own labels, such as woke for bathroom. The Daily Journal holds the one line on anything unusual, by voice when typing is tiring. Insights can show whether shorter sleep weeks came before higher-energy days in your own log.
Who is on your care team and what to bring to each appointment
List every person involved: the prenatal clinician or midwife, a primary care clinician, the prescriber for bipolar disorder, a therapist if you have one, a perinatal mental health clinician if you are referred, and your support person. For people at high risk of postpartum psychosis, a group that includes an existing bipolar disorder diagnosis, the NHS describes a pre-birth planning meeting around 32 weeks of pregnancy with everyone involved in care, followed by a written copy of the care plan (NHS).
Ask early whether such a meeting is available where you receive care. The table below shows what each appointment can use from the log.
What to bring to each pregnancy appointment
Bipolar Journey matches each appointment with the part of the log to bring and one question to write beforehand:
| Appointment | Bring from the log | Question to write beforehand |
|---|---|---|
| First prenatal visit | Baseline page and medicine list | Who will coordinate mental health care during pregnancy? |
| Prescriber visit | Four weeks of sleep and mood lines, medicine times, and any missed times | What should I do if sleep drops for two nights in a row? |
| Routine prenatal visit | One-page summary and weight or blood pressure notes the team gives you | Which results this month are relevant to my mood plan? |
| Pre-birth planning meeting | Early warning sign list and support contacts | Who do I call after hours, and who calls me? |
| First postpartum check | Sleep totals since delivery and mood words by day | How often will someone check in during the first weeks? |
Source: Bipolar Journey
In Bipolar Journey, My Care Team stores each clinician's name and visit notes, so the roster in the care plan and the answers from each visit stay in one list. Visit notes are written during or right after the appointment, so preparation for the next one starts from what was said. Notes dated by visit show which questions have answers and which follow-up pattern is still open.
Pregnancy with bipolar disorder: medicine record and prescriber questions
The medicine record has one job: to give the prescriber accurate facts. Write each medicine by the name on the label or pharmacy printout, the time of day it is taken, and the date of every change the prescriber made, with who decided and the reason given. Add any late or missed times with the reason, such as nausea or a night wake-up. Include vitamins and supplements. Leave decisions about stopping, starting, or changing a medicine to the prescriber.
Questions for the prescriber during pregnancy
Bipolar Journey suggests writing these questions before the visit, for a prescriber or perinatal clinician:
- Which parts of the current plan will be reviewed at each stage of pregnancy?
- How does the plan change after birth?
- What is the plan if I intend to breastfeed?
- Which blood tests are scheduled, and when?
- Who do I call between visits?
Write the answer under each question during the visit, with the date and the clinician's name.
The medicine record in Bipolar Journey uses four kinds of entry, shown here with an example of each:
| Record | Example entry |
|---|---|
| Medicine and time | Name as on the label; taken 8 p.m.; late by 2 hours, reason: nausea |
| Change by prescriber | Date, name of prescriber, reason given, next review date |
| Question and answer | Question as written; answer in the clinician's words; date |
| Tests | Test name, date drawn, date results were shared |
Source: Bipolar Journey
In Bipolar Journey, My Meds stores medicine names and timing as prescribed, and each logged time is dated against that night's sleep hours and the next day's mood. My Labs keeps the result dates for tests the team orders during pregnancy, so a result sits in the same history as the weeks around it. Insights can relate medicine timing and test dates to sleep and mood across the weeks you logged.
Early warning signs of a bipolar episode and who to call for urgent help
Early warning signs are the first changes you or others noticed before earlier episodes. The NHS lists, among the symptoms of high mood, having a lot of energy, feeling restless, or not needing much sleep, and among low mood symptoms, difficulty sleeping or sleeping a lot (NHS). Your own list is more specific: write the sign, how many days before the episode it appeared, and who noticed it. Use two columns, signs of rising mood and signs of lowering mood.
Give a copy to your support person and to the team, and write the contact for each. After birth, the NHS lists hallucinations, delusions, mania, a low mood, and feeling very confused among the symptoms of postpartum psychosis, which it describes as a serious mental illness that should be treated as a medical emergency (NHS).
Who to call for urgent help, in order
Bipolar Journey keeps the urgent-help order on the early-signs sheet, so everyone near you reads the same steps:
- If anyone is in immediate danger, call your local emergency number (911 in the US, for example).
- If you have a care plan from a mental health team, call the crisis contact written in it.
- For urgent emotional support, contact a crisis line where you live (988 in the US, for example).
- Tell your support person and show them the early-signs sheet.
In the US, the 988 Suicide & Crisis Lifeline describes itself as available 24/7/365 (988 Lifeline). Health services publish urgent-help pages too: the NHS page on urgent mental health help advises getting urgent help if someone's life is at risk or if you do not feel you can keep yourself or someone else safe (NHS).
In Bipolar Journey, the Daily Journal holds the early-signs sheet as text or a voice note, so partner and clinician read the same words. The Flare Tracker marks the date a listed sign first appears and the date it settles. Marks across several months show which pattern of signs came first.
What to log in the first weeks after birth
NICE advises that health professionals monitor regularly for symptoms throughout pregnancy and the postpartum period, particularly in the first few weeks after childbirth (NICE CG192, 1.4.8). Plan the log before delivery, because sleep is divided into short blocks and hands are often busy. A four-line version works: total sleep in 24 hours and the longest single block, a mood word, energy 0–10, and one line on racing thoughts, irritability, or unusual plans.
The NHS adds that someone with postpartum psychosis may not realize they are ill, and that a partner, family member, or friend may spot the signs and take action (NHS). Share the early-signs sheet before birth and agree that your support person can write dated observations, for example slept two hours total and talking fast. For next-day entries after short nights, see How Short Sleep Affects Mood the Next Day in Bipolar Disorder. Agree in advance who covers which night feeds and write the plan on the page you bring to the planning meeting.
In Bipolar Journey, the Daily check-in takes one short pass at the same time each day, and the Daily Journal accepts a voice note when hands are busy. A support person's observation can be added as a dated journal line. Sleep totals across the first weeks then show a pattern that clinicians can read with the delivery date in view.
How to turn the log into a one-page summary for visits
Build the page the day before each appointment from the log, and keep it to one side of paper. Start with the dates covered and the week of pregnancy. Add sleep: the typical range and the shortest night. Add mood words by week, any days marked as clearly worse, the current medicine list with the date of any change, and the next test dates.
Finish with three to five questions and the early-warning sheet. Bring the same page to the prescriber, the prenatal clinician, and the planning meeting, so each person reads the same facts. If family members want to understand what the page records, How to Explain Bipolar to Family Who Cannot See It is a useful place to start.
In Bipolar Journey, the Doctor Report exports a one-page summary from the history you logged, including dates, sleep and mood context, and function. My Care Team keeps the clinicians' names and visit notes with it, so the questions for each visit are ready from the last one. Comparing pages from successive visits shows which pattern is settling and which needs attention.
How Bipolar Journey can help
A notebook can hold a few weeks of sleep hours and mood words. The harder step is keeping months of entries, medicine times, test dates, and visit notes together, and turning them into a page before each appointment. A dated history that already holds sleep, mood, medicines, and care-team notes makes that page faster. For a comparison of trackers, see Best Bipolar Apps 2026.
Bipolar Journey is a personal bipolar disorder tracker from Health Journey Labs on the App Store and Google Play. On this topic, it lets you log sleep, mood, and medicine times through pregnancy and the first weeks after birth on one timeline, with a place for early warning signs and visit notes. That dated history gives your care team a clear picture of how pregnancy changed your sleep and mood, and gives you a ready page for each appointment. Below is what you can use and how each part helps.
- Daily check-in — A short guided pass across symptoms, mood, nutrition, sleep, exercise, and meds, so insights can show links memory misses.
- Daily Journal — Freer notes, including voice when typing is hard, that give insights context scores cannot carry.
- Flare Tracker — Mark a day clearly worse than usual, so insights can separate a one-off spike from a repeating pattern.
- My Meds — Medicine names and timing, including options you already take as prescribed. Insights can relate timing to sleep hours and next-day mood.
- My Assessments — Structured check-ins that give insights more context about your life.
- Learn — Short education topics on bipolar themes such as sleep, mood, routines, and visit prep.
- AI companions — Clara and specialist companions answer with your logged history in view.
- Weekly Goals — Set one small aim and see whether it held, which shows whether a habit change helped.
- Doctor Report — Export a one-page summary from your logged history when a written summary helps a short visit.
- My Care Team — Add clinicians and visit notes to prepare questions and review answers.
- My Labs — Result dates for ordered tests, weighed against sleep, mood, and function in the same weeks.
- Period Tracker — Start and stop dates, flow, and how heavy bleeding felt, so insights can relate cycle weeks to sleep and mood.
- Food Tracker — Meal or drink lines, so insights can relate food, caffeine, or alcohol to sleep and mood.
- Weight Tracker — Scale notes when weight is part of what you and your clinician are watching, joined to the same sleep and mood history.
Everything you log builds one history, and insights get stronger as it grows. Custom symptoms let you add your own labels.
We make Bipolar Journey at Health Journey Labs. This guide is educational and does not replace medical advice. Diagnosis, medication decisions, and urgent care decisions belong with your treating clinicians.
Sources
- Wesseloo et al., Risk of Postpartum Relapse in Bipolar Disorder and Postpartum Psychosis, Am J Psychiatry 2016
- NICE CG192 — Antenatal and postnatal mental health: recommendations
- NHS — Bipolar disorder
- NHS — Postpartum psychosis
- NHS — Tiredness and sleep problems in pregnancy
- 988 Suicide & Crisis Lifeline
- NHS — Where to get urgent help for mental health
FAQ
How do I tell pregnancy changes in sleep and appetite from mood changes in my log?
Record both and write the order. Note when sleep shortened, when energy changed, and what else was happening, such as nausea, a heavy workday, or a night of discomfort, with the date for each.
With Bipolar Journey, the Daily check-in keeps the same fields each day, and custom symptoms hold labels such as woke for bathroom. Insights can then separate weeks when sleep changed with a physical cause from weeks when sleep changed with mood.
What is a specialist perinatal mental health service?
NICE refers to a secondary mental health service, preferably a specialist perinatal mental health service, and advises considering a referral for preconception counseling for anyone with a current or past severe mental health problem who is planning a pregnancy (NICE CG192, 1.4.2). Ask your prenatal clinician or prescriber whether one is available where you live.
In Bipolar Journey, My Care Team stores the service's name, the clinician, and notes from each contact, so the referral and every follow-up stay in one list, and the Doctor Report carries the logged weeks to that first appointment.
What goes into a written care plan for pregnancy and after birth?
NICE says a written care plan from secondary mental health services should cover pregnancy, childbirth, and the postpartum period, with jointly agreed treatment goals, how outcomes are monitored, increased contact with perinatal services, and the names and contact details of key professionals (NICE CG192, 1.6.6). Ask for a copy for yourself and your support person.
With Bipolar Journey, My Care Team holds the names from the plan, and the Doctor Report turns your logged weeks into a page that matches the goals in it. Dated entries then show whether sleep and mood stayed inside the plan's monitoring schedule.
What is the difference between baby blues and postpartum psychosis?
The NHS says many people experience mild mood changes after birth, known as the baby blues, which usually last only a few days, and that postpartum psychosis is very different, a serious mental illness that should be treated as a medical emergency (NHS). Write the date any symptom began and contact the crisis number in your care plan.
In Bipolar Journey, the Daily Journal holds a dated line for each change, so you or your support person can say exactly when it began. The Flare Tracker marks the day a symptom first stood out.
Who should know my early warning signs?
Give the sheet to your support person, your prescriber, the prenatal clinician, and anyone who covers nights after birth. Write the contact beside each name, so the person who notices a change knows who to call.
With Bipolar Journey, the Daily Journal keeps the sheet in your own words and the AI companions, including Clara, can help word a short message from your logged history, so the sheet reaches each person in the same words.
How often should I log during pregnancy?
Once a day for the short set is enough: sleep, a mood word, energy, and one unusual line. On a day that is too full, a word and a number still count, and a gap can be marked and picked up the next day.
In Bipolar Journey, the Daily check-in is a short guided pass, and the Daily Journal accepts voice when typing is hard, so a short entry on a hard day still adds to the history.
What should I write down when my prescriber changes a medicine?
Record the date, the prescriber's name, the reason given, what the prescriber said to watch for, and the date of the next review. Write the entry during or right after the visit, while the wording is fresh.
With Bipolar Journey, My Meds stores the medicine names and timing as prescribed, and My Care Team holds the visit note. Insights can relate the date of a change to sleep hours and next-day mood in the weeks that followed.
What should I do if my sleep drops for several nights?
Mark the nights, write how you felt and what else changed, and contact the person named in your care plan the same day. Early contact gives the team the dates while they are accurate.
In Bipolar Journey, the Flare Tracker marks the first short night and the Daily check-in records how sleep and energy moved over the following days. Insights can show whether earlier short stretches led to a change, which gives the team a pattern to review.
How do I keep logging when pregnancy fatigue makes everything hard?
Use the minimum set: hours slept, one mood word, and energy 0–10. A single line of voice or text on anything unusual is enough. Add detail only on days when something changed.
With Bipolar Journey, the Daily check-in takes a short guided pass, and the Daily Journal accepts a voice note, so a hard day still leaves a dated line in the history.
Which tests belong in my record?
Write the test name, the date it was drawn, and the date the result was shared with you. Tests ordered in pregnancy and tests ordered by the prescriber both belong.
In Bipolar Journey, My Labs stores result dates in the same history as your daily entries. Insights can weigh a result against the sleep and mood you logged that week.
How can I prepare for labor and delivery with bipolar disorder?
Write a one-page hospital note: your diagnosis in your own words, the care team contacts, the current medicine list, and your early warning signs. Ask the team whether the care plan covers sleep during labor and the first nights, and who will be told your plan.
With Bipolar Journey, the Doctor Report exports a one-page summary from the history you logged, and My Care Team keeps the contacts for the note, so the hospital page is assembled from entries you already made.
What should a partner or support person write down?
Dated observations in plain words: how many hours you slept, whether speech was faster than usual, irritability, and anything that matched the early-signs sheet. They can add the time of day and who else was present.
In Bipolar Journey, the Daily Journal accepts a line from your support person as a dated entry, and Insights can place those observations alongside your own entries, so differences between how a day felt and how it looked become visible.
What counts as a flare day in pregnancy?
A day clearly worse than your usual hard day: a low mood that lasts the whole day, a night of very little sleep with high energy, or racing thoughts that interfere with plans. Write the date, what changed, and what happened over the next days, so the entry carries its own context.
With Bipolar Journey, the Flare Tracker marks the day with intensity and a note, and the Daily Journal holds what happened afterward. Insights can separate a one-off spike from a repeating pattern across months.
Can an AI companion help me prepare questions for a prenatal visit?
It can help you organize questions and summarize patterns from your own entries. Bring its summary to the visit as a starting point, so the team can add their own assessment to it.
The AI companions in Bipolar Journey, including Clara, see your logged history, so they can help shape a question list and a one-page summary from your own weeks. The team then receives specific dates and examples.
Why does privacy matter for your health records?
Health notes are personal — symptoms, medications, mood, and what you canceled. Treat any digital log as sensitive; on paper, keep the notebook somewhere only you control.
Entries you add to Bipolar Journey are your own health notes. Check the app's privacy policy for how data is stored and handled. Nothing in this article is medical advice.