What Is Postpartum OCD? This Anxiety Disorder Can Be Really Scary For New Moms
Obsessive-compulsive disorder has a simplistic and incorrect reputation; it's often seen as the need for things to be neat, rather than the serious mental issue it actually is. People with OCD cope with intrusive, obsessive thoughts, often about harm coming to themselves or others, by developing ritualistic compulsive behaviors to prevent the harm. But one aspect of OCD often flies under the radar: the phenomenon of postpartum OCD, which appears in women shortly after giving birth, and can be deeply debilitating. Bustle spoke with a woman who has been diagnosed with postpartum OCD, and her experience shows a disorder that's often hidden and misunderstood.
Postpartum OCD can emerge at any point in the first two to three months after giving birth, according to the OCD Center of Los Angeles. In a review of postpartum OCD studies from the 1950s to the modern day, researchers in the Journal of Obstetric, Gynecologic & Neonatal Nursing in 2011 pointed out that most of the attention paid by scientists and medical professionals to postpartum psychiatric conditions has focussed on postpartum depression. And while that's a serious issue, postpartum OCD has the potential to be just as distressing. The 2011 review found that 4 percent of women in one postpartum study had developed serious OCD symptoms, despite never experiencing clinical OCD before, and 34.1 percent of women who had OCD before they got pregnant reported that their symptoms worsened after giving birth. So what's going on here, and how can women experiencing symptoms get help?
The Realities Of Postpartum OCD
The overwhelming defining symptom of postpartum OCD, according to the OCD Center of Los Angeles, is incredibly distressing thoughts about one's new infant. Their list includes "horrifying, intrusive thoughts of stabbing or suffocating a newborn child; unwanted images of throwing or dropping a baby; disturbing thoughts of sexually abusing a child; fear of accidentally harming a child through carelessness; intrusive thoughts of accidentally harming the fetus or child by exposure to medications, environmental toxins, germs, chemicals, or certain foods", and other terrors revolving around accidental or intentional harm. (If you want to know more about intrusive thoughts, IntrusiveThoughts.org has the rundown.)
People with "regular" OCD will recognize these intrusive thoughts by their type, if not their content. OCD is an anxiety disorder, and the anxiety response of the body in OCD is worked to fever pitch by unwanted and extremely upsetting thoughts that sufferers will do virtually anything to banish. A case study of postpartum OCD in 1999 suggested that "postpartum OCD may be a distinct clinical entity with features that include early postpartum onset; repetitive, intrusive thoughts about harming the baby; avoidant behavior; anxiety; panic attacks; secondary depression; and disruption of the mother-infant relationship."
"Having lived with Pure OCD since I was just a little girl," Jordaine Chattaway tells Bustle, "postpartum OCD was always a risk for me. For parents, harm obsessions and sexual obsessions are especially common in Postpartum OCD. For me, despite spending my entire pregnancy and a good three weeks post-baby (and the trauma of giving birth) in a blissful baby bubble, all it took was a single sleep-deprived intrusive thought to sucker-punch me and boom, I was on the floor crying."
Figuring out how common postpartum OCD might be is difficult, because women who experience thoughts of harming their children are often, understandably, not willing to disclose them, even to medical professionals. But it may be more common than you'd think; in a study of 400 women who had given birth in 2009, 39 percent met the criteria for postpartum OCD.
Certain factors, doctors have discovered, seem to raise the likelihood of developing postpartum OCD symptoms. It's more common after first children than after subsequent births, and it's more likely if you've had previous psychiatric disorders (particularly anxiety), had significant complications during pregnancy or delivery, and experience postpartum depression.
Some theorists believe that, particularly for first infants, some women (and men) may become overwhelmed with the idea of their responsibility and the helplessness of their babies, experience extreme stress, and begin to see threats everywhere. Protective behavior for babies is a good evolutionary strategy, but when someone has postpartum OCD, the impulse becomes more stressful than helpful. The organization OCD UK explains:
"During pregnancy women will read and hear many guidelines encouraging them to be more careful about their diet and behaviour, and frequent messages about the safety of various activities for their baby in the short- and longterm. Most women become a lot more concerned about protecting their baby and about how their actions can impact on their unborn child. It is also a time of increased stress, major physical change and transition to a new role which can increase vulnerability to developing difficulties."
"For mothers and fathers," Chattaway says, "a new baby is the most precious gift in the world. A parent's obsessive intrusive thoughts about harming their baby or harm coming to their baby [are] the flip side of their core value: protecting their child. OCD takes that primal love and protection and attacks it. Unfortunately, many parents are too afraid to speak up about their situation for fear of judgement, ridicule or worse." It's no accident that the compulsive behaviors associated with postpartum OCD are often related to hygiene and health, like refusing to use certain foods in case of poisoning or obsessively cleaning surfaces. Other symptoms include aggression towards people who "might harm" the baby and repeated reassurance-seeking from others that the baby's OK.
The Consequences Of Postpartum OCD
Many people, Chattaway says, "suffer in silence" with postpartum OCD. While she immediately was able to diagnose herself, thanks to her own years of experience with OCD, others haven't been so lucky. After she talked about her postpartum OCD publicly on HuffPost, she tells Bustle, she "had people reach out to me from around the world. What surprised me the most was that I also had some friends reach out to me to share that they had experienced the exact same thing. Most of these people had never spoken to anyone about it primarily because they had not experienced OCD prior to having a baby." Lack of education, and misconceptions about what postpartum OCD actually is, are causing parents to suffer without getting proper treatment.
Postpartum OCD can have potentially damaging consequences for both the sufferer and their relationship with their child. In a study of seven women with postpartum OCD in 1999, none of the women acted on any of their intrusive thoughts, but five reported "dysfunctional" mother-child relationships because of their disorder. Some found it difficult to let their child participate in activities with others, others took them to the doctor frequently, and some refused absolutely to let anybody except themselves hold the baby; others avoided their child altogether.
"For sufferers of postpartum OCD," Chattaway says, "the guilt and misunderstandings of one's own condition can lead to a excruciating feeling of isolation and heartbreak." People need to know, she tells Bustle, "that it is okay and incredibly common. Don't be afraid to seek help."
The good news is that, if diagnosis is done properly, there are good treatment options. A conventional OCD therapy known as "exposure and response prevention," in which people are exposed to the things that trigger their obsessive thoughts and shown how to modulate their fear responses, has been shown to be helpful. It's often treated with cognitive behavioral therapy and antidepressants, too. "It's a really important message to anyone suffering with OCD to hear," Chattaway says, that "a diagnosis of OCD does not equal a life of misery."