Postpartum OCD Is Real and We Need to Talk About It | SELF

It’s normal to worry about your baby, I assured myself as I stood in the dark, hand resting on my sleeping baby, carefully counting the rise and fall of her chest in sets of five. I was exhausted and on edge. According to the superstitious creature in my otherwise rational mind, my precious baby might perish while I slept, and it would be all my fault if I didn’t check her breathing.

I envisioned the fallout vividly: walking to the crib to find her cold, the futile attempts to wake her, the screaming, the agony, and the unbearable act of breaking the news to loved ones. After several minutes, the creature temporarily appeased, I stumbled back to bed only to rise minutes later and do it all again.

It wasn’t normal worry. The realization dawned gradually after weeks of around the clock counting of breaths, checking of locks and stove knobs, knocking on wood, and other seemingly necessary rituals, all of which made leaving home with my baby an ordeal of epic proportions. I mostly avoided going out, trapped in the prison inside my head.

Checking and counting are just two of many types of compulsions, the C in OCD, which stands for Obsessive Compulsive Disorder. Performing the compulsion temporarily relieves distress from the obsessive thought, the O in OCD—in my case, horrific images of harm coming to my daughter. Despite common stereotypes, the disorder is not a cute, “I’m so OCD about cleaning my kitchen” quirk. It’s a miserable, vicious cycle. OCD is a chronic or long-term anxiety disorder that ebbs and flows with life’s challenges. It’s thought to affect 1-2 percent of the U.S. population, according to the National Institute of Mental Health (NIMH).

While not causal, stressful life events can trigger or worsen symptoms in those predisposed to OCD, according to the Anxiety and Depression Association of America (ADAA). For me, the birth of my daughter, whom I love as unfathomably as any parent loves her child, was a major trigger. In retrospect, I suspect I’ve had OCD since my teenage years, but never as intensely as in the months following new motherhood. I started medication for anxiety following the birth of my daughter in 2011, but I didn’t receive an official OCD diagnosis until 2014, nearly a year after my son was born. Jenny Yip, Psy.D., a clinical psychologist, institutional member of the International OCD Foundation, and a mother who suffered a flare of her own OCD symptoms postpartum, tells SELF that “OCD thrives on what you care about in the moment, so it makes sense that new mothers and fathers could experience the overwhelming, excessive fears that occur with OCD.”

There are a lot of studies on OCD, but there is little data on postpartum OCD, which is an unofficial term for OCD that manifests, in both moms and dads, during the postpartum period. Experts “think that many people with postpartum depression also have OCD but they don’t want to talk about their obsessional thoughts because of fear associated with them,” Jonathan Abramowitz, Ph.D., professor of psychology and neuroscience at University of North Carolina at Chapel Hill and Editor-in-Chief, Journal of Obsessive-Compulsive and Related Disorders, tells SELF. “We don’t know the exact prevalence, but it’s definitely under-diagnosed and under-recognized.”

Worrying about your child is normal, especially during the postpartum period. “It’s even normal to have all sorts of strange and very unpleasant thoughts,” says Dr. Abramowitz. “Most people recognize these kinds of thoughts are senseless”—he calls them “brain farts”—and just move on. So how can a parent tell if worries are excessive? “[A]sk yourself these questions,” says Dr. Yip. “Are you doing more than what most parents would be doing? Are your family members noticing your fears and worries?”

Everyone double checks things sometimes, but according to the National Institute of Mental Health, people with OCD can’t control their thoughts and behaviors, spend more than an hour a day performing compulsions, derive temporary relief but no enjoyment from the compulsions, and experience significant problems in daily life due to the disorder. If you spend hours sanitizing, checking, avoiding activities, or engaging in other rituals at the expense of sleep or time with your baby, you may have OCD.

Like others with OCD, new parents suffering from the disorder can benefit from psychotherapy, medication, or a combination of the two. Cognitive behavioral therapy (CBT), a type of psychotherapy that trains the mind to react differently to intrusive thoughts, and a class of medications known as selective serotonin reuptake inhibitors (SSRIs), are the recommended first-line treatments for OCD. Drs. Abramowitz and Yip advise consulting with your doctor if you’re breastfeeding and considering an SSRI. In my case, my doctor and I decided that the benefit of taking an antidepressant while breastfeeding far outweighed any risk to each of my children.

Untreated OCD was a horrible way to live. My kids are now six and four, and the superstitious creature still lives in my mind and occasionally rears its head. The medication I started in 2011 helped dampen my symptoms, and regular CBT sessions since my diagnosis in 2014 have armed me with tools to keep them at bay. I learned to recognize the underlying cognitive distortions spurring OCD thought patterns, like a sense of inflated responsibility—the belief that I could cause or prevent negative outcomes simply by performing irrational rituals or being “extra careful.”

Rather than give in to compulsions, my therapist taught me to tolerate temporary distress in favor of long-term wellness. So, despite how uncomfortable I may be while fighting the urge to check the locks tens of times in multiples of five throughout the night, it allows me to recognize the following morning that—despite ignoring the impulse—my loved ones didn’t burn alive overnight. These realizations reshaped the way I think and act, freeing me from the prison in my mind.

If you suspect you have postpartum OCD, don’t hesitate to see a medical professional. “It’s important to remember that the postpartum period is also about self-care,” says Dr. Yip. “You can only help your baby the most if you’ve taken care of yourself, too.”


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