Postpartum OCD: Symptoms, Causes, and Treatment

It’s normal for new parents to fret about the health and well-being of their baby. However, if these thoughts become intrusive (unwelcome and involuntary) and begin to affect your functioning, you may be suffering from postpartum obsessive-compulsive disorder (pOCD). 

In about 2.5% of women and some men, OCD symptoms can become worse during pregnancy or childbirth. When this happens, it’s called postpartum OCD or perinatal OCD. Luckily, treatments such as cognitive behavioral therapy can help. 

This article discusses postpartum OCD, including OCD symptoms, treatments, and how to help a loved one with this condition. 

Asian mother and baby.

Asian mother and baby.

rudi_suardi/Getty Images


What Is Postpartum OCD?

Postpartum OCD is an obsessive-compulsive disorder that emerges in the year after a person gives birth. OCD symptoms can also emerge during pregnancy. This is known as perinatal OCD. These conditions are treated similarly and are collectively known as pOCD.

Like OCD, pOCD is characterized by these two sets of symptoms:

  • Obsessions are intrusive thoughts, impulses, or beliefs that cause distress.
  • Compulsions are actions and rituals undertaken to try to control, prevent, or avoid obsessions.

Examples of Postpartum OCD

Understanding the symptoms of postpartum OCD can help you identify if you or a loved one is dealing with pOCD. Here’s what the symptoms might look like. 

Obsessive Thoughts

Obsessions can include:

  • Fear of accidentally harming your baby
  • Worry or obsession that someone else has harmed the baby
  • Intrusive thoughts about the baby dying
  • Intrusive thoughts about shaking, drowning, or harming the baby, even when this horrifies you 
  • Worry about the baby getting sick
  • Fear that you put the baby somewhere dangerous or forgot the baby 
  • Worry about SIDS (sudden infant death syndrome, the unexplained death of a seemingly health infant during sleep)

Although obsessive thoughts can be disturbing, research shows that they are normal, and mothers with pOCD are extremely unlikely to harm their infants.

Compulsions

In order to deal with obsessions, people with pOCD develop compulsions. These can include:

  • Checking on the baby excessively
  • Insisting on having another adult present when you’re with the baby
  • Not allowing others to watch or hold the baby
  • Avoiding activities like bathing, carrying the baby on stairs, or leaving the house
  • Handwashing and sanitizing in excess 
  • Not sleeping for fear of something happening to the baby

Other Symptoms of Postpartum OCD

While obsession and compulsions are the main symptom sets of OCD, they can lead to other symptoms. You may:

  • Feel depressed
  • Question your ability to parent
  • Hide your symptoms for fear that someone will take you away from the baby
  • Have trouble caring for or bonding with your infant
  • Experience distress in other relationships, like with your spouse

Postpartum OCD vs. Postpartum Anxiety

Postpartum and perinatal mood disorders can be difficult to tell apart because there is a lot of overlap with conditions like postpartum anxiety, depression, and OCD. Because of this, the medical community thinks that pOCD is likely underdiagnosed. 

Postpartum OCD differs from postpartum anxiety because it features both obsessions and compulsions. Still, OCD can cause anxiety, and anxiety can fuel OCD. It’s possible to have more than one postpartum mood disorder at once.

Whenever you’re experiencing symptoms of a mood disorder in the postpartum or perinatal period, it’s best to talk with an experienced health professional who can get you an accurate diagnosis. 

Causes and Risk Factors

Healthcare providers don’t know what causes postpartum and perinatal mood disorders, including postpartum OCD. It’s believed that hormonal changes and lack of sleep play a role. Postpartum OCD is most common in the birthing parent, but partners who did not give birth can also experience pOCD. 

People who have previously been diagnosed with a mood disorder are at higher risk for developing pOCD. Between 25% and 75% of people with OCD will have a recurrence after they give birth.

In addition, pOCD also occurs alongside other mood disorders. More than 70% of people with pOCD also experience depression and more than 27% also experience an anxiety disorder. If you’re getting treatment for postpartum depression or anxiety, but still experience symptoms of OCD, talk with your healthcare provider about whether you might also have postpartum OCD. 

Treatment for Postpartum OCD

Treatment for pOCD is similar to treatment for OCD. Cognitive behavioral therapy (CBT) is the first-line treatment for postpartum OCD. During CBT sessions, you’ll learn that intrusive thoughts are normal and not dangerous. This allows you to change how you interpret your thoughts, and eventually change or eliminate your compulsive behaviors. 

In addition, medications known as serotonin reuptake inhibitors (SSRIs) can help control symptoms of OCD. These are safe for most pregnant and breastfeeding people, although you should talk to your healthcare provider about your specific circumstances. 

It’s important to get help for postpartum OCD as soon as possible. Postpartum OCD often comes on suddenly and can be severe. Taking medication and attending therapy—even with your baby in tow— can help you feel healthy again.

Summary

Postpartum OCD is an obsessive-compulsive disorder that emerges or worsens in the first year after giving birth. It can also emerge during pregnancy, which is known as perinatal OCD. The condition is characterized by intrusive thoughts, such as worrying about the baby’s safety, and compulsions, like watching the baby sleep. Therapy and medication can both help control symptoms. 

A Word From Verywell

Many new parents anticipate that bringing home a baby is going to be a time of great joy. When you or your partner experiences postpartum mood disorders like postpartum OCD, it can be devastating. Remember that these conditions are normal complications of childbirth. Ask for help. Treatments are available that will have you feeling back to normal in no time. 

Frequently Asked Questions

  • It’s normal for new parents to experience some obsessive or intrusive thoughts. However, if these last longer than two weeks or interfere with your ability to care for your baby, they are considered postpartum OCD. It’s unclear how long postpartum OCD lasts, but it’s important to get treatment as soon as possible. 

  • Yes, postpartum OCD is related to postpartum depression. These two conditions can coexist and make each other worse. If you’re dealing with a postpartum mood disorder, talk to your healthcare provider about all your symptoms. 

  • Postpartum OCD is characterized by obsessions and compulsions. You might have intrusive thoughts of violence, like seeing yourself shaking the baby, but you know these are wrong. Postpartum psychosis is much rarer. It’s characterized by hallucinations and delusions, where you truly believe things that are false. For example, someone with postpartum psychosis might believe their baby is possessed and must be harmed.

  • The best way to help a loved one with postpartum OCD is to connect them with an experienced mental health professional. Assuring them that everything will be fine or downplaying their obsessions can actually make matters worse. Remember, postpartum OCD is a medical condition that requires medical treatment.

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