Understanding Postpartum OCD and Scary Intrusive Thoughts

by

Postpartum OCD and scary intrusive thoughts

There has been an increase in awareness about Postpartum Depression in recent years, and a growing awareness of Postpartum Anxiety, but women who experience Postpartum OCD often suffer silently and don’t talk about their experiences because their thoughts are often shrouded in shame and fear of harming their baby.

Postpartum Obsessional Compulsive Disorder (OCD) is a subset of postpartum anxiety disorders,  and includes a range of intrusive thoughts and compulsions. Unlike general postpartum anxiety, which can manifest as pervasive worrying, postpartum OCD is characterized by obsessive repetitive, unwanted and often distressing thoughts, often accompanied by compulsions – repetitive behaviors that one feels the urge to perform in response to an obsessive thought.

Ninety-one percent of new moms report having scary, intrusive thoughts about harm to their baby or themselves sometimes, but studies about the prevalence of Postpartum OCD suggests that only between 1.7% to 7.0% of new moms have them to the extent it can be diagnosed as Postpartum OCD. These rates vary so much due to the limited studies that are available and also, because women tend not to talk about these types of symptoms for fear of judgement or that their child will be taken away from them, I think the actual rate of occurrence is much higher.

With Postpartum OCD, the intrusive thoughts can take on various forms, often revolving around a new mother’s ability to care for her child. Common themes include fears of accidentally harming the baby, images of the baby or oneself in dangerous, negative or even sexual situations, and there are often preoccupations with cleanliness and orderliness to the point of obsession. These thoughts are extremely at odds with a new mother’s true beliefs and are highly distressing but women are scared to let anyone know what is happening to them.

In my 25 years of working with new moms I have met so many women who are scared and ashamed about the intrusive thoughts they are having, not knowing that they are experiencing a treatable mental health condition, and it is not happening because they are a bad mother.  I am passionate about bringing more awareness about this condition and this blog aims to provide a comprehensive understanding of postpartum OCD, including details on OCD symptoms, potential risk factors, and treatment options available.

Recognizing Postpartum OCD Symptoms

Postpartum OCD presents as a subtype of the better-known obsessive-compulsive disorder. As the name suggests, it specifically affects women during the postpartum period, which is the first 12 months following the birth of a child. Women suffering from this condition may experience debilitating obsessional thoughts, as well as compulsive behaviors stemming from these thoughts. The obsessions are most commonly centered around the infant’s well-being, along with an intense fear of unintentionally harming their child. These intrusive thoughts can be extremely distressing to the new mother, and they often lead to excessive worry, guilt, and shame.

Compulsive behaviors often accompany obsessions, as the mother tries to ease her anxiety and protect her child. These behaviors may include washing their hands excessively, checking the baby’s room or crib multiple times, or being overly cautious when handling the baby. These compulsions may provide temporary relief, but they ultimately contribute to a vicious cycle of anxiety and further obsessions.

Knowledge is essential when it comes to identifying the symptoms of postpartum obsessional compulsive disorder (OCD). The primary feature of this mental health condition is the presence of intrusive, unwelcome thoughts surrounding the newborn’s safety and well-being. These obsessions can manifest in various ways, such as constant worry over accidentally dropping the baby or even more disturbing thoughts, like fearing that one might intentionally cause harm to the infant. While it is essential to emphasize that these thoughts are irrational and not reflective of the new mother’s intentions, they can still cause significant distress and guilt.

Along with these obsessions, postpartum OCD often involves performing compulsive behaviors to alleviate the anxiety triggered by intrusive thoughts. These compulsions can take several forms, including but not limited to:

  1. Excessive handwashing or cleaning to prevent the baby from being exposed to germs or illnesses.
  2. Repeatedly checking on the baby’s safety, such as ensuring the crib is properly set up, or checking on the baby’s breathing multiple times throughout the night.
  3. Seeking constant reassurance from others that the baby is safe and well.
  4. Avoidance behaviors, such as refusing to be left alone with the baby or withdrawing from daily life and social interactions.

Risk Factors for Postpartum OCD

Identifying who may be at risk of developing postpartum OCD is not an exact science, as the condition can affect women of various backgrounds and lifestyles. However, certain factors can contribute to a woman’s likelihood of developing the disorder. Some of these risk factors may include a personal or family history of anxiety, depression, or OCD, as well as hormonal imbalances caused by the rapid shift in hormone levels after childbirth.

While any new mother can potentially develop postpartum OCD, there are specific risk factors that may increase the likelihood of the condition. Being aware of these factors can help both the mother and those around her recognize possible warning signs, and support the mother in seeking professional assistance. Key risk factors for postpartum OCD include:

  1. Personal or family history of mental health disorders: Women with a history of anxiety disorders or OCD, either themselves or within their family, may have a heightened risk for developing postpartum OCD.
  2. Hormonal changes: The postpartum period is characterized by rapid shifts in hormone levels, which can contribute to the development of mood and anxiety disorders, including OCD.
  3. Stressful life events: The presence of external stress factors, such as a traumatic childbirth experience or difficulties in managing new motherhood, can exacerbate the risk of postpartum OCD.
  4. Previous perinatal loss: Women who have experienced miscarriages, stillbirths, or other forms of perinatal loss in the past may be more prone to postpartum OCD due to the heightened anxieties surrounding their new baby’s well-being.

Treatment Options for Postpartum OCD

For women suffering from postpartum OCD, multiple treatment options are available to suit each individual’s specific needs. Choosing the right course of action often comes down to personal preferences and the severity of the disorder. Here are some common treatment options:

  1. Cognitive-Behavioral Therapy (CBT): This form of psychotherapy has proven highly effective in treating OCD, including postpartum OCD. CBT focuses on recognizing and challenging irrational thought patterns, allowing individuals to regain control of their fears and anxieties.
  2. Exposure and Response Prevention (ERP): A specialized CBT technique, ERP involves gradual and controlled exposure to anxiety-inducing thoughts or situations, while simultaneously resisting the urge to carry out compulsive behaviors.
  3. Medication: Depending on the severity of the disorder, medication, such as selective serotonin reuptake inhibitors (SSRIs), may be prescribed by a healthcare professional. Medication can be an effective way to manage the symptoms of postpartum OCD and can be used as part of a larger treatment plan that include therapy.
  4. Support groups: Connecting with other women experiencing similar difficulties can offer both emotional support and practical advice in dealing with postpartum OCD.

Resilience and Hope for the Future

Recovering from postpartum OCD may seem challenging at times, but it is essential to remember that hope and resilience can pave the way to a healthy future. With the right support, understanding the condition’s symptoms, risk factors, and treatment options, women suffering from postpartum OCD can regain control of their lives, build a strong bond with their newborn, and enjoy motherhood more. Postpartum obsessional compulsive disorder is a reality that many new mothers face, often silently. By shedding light on this mental health condition, increasing awareness, and providing support, we can play a crucial role in helping affected women seek the help and care they deserve. No mother should suffer in silence – please reach out if you or a loved one are experiencing symptoms of postpartum OCD.

No article would be complete without mentioning the best book I have ever read about Postpartum Scary Intrusive Thoughts. It is called Good Moms Have Scary Thoughts by Karen Klein. It is available from Amazon.

Dr. Sarah Allen

Dr. Sarah Allen has 25+ years of experience in private practice helping women to transition to being the mom they want to be. She is the Founding Director of the statewide non-profit Postpartum Depression Alliance of IL. She also specializes in pregnancy loss & infertility & has published research on postpartum depression and traumatic childbirth.

If you would like to work with Sarah, please phone her at 847 791-7722 or on the form below.

If you would like to read more about me and my areas of specialty,  please visit Dr. Sarah Allen Bio. Dr. Allen’s professional license only allows her to work with clients who live in IL & FL & the UK and unfortunately does not allow her to give personalized advice via email to people who are not her clients. 

Dr. Allen sees clients in person in her Northbrook, IL office or remotely via video or phone.

    What Can I Read That Helps Me While I Am Waiting For My First Appointment With Sarah?

    If you feel that you may be experiencing pregnancy or postpartum mood disorder, or worry that you may be at risk of developing it, please download my free booklets below.

    See each specific webpage to download one or many.

    As featured in

    Warm & Knowledgeable.

    I highly recommend Dr. Allen! She is warm and so easy to talk to. She has lots of knowledge about women’s health.

    Kathryn Gardner, LCSW

    Excellent Therapist!

    Dr. Allen is a colleague of mine and she is an excellent therapist. She is warm, caring, and exceptional at her work. I refer clients to Dr. Allen and I highly recommend her if you are looking for a top notch therapist.

    Jodi Petchenik, LCSW

    Sarah Transformed Our Family’s Sleep and Sanity

    My baby didn’t sleep. She wouldn’t sleep more than a couple of hours at night and no more than 30 minutes during the day. I was completely overwhelmed and my husband and I were at each other’s throats. I was supposed to be going back to work but was barely functioning. Sarah helped us to learn how to get our baby sleeping and then she supported me in my transition back to work. She also helped my husband and I navigate how to share childcare and running the house fairly. She is a very knowledgeable therapist and has really helped us.

    Pam. L.

    Dr. Allen Helped Me to Feel More Empowered

    Dr. Allen has really helped me find my own voice. When I began therapy I would swing between being passive and doing whatever other people wanted me to do to being angry and frustrated. I have been on antidepressants for quite a few years but it wasn’t really working. Through therapy I have learned to listen to my own needs and to speak up. I used to worry that people wouldn’t like me if I didn’t agree with them but when Dr. Allen gave me the support I needed I challenged my fears. I spend a lot less time feeling angry and depressed now and I have really widened my social network. This is how I have always wanted to be but didn’t know how to get there. Dr. Allen has a very reassuring manner and makes you challenge yourself but by using small steps so you feel ready to do it. I have really come out of my shell and would recommend anyone who is feeling depressed to come and talk with her.

    Rebecca F.

    Trusted & Knowledgeable Therapist.

    When I need to refer any of my patients for talk therapy I immediately think of Dr. Allen as she is wonderful at helping people with severe and complex issues really get to the root of their problems. She is very caring and knowledgeable and I have found her extensive experience really helps people to change their lives for the better.

    Dr. Teresa Poprawski

    Dr. Allen is an expert in treating perinatal mood disorders.

    I refer as many patients as I can to Dr. Allen. She is an expert in treating perinatal mood disorders, and a well-trained and experienced therapist who is committed to working with her clients to develop a treatment plan designed for each individual. She exhibits genuine warmth, kindness and compassion for each of her clients. Dr. Allen has been a colleague of mine for more than 20 years, and I have great confidence when I refer patients to her.

    Leslie Lowell Stoutenburg

    I become empowered and a happier person.

    I began seeing Dr. Allen when my first child was around a year old. I had experienced a very traumatic birth, after a difficult pregnancy where I was on bed rest for a good portion of the time. The first year of my son’s life was spent worrying constantly. I also experienced flashbacks to the birth, which was an emergency C-section under general anesthesia. My son was in the NICU for several days following his birth, and I was not given very much information as to why. I remember thinking that he would die, or that something awful was going to happen.

    I experienced a great deal of anxiety that first year, and I thought that it was due to being a new mom. I wasn’t sleeping, I wasn’t eating as normal, and I remember being worried about leaving the house or taking my baby with me anywhere. I worried constantly about illness, germs, etc.

    The first day that I saw Dr. Allen, she gave me some questionnaires to fill out before we started talking. Then we sat down and talked about my experiences with my son’s birth and the early days of his life, and the year or so since then. I remember to this day the relief that I felt when she looked at me and said that I had PPD and PTSD, which was a result of the trauma I experienced during and immediately after the birth of my son. She explained how my brain had reacted to the stress of these events, and related it to why I was feeling the way that I felt. It made so much sense. Then, she described ways that I could get over the trauma, work through the feelings, and recover from PTSD and PPD. I felt so empowered, and so happy that the way I felt had a name, and that it was treatable. It also made me feel so validated in the ways that I had felt and reacted following my son’s birth. I wasn’t going crazy. My reaction was normal and natural. And with the help of Dr. Allen, and the type of therapy that she uses, I knew I could recover.

    It is over five years since that first visit with Dr. Allen, and I still use the tools that she taught me today to deal with stress. I credit her with helping me to become a more empowered, happier person.

    Elizabeth

    Overcoming PPD with Dr. Sarah’s Support

    When I had my first baby I had what I now know was postpartum depression but I didn’t get any help. It did go away after about 18mths but it was a miserable way to begin motherhood.  When I was pregnant with my second child I started to become depressed again and this time told my OB/GYN how I was feeling and she referred me to Sarah. By starting to deal with how I felt and change the way I was handling the stresses in my life, I was in a much better place when my baby was born. The second time round my PPD was much less severe and didn’t last as long. 

    Sarah was also really helpful in teaching me ways to make the transition of becoming a big sister easier for my oldest one too.   My husband came with me for some sessions and that really helped our relationship and we started working on parenting issues together.  Sarah’s counsel and support really helped our family transition to the good place we are all in today.

    Sarah C.

    Share:

    If you are thinking about getting counseling and you’d like to talk to someone about the things that are troubling you, I am happy to help.