World of Postpartum OCD

We thank our partners at UCSF for helping us understand this phenomena. 

Postpartum obsessive-compulsive disorder (OCD) is the most misunderstood and misdiagnosed of the perinatal mood and anxiety disorders (PMADs).

About 15 to 20 percent of women experience PMAD, and perinatal depression is the most common. (The term “perinatal” includes pregnancy through postpartum.) However, 3-5% of new mothers and some new fathers experience symptoms of perinatal OCD. 

Symptoms of postpartum OCD include obsessive thinking; repetitive, intrusive images and thoughts that persist and seem to come “out of the blue”; and compulsive behaviors such as washing the same load of clothes four times or frequently checking the baby’s breathing. There is also usually a fear of being left alone with the baby. And many women with postpartum OCD have an understanding that their thoughts are unwanted and unreasonable.

Some women with postpartum OCD have more “classic” OCD symptoms associated with compulsive cleaning, checking, or having things in order. Others suffer from intrusive “what if” obsessions (what if I drop the baby? What if I accidentally stab her while I’m cutting fruit?). Some experience both.

Like most mental health conditions, there is no one exact cause of postpartum OCD. Its onset has a lot to do with the woman’s mental health history and other elements in her life.

Sudden and drastic decreases in hormones after giving birth may contribute to certain postpartum OCD symptoms. These changes, combined with chronic fatigue and overwhelming feelings as they care for the new baby, can lead many women to develop severe anxiety that evolves into OCD.

Here are some possible risk factors of developing postpartum OCD:

  • A history of OCD at other times in life
  • Unmet expectations regarding motherhood that cause negative thoughts and self-doubt

Many women who had ongoing OCD before childbirth find that having a baby worsens their symptoms, as a new baby provides more uncertainties and responsibilities that can aggravate intrusive and anxious thoughts.

Postpartum OCD in men doesn’t share the same biological causes as postpartum OCD in women. Therefore, it is believed that a big contributing factor to developing postpartum OCD is the natural fear and anxiety that comes with the pressure and responsibility of caring for an infant.

Postpartum OCD treatment is available to new mothers and fathers struggling with this terrible condition. Treatment options usually combine medication and therapy in order to fully manage symptoms and help the person cope.

Cognitive Behavioral Therapy (CBT) and other forms of psychotherapy help people work through their intrusive thoughts in a safe and non-judgemental environment. Psychologists, psychiatrists and other mental health professionals are trained to understand mental health issues and teach coping skills to improve the quality of life.

Physicians and psychiatrists will likely also suggest a course of medications such as antidepressants, specifically SSRIs. Antipsychotic medications may also stop obsessive and compulsive thoughts from taking over the mind. Anti-anxiety medications called benzodiazepines are also effective at immediately providing relief from the nervous energy and fears associated with postpartum OCD symptoms.

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