While many of us have heard of the baby blues and Postpartum Depression (PPD), there are other mental health challenges that women can face after birth. For more information, check out our blog “The Difference Between Baby Blues and Postpartum Depression.”
One of the lesser known mental health disorders women experience after birth is Postpartum Obsessive Compulsive Disorder (OCD). Postpartum OCD is similar to OCD that any other child, teen, adult, or senior citizen else can experience, but it also involves thoughts and behaviors specifically about your newborn baby.
You do not have to struggle with Postpartum OCD on your own. If you believe you are struggling from Postpartum OCD, it is recommended to seek the support of an OCD specialist as soon as possible so you can get the professional care you deserve.
Anchor Therapy is a counseling center in Hoboken, NJ with mental health therapists specialized in helping children, teens, adults, couples, and families with anxiety, depression, relationship issues, trauma, life transitions, and more. Anchor Therapy is accepting new clients and is now providing in-person sessions and teletherapy sessions to residents of New Jersey, New York, and Florida.
What are the symptoms of perinatal OCD?
OCD is a type of anxiety disorder. Perinatal OCD is when you experience OCD during pregnancy or a year within giving birth.
As with a standard OCD diagnosis, obsessions and compulsions are a part of the disorder.
An obsession is a thought, feeling, image, urge, worries, and/or doubts that repeatedly come to your mind. It may feel like your mind is on loop and you cannot stop thinking about it no matter how hard you try. You may try to make meaning out of your obsessions or wonder why they will not go away. These obsessions can cause a lot of distress.
Here are some examples of perinatal obsessions:
Afraid of making the wrong decision (e.g., seeking medical treatment)
Disturbing thoughts of abusing your child
Intrusive thoughts about harming your baby (either during or after pregnancy)
Fear of being responsible for getting your baby sick
For more information, read our blog “How to Manage OCD Intrusive Thoughts with CBT.”
A compulsion is repetitive behaviors you do in an attempt to lessen your distress or anxiety caused by your obsessions. Compulsions are physical things you do, such as checking that you turned your oven off seven times. But, they can also be things you do in your head, like saying a specific word or phrase to yourself. You may even involve other people in your compulsions, like asking a family member for reassurance.
Here are some examples of perinatal compulsions:
Washing your baby’s clothes, bottles, and/or toys too much
Constantly checking your baby (e.g., waking them up from a nap to make sure they are okay)
Asking people around you for parenting reassurance
Keeping your baby away from other people in case they hurt them
Going over the day’s events to make sure you have not hurt your baby
For more information, check out our blog “How Counseling Can Help You Break OCD Habits.”
While pregnant or after giving birth, it is normal to worry about your baby. You want to protect your baby, and you want the best for your child and yourself. However, if obsessive thoughts and compulsive behaviors are negatively impacting your daily life, it may be a sign of perinatal OCD. If that is the case, it is likely that the obsessions and thoughts you are experiencing are related to motherhood and your baby.
It can be hard to open up about your obsessions and compulsions, but it is necessary for receiving OCD treatment.
Does pregnancy trigger OCD?
In some cases, pregnancy can trigger OCD. If you were already diagnosed with OCD prior to pregnancy, your OCD symptoms may worsen throughout pregnancy and possibly after birth. According to the National Institutes of Health, 40% of childbearing OCD clients experienced the onset of OCD during pregnancy and 30% in the postpartum period.
There are some factors that make getting OCD more possible, such as:
Being a first-time mother
Having a family member with OCD
Having had OCD before
Hormonal factors
The severity of perinatal OCD varies from person-to-person. Some women experience OCD symptom improvement during pregnancy and after birth. For other women, they see no difference in the quality of their symptoms throughout this life transition. If perinatal OCD is left untreated, it can continue.
What are intrusive thoughts after birth?
It is extremely common for new mothers to experience intrusive thoughts and anxiety after having a child. Intrusive thoughts and protective behaviors can actually be adaptive in protecting your baby from potential harm.
For most women, the anxiety is temporary and it does not interfere with their ability to parent, work, and continue with everyday life. On the other hand, some mothers experience Postpartum OCD which comes along with more significant symptoms.
Research has shown that roughly 34% to 65% of postpartum mothers have anxious thoughts which are considered “normal” for new parents given the life transition they have just gone through.
Postpartum OCD symptoms can sometimes be confused with anxiety and/or depression. For further clarification, take our Anxiety Quiz and Depression Quiz.
Some people may even confuse Postpartum OCD with ‘mom brain.’ ‘Mom brain’ is a term that was created to describe the cognitive changes that occur for a new mom during pregnancy or after giving birth.
‘Mom brain’ is not a clinical diagnosis, but it is a phenomenon that many women experience during this phase of their life.
Here are some common signs of ‘mom brain’:
Mental fog
Disorganization
Short-term memory loss
Enhanced anxiety
Forgetfulness
Hard time concentrating
Word-finding issues
Less mental sharpness
Multitasking concerns
A variety of factors typically trigger ‘mom brain’, like:
A lack of sleep (Read “How CBT Can Help With Your Insomnia”)
Stress (Check out our blog “Everything You Need to Know About Stress Management Therapy”)
Hormonal changes
The new demands of motherhood (Our blog “Your Guide to Self-Care As A Parent” is a must-read)
‘Mom brain’ typically improves on its own as mothers get a sense of their new role and the routine that comes along with having a child.
Is Postpartum OCD temporary?
The severity of OCD symptoms can change throughout the course of pregnancy and even after giving birth. You may have periods of time where your OCD feels very manageable and then other times it may be interfering with your ability to complete daily tasks. Even though your OCD may improve at times, it is unlikely that Postpartum OCD will go away completely on its own.
Luckily, Postpartum OCD is temporary and it is very treatable with the help of a professional OCD therapist at Anchor Therapy.
What is the best therapy for OCD?
Generally speaking, Postpartum OCD is treated in the same way as standard OCD. Obviously, an OCD counselor will make OCD treatment adjustments to account for factors in a postpartum context.
Here are some therapy modalities used to treat Postpartum OCD:
Cognitive Behavioral Therapy (CBT)
One successful type of therapy used to treat OCD is Cognitive Behavioral Therapy (CBT). CBT therapy for Postpartum OCD focuses on identifying and changing negative thought patterns and behaviors.
In CBT for OCD, an OCD therapist will first educate you on OCD, the causes of the disorder, the patterns of intrusive thoughts and compulsions, and the benefits of CBT counseling.
In order for a mother to understand or even take notice of automatic, intrusive thoughts, she may be encouraged to keep a journal. In this journal, you can jot down intrusive thoughts and compulsive behaviors you may be experiencing. For instance, you may have intrusive thoughts about your baby being harmed which leads you to check-in on your baby excessively.
Here’s an example of CBT in action for Postpartum OCD:
Intrusive thought: “If I do not check on my baby every five minutes, something horrible is going to happen to him.”
Challenge the thought: A CBT therapist may question the above statement by asking thought-provoking questions, such as “What evidence is there that checking every 5 minutes prevents harm?”.
Alternative thought: “My baby is safe. Checking on my son less frequently will not cause him any harm.”
2. Exposure and Response Prevention (ERP) Therapy
Exposure and Response Prevention (ERP) Therapy is often referred to as the gold standard treatment for OCD. ERP for OCD is actually a form of CBT where you are gradually exposed to your fears while you learn to resist engaging in compulsive behaviors. This helps you challenge and change your irrational thoughts as well.
In ERP therapy for OCD, you are exposed to the source of your anxiety. Going off of our example in the previous section about CBT for Postpartum OCD, your OCD therapist may encourage you to increase the amount of time that passes between checking in on your baby.
Maybe you start from five minutes, work your way up to 10 and so on. During this waiting period, you will refrain from doing a compulsion even though it enhances your anxiety levels. Your exposure therapist for OCD will teach you tools to help manage your distress during this time.
3. Mindfulness-Based Cognitive Therapy (MBCT)
Mindfulness-Based Cognitive Therapy, also referred to as MBCT, combines mindfulness and cognitive therapy. By undergoing MBCT for Postpartum OCD, you will learn to be aware of your thoughts and emotions with no judgment attached. By removing judgment, you can actually lessen the impact of your intrusive thoughts and compulsive behaviors.
The core of MBCT involves mindfulness practices.
Present moment awareness and the removal of judgment of your thoughts and emotions can be done through the following mindfulness exercises for example:
Mindful movement - Yoga, walking, and even paying attention to your bodily sensations are great mindfulness techniques. For more information, read “5 Ways Exercise Benefits Your Mental Health.”
Body scan meditation - Focus on different parts of your body, simply noticing sensations without trying to alter how you feel. Read “How Meditation Can Lead to Stress Reduction” for more information on the different types of meditation that exist.
Breathing exercises - Breathwork can be an incredible tool for noticing thoughts and bringing your attention back to your breath. Our blog “5 Breathwork Techniques to Decrease Anxiety” is a must-read.
For more information, check out our past blog “Everything You Need to Know About Mindfulness-Based Cognitive Therapy (MBCT).”
4. Acceptance and Commitment (ACT) Therapy
Acceptance and Commitment (ACT) Therapy can be used to treat Postpartum OCD. ACT therapy for OCD focuses on accepting negative thoughts and feelings instead of trying to fight them off to your detriment. Additionally, you will engage in behavior changes that align with your values.
As a new mom, ACT will teach you how to accept your intrusive thoughts and feelings without trying to change or avoid them. By doing so, the power and impact of your thoughts lessen.
Let us say that you have the intrusive thought of “I might accidentally hurt my baby.” By practicing acceptance, you will come to realize “This is an automatic thought from my mind that does not require action.” You do not have to forcefully try to push this thought away.
Defusion is a popular therapy technique used in ACT for Postpartum OCD. Defusion refers to tools used to create space between you and your thoughts. Just because you think it, does not mean that it is true. Your intrusive thoughts and/or obsessions are just words and images.
If you start thinking “I am a horrible mother if I am not always home with my baby.” You could simply say “I am having the thought that I am a horrible mother if I leave my baby at home with a trusted caregiver.” You could even sing your initial uncomfortable thoughts which helps you see the thought as separate from yourself.
ACT also gives you the chance to explore your values as a new mother. Perhaps this gives you a chance to explore motherhood and your personal well-being on a deeper level. You can discuss what kind of mother you want to be and choose actions that align with that even when intrusive thoughts are coming up. For guidance, read “6 Ways to Handle Intrusive Thoughts.”
A primary objective of ACT is aligning your values and actions. For instance, even though you may be having an intrusive thought about harming your baby, you can instead choose to spend more time with your child. You will then be focusing on nurturing your relationship with your baby to exhibit your values as a loving mother.
After childbirth, you may find yourself worrying all the time. These thoughts may occur frequently and even get worse. Postpartum OCD treatment is available if you are struggling.
Victoria Scala
is the Social Media Manager and Intake Coordinator at Anchor Therapy in Hoboken, New Jersey. She is a graduate of the Honors College of Rutgers University-Newark. In her roles, Victoria is committed to managing the office’s social media presence and prioritizing clients' needs.
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