A Brief Guide To Postpartum OCD

As a parent, you may occasionally get upsetting thoughts about your baby's health and safety or worry about them. These thoughts are normal. One study¹ found that up to 100% of new mothers reported unwanted, intrusive thoughts about infant-related harm.

However, if your intrusive thoughts become frequent and you engage in repetitive behaviors, you may have postpartum OCD. 

What is postpartum OCD?

Postpartum OCD² (also called perinatal OCD) is an anxiety disorder that affects mothers and fathers. It leads to intrusive thoughts, and you may obsessively worry about accidentally hurting your baby. You may also be concerned that something else will harm your baby.

Since these thoughts and behaviors are repetitive and constant, they can affect your daily life. You may even avoid your newborn for fear of harming them, affecting your relationship.

Luckily, treatment for postpartum OCD exists, and with the proper guidance, you can manage the symptoms. 

Symptoms of postpartum OCD

Below are common postpartum OCD symptoms:

• Fearing you might harm your baby even when you don't have bad intentions.

• Sleeping difficulties due to obsessive and compulsive urges.

• Avoid activities with your baby, like bathing them or changing their diapers. 

• Not wanting to tell others about your fears. This may be because you don't want others to judge you, or you may fear a diagnosis of another condition warranting hospitalization.

• Fearing that something may harm your baby.

• You may feel compelled to carry out rituals to stop the obsessive thoughts or prevent your fears from becoming a reality. You may frequently check on or wash your baby.

People usually begin seeing postpartum OCD symptoms in the first 2-3 weeks after delivery.  Sometimes, however, it may take months for you or your family to notice these symptoms.

If you're concerned you have postpartum OCD, speak to your loved ones and a healthcare provider. They will be able to treat you and prevent your symptoms from worsening.

What causes postpartum OCD?

There's still no known exact cause for postpartum OCD. Your mental health history may have a role in some postpartum OCD symptoms. Realizing that you are responsible for caring for and protecting a baby may cause the condition.

Research has linked the condition in women to hormonal changes during pregnancy and after delivery. Both progesterone and estrogen³ can affect the serotonin pathways. 

Serotonin is a chemical messenger which influences your emotions, sleep, and mood. The changes may combine with chronic fatigue and overwhelming feelings of caring for your newborn baby. This can cause severe anxiety, which can evolve into OCD. 

Postpartum OCD vs. postpartum depression

Postpartum depression and postpartum OCD are two distinct disorders. Postpartum OCD is a type of anxiety triggered by pregnancy and childbirth where you have intrusive thoughts and compulsive behaviors. Postpartum depression is a mood disorder.

However, there is a relationship between the two. When you become depressed, you may have more negative thoughts, which may progress into obsessions. Similarly, obsessions and compulsions are distressing symptoms that may lead to depression. 

People expect a wonderful time after childbirth, so they may feel extremely sad and anxious if they have any negative, obsessive thoughts. 

Postpartum OCD⁴ and depression tend to co-occur, and you may simultaneously have compulsions, obsessions, and depression. This can affect your life and how you take care of your baby.

Postpartum OCD vs. postpartum psychosis

Postpartum psychosis⁵ is a severe post-childbirth mental disorder involving delusions or false ideas you perceive as true. Unlike in postpartum OCD, the thoughts and beliefs do not cause stress. Therefore, it's more likely that you'd act on them. 

If you've previously had postpartum psychosis, your risk of developing the condition is 50%. It appears exceptionally rare in men, but studies⁶ have documented a few cases. If you're worried about postpartum psychosis, seek treatment immediately.

How is postpartum OCD diagnosed?

Symptoms of postpartum OCD mirror other conditions, such as postpartum depression, making it difficult to diagnose the disorder. Like other postpartum mood disorders, if you have postpartum OCD, you may be hesitant to talk about your symptoms. 

Many mothers fear that they will be hospitalized or lose their children. However, this is not the case. Healthcare professionals can help you recover and recommend childcare resources, should you need assistance.  

Reach out to a medical practitioner if you experience postpartum OCD symptoms. The doctor can screen you for the condition alongside other postpartum mood disorders and refer you to a mental health specialist.

Treating postpartum OCD

The first lines of treatment for postpartum OCD are usually therapy and self-care, especially if you're breastfeeding. However, your healthcare provider may also recommend pharmacological treatment and hormone therapy. 

Therapy

Cognitive behavior therapy⁷ (CBT) is an effective therapy for postpartum OCD. This treatment focuses on changing the negative thoughts linked to obsessions. It teaches you how to face thoughts or situations that provoke anxiety. 

Exposure and Response Prevention (ERP) helps you learn to handle the anxiety resulting from intrusive thoughts, gradually reducing compulsive behaviors. 

Couples therapy can significantly help when you have postpartum OCD. The condition may make you feel guilty or ashamed of your feelings. Couples therapy can educate you and your partner about the condition so that you can cope more effectively with your symptoms.

Self-care

Self-care strategies may not cure postpartum OCD, but they can make you feel better when combined with other treatments. Self-care may include exercising, getting adequate sleep, linking with a support network, and eating well. Something as simple as doing things you enjoy, like your favorite hobby or taking a long bath, can also help. 

Practicing these strategies is great for your mental health. They can improve your ability to be a more present parent and allow you to enjoy bonding with your baby.

Medication

The doctor may recommend medication, especially for moderate-to-severe postpartum OCD. Selective serotonin-reuptake inhibitors (SSRIs), such as fluoxetine and fluvoxamine, effectively treat the condition. 

These medications hinder the reuptake of serotonin. Therefore, more serotonin becomes available to carry more signals to the nearby nerve cells. Sometimes the doctor may recommend other drugs, such as benzodiazepines and antipsychotic medication, to enhance the SSRI effects. 

Another common medication for treating postpartum OCD is clomipramine. This tricyclic antidepressant medication acts on brain chemicals differently from SSRIs. 

If you have postpartum OCD, you'll need larger doses of medications than people with other types of anxiety disorders. Your doctor will increase your dose gradually to reduce side effects. 

Many people have concerns about taking postpartum medication while breastfeeding. Studies⁸ reveal that only small traces of antidepressant medication appear in breast milk and have no adverse effects on the breastfeeding baby. However, you should discuss the medications for postpartum OCD with your healthcare provider before considering taking them. 

The lowdown

You are not alone if you experience intrusive, worrying thoughts about your baby's health and safety, you are not alone. Postpartum OCD is a common condition among new mothers or fathers. The condition is temporary and treatable with therapy, self-care, and medication. Visit your doctor if you experience postpartum OCD symptoms to get help.