You grab the eraser and wipe the board as fast as you can. Nothing’s disappearing. No matter how much you try, every thought you’ve scribbled down seeps deeper into the wall, cementing its place in your mindset as a new mom. You leave the room, trying to distract yourself, but every time you pass by, you’re confronted with your own personal storyboard of irrational fears and disturbing thoughts. To me, this is what postpartum obsessive-compulsive disorder (OCD) felt like. After the birth of my first daughter, I experienced what’s known as “intrusive thoughts.” Most people are able to disregard these thoughts immediately or write them off as ridiculous. They’re able to “erase” them from the dry erase board—but not me. I would have mental images of the worst possible scenarios happening to my daughter: What if she gets hurt? Stops breathing? Drowns? What if someone else hurts her? What if I hurt her? I would never. Why would that even cross my mind? The onslaught of obsessive thinking made me question whether or not I was fit to be a mother. Every thought played on repeat, a relentless broken record, its needle piercing a hole in any shred of sanity I had left. I felt alone and terrified—scared of the “what ifs” to a debilitating degree. I began having regular panic attacks, and because I wouldn’t tell my husband what was going on, arguments with him were at an all-time high. All he saw was a neurotic, anxious shell of his once bubbly, outgoing wife, and didn’t understand why. After ten months of bottled-up anxiety, I reached my breaking point: a panic attack that landed me in the hospital. It was the wake-up call I needed to finally get help. Here’s the good news: It is possible to silence that compulsive, domineering voice inside your mind. I began taking medication for anxiety and depression, listening to meditations every night, and opening up to my husband (no matter how embarrassed I was), who supported me every step of the way. The intrusive thoughts may have consumed me, but they didn’t define me. For those who may experience this or would like to learn more about it, I am sharing my own journey as well as research and advice from Carly Snyder, MD. Dr. Snyder is a reproductive and perinatal psychiatrist and mother of three, devoted to bringing awareness to postpartum mental illness. Learn more about postpartum OCD and intrusive thoughts—as well as how to overcome stigmas surrounding these conditions.
Signs of Postpartum OCD
Along with intrusive thoughts, many new moms find themselves conforming to their irrational way of thinking. The barrage of “what if” scenarios can force them to avoid certain behaviors, fearing their child may accidentally get hurt. Whether they refrain from bathing them, changing them, or driving with them, it severely affects how they care for their baby, ultimately straining the bond with their newborn. The constant anxiety can also lead to relationship problems and arguments. Some mothers suffering from postpartum OCD may also engage in rituals (knocking on wood, counting ceiling tiles, excessive washing, etc.) thinking it will prevent any bad scenarios from playing out. While you frequently hear about cases of postpartum depression and anxiety, postpartum OCD is much less commonly reported, with an estimated 3 to 5 percent of women suffering from it. “I believe it is highly underreported,” says Dr. Snyder, pointing out that many women feel ashamed or scared to talk about it. Because of this, certain cases may not be properly identified or treated. While postpartum anxiety, depression, and OCD are all Perinatal Mood and Anxiety Disorders (PMADs), they are not interchangeable. Dr. Snyder refers to postpartum OCD as an offshoot of postpartum anxiety; however, someone with OCD may not have anxiety and vice versa. It’s very possible for someone to be misdiagnosed with anxiety or depression rather than OCD if not all of the symptoms are disclosed. Because intrusive thoughts can be so horrifying to deal with, many mothers are afraid to admit them. Additionally, anyone can develop postpartum OCD, regardless of whether or not they’ve experienced anxiety or depression in the past.
Living With Intrusive Thoughts
Worrying about a newborn is normal, but I knew that what I was experiencing in my mind was more than that. I was afraid to be left alone with my daughter. I was afraid of bathing her, driving her, or holding her while walking down the stairs. Every time I saw a heartbreaking news story about a child, I couldn’t shake the image of my own daughter meeting the same fate. It was an unbearable, around-the-clock fear. I felt the overwhelming need to protect my daughter, but from what? From other people? My thoughts? Myself? Dr. Snyder describes these types of intrusive thoughts as ego-dystonic—meaning, they run contrary to your sense of self and who you are. They’re completely out of character and outside of your moral compass. “They are not pretty,” says Dr. Snyder. “They don’t fit in a nice package, and they are hard to disclose [to others].” The main reason they are so alarming is that you know you’d never act on them. (And the chances of a mother actually doing so are virtually nonexistent.) The fact that they crossed your mind in the first place is enough to terrify you, and instead of dismissing them, you dwell on them, shifting your protective instincts into overdrive. As part of her own theory, Dr. Snyder refers to postpartum OCD, in part, as “maternal instincts on steroids.” While everyone’s thoughts vary, they all have one thing in common—debilitating fear.
Overcoming Postpartum OCD
Postpartum OCD is very treatable. Treatment usually includes seeing a therapist, who may prescribe medication if indicated. In my case, I was prescribed an SSRI antidepressant, which is one of the most common treatments for depression, anxiety, and OCD. Dr. Snyder explains that an SSRI antidepressant in combination with cognitive-behavioral therapy (CBT) is incredibly effective. Of course, the best plan of action is to speak with your doctor to find the best solution for your specific situation. Looking back four years ago, I realize now that my intrusive thoughts weren’t what was “wrong” with me—it was keeping them to myself. There are many women who experience the debilitating effects of postpartum OCD, and without a head-on confrontation, they can cause devastation to your health, relationships, and overall well-being. The most important step in overcoming postpartum OCD is being honest with yourself and those around you. It’s recognizing that your intrusive thoughts are not “crazy.” The obsessive need to protect your baby is reassurance that your thoughts are just that—thoughts, not intentions. Seeking help for postpartum OCD is a sign of strength and the first step toward feeling better. If you think you may be experiencing this, seek help from a medical professional. Talk to your partner, family, or close friends about what you’re feeling, as well. This is a treatable condition, and with the right support and plan in place, you could be enjoying more time with your newborn. Those sweet smiles, giggles, and movements are worth focusing on!