Postpartum OCD falls under the vast category of postpartum anxiety disorders. It is a complex kind of anxiety that is observed in some new parents, especially mothers, right after childbirth.
Studies have shown that postpartum OCD affects 1-2% of the population.
The most common symptoms are when a parent feels extreme concern about the overall safety of their baby. A mother with postpartum OCD may feel that anything her baby touches may infect him/her with deadly germs or that she may accidentally hurt her baby.
Having postpartum OCD can result in disrupting the daily life of the person as well as their family members. Since it is not a widely known disorder, mothers suffer a lot alone, feel ashamed, and are afraid to get help.
This can cause problems in relationships, as the partner might feel frustrated and not understand the depth of the situation. Extended families may also become frustrated or think that the mother is not doing her duty when they have to help with childcare duties.
Postpartum OCD is a devastating condition. It can prevent attachments and bonding between parent and baby. It also hampers the person’s ability to enjoy parenthood fully and acts as a barrier to forming a healthy relationship with the baby, as the bonding time gets overridden by constant intrusive thoughts and stress.
Sufferers may find themselves distancing themselves from their partner if he/she does not understand the condition or if the sufferer refuses to get help. Mothers suffering from postpartum OCD often never return to work or excessively throw themselves into work to avoid contact with the baby.
Symptoms of Postpartum OCD
The symptoms of postpartum OCD vary from person to person. Usually, it is a combination of obsession and compulsion. Some of the most common symptoms of postpartum OCD are as follows:
Continuous Intrusive Thoughts in Postpartum OCD
Continuous intrusive thoughts regarding the safety, health, and well-being of the baby are defining symptoms of postpartum OCD. For instance, new parents affected by this condition might constantly be tortured by feelings like:
- Violent intrusive thoughts about harming or killing the baby- It is important to note that there have been no recorded cases of a mother with OCD and violent intrusive thoughts ever harming her baby, and the intrusive thoughts are a reflection of the mother’s worst fears. Reassurance is extremely important in such cases.
- Avoiding the baby or being afraid to pick up the baby- family members may feel frustrated, and not be understanding why the mother would not pick up the baby.
- Intrusive sexual thoughts about the baby- It is important to note, that OCD with intrusive sexual thoughts does not mean a person has pedaphilia. It is a reflection of the mother’s worst fears, presenting as an OCD symptom.
- Intense feelings of fear and shame- Intense fear that someone else will harm the baby and inability to return to work as the mother will not utilize childcare services, leading to mothers to feel a sense of guilt and shame.
Compulsively Checking in Postpartum OCD
Continuously checking on the baby is a common behavior in postpartum OCD. Parents affected by this condition may feel compelled to repeatedly monitor their baby’s health conditions, breathing patterns, temperature, and other vital signs.
This behavior stems from a deep-seated fear of something going wrong and a desperate need for reassurance about the baby’s well-being. The compulsion to check on the baby can disrupt the parent’s daily routine and sleep schedule.
They may feel unable to focus on other tasks or responsibilities because their attention is constantly drawn back to monitoring the baby. This can lead to significant distress and exhaustion for the parents, as they struggle to balance their need to check on the baby with their own need for rest and self-care.
Despite knowing that excessive checking is unnecessary, the anxiety and fear associated with postpartum OCD can make it difficult for the parent to resist the urge to repeatedly check on their baby.
Compulsive Cleaning in Postpartum OCD
Repetitive cleaning is a common compulsion in postpartum OCD, driven by an intense fear of contaminating the baby. Parents experiencing this form of OCD may feel compelled to clean their hands, clothes, and household items excessively due to an overwhelming fear of bacteria or germs that could potentially harm their baby.
For example, a parent might repeatedly wash their hands after touching objects or surfaces, even if they don’t appear dirty, for fear of transferring harmful germs to the baby. They may also feel compelled to clean and sanitize baby items, such as toys, bottles, or pacifiers, to reduce the risk of infection.
This compulsive cleaning behavior can disrupt the parent’s daily life, consuming significant time and energy. It may also lead to feelings of guilt, shame, or inadequacy if the parent believes they are not doing enough to keep their baby safe.
Due to the unreasonable fear that the baby will catch a virus or illness, a person with postpartum OCD may even refuse to go out with the baby or have visitors.
Causes of Postpartum OCD
Postpartum OCD is a very complex disorder and all of its exact causes aren’t yet confirmed. Studies and research are still being conducted to find out more about them. Some of the underlying causes that have been discovered are as follows:
Hormones as a Cause of Postpartum OCD
During pregnancy, a woman’s body undergoes lots of changes, including hormonal change, which is a major one. Throughout the pregnancy, fluctuations in hormone levels occur, especially observed in the case of estrogen and progesterone, which are more commonly known as the ‘pregnancy hormones’ or ‘female sex hormones’.
Apart from their role in maintaining the pregnancy, these hormones are also responsible for various physiological processes like – mood regulation, cognition, etc. The hormonal shifts can impact the brain’s ability to produce serotonin, dopamine, GABA, etc. which results in the formation of OCD.
Serotonin, in particular, is closely linked to OCD. It is a neurotransmitter that helps regulate mood, anxiety, and obsessive thoughts. Fluctuations and disbalance in the serotonin system have been associated with the development of OCD symptoms.
During pregnancy and childbirth, drastic changes in estrogen and progesterone levels can influence serotonin activity, potentially contributing to the onset of OCD symptoms in susceptible individuals.
Psychological Stressors as a Cause of Postpartum OCD
Going through pregnancy and giving birth to a baby brings life-changing situations into the lives of new parents. For example, sleep deprivation and physical discomforts, such as pain from the delivery, etc.
Stressors like these can result in heightened anxiety levels, which then lead to the chance of developing OCD.
Social Factors as a Cause of Postpartum OCD
Social factors, such as social support, relationship quality, economic status, etc., can also lead to postpartum OCD. Getting no support, mentally or physically, during pregnancy and childbirth can affect a new mother and result in deteriorating her mental health.
Similarly, having a faulty relationship with family members, especially the significant other, can take a toll and contribute to the occurrence of OCD. It can be said that less support from family increases the chance of contracting postpartum OCD. Pregnancy leads to drastic body changes in many women, which sometimes instills a feeling of insecurity regarding body image in them, which in turn affects their minds.
Traumatic Birth Experience as a Cause of Postpartum OCD
Giving birth is a very painful, complex, and delicate process. Having a difficult or scary experience during childbirth can make things even tougher for new mothers.
Those who’ve been through traumatic births may feel a lot of anxiety afterward, especially about their baby’s health and safety. They might replay the scary moments in their heads over and over, making it hard to feel calm and happy. These worries can sometimes lead to postpartum OCD.
Treatment of Postpartum OCD
Postpartum OCD can be treated with proper medical interventions and care. Encouraging new mothers to seek treatment should not evoke embarrassment or shame; rather, they should be motivated to undergo screening and diagnosis if symptoms persist.
There are several treatment options available for postpartum OCD, like:
CBT for Postpartum OCD
Cognitive-behavioral therapy (CBT) is a widely used and highly effective therapeutic approach for treating various mental health conditions, including obsessive-compulsive disorder (OCD).
In the context of postpartum OCD, CBT can be particularly beneficial for helping new mothers manage intrusive thoughts and compulsive behaviors that interfere with their daily lives and parenting responsibilities.
During the therapy session, a trained psychiatrist will talk to the affected person and help them sort out their intrusive thoughts. With the progression of therapy, the person gets the confidence to fight against the constant thoughts and learns to develop more realistic thinking styles.
A therapist can guide, support, and encourage new parents with postpartum OCD, which is necessary to make a path for a full recovery.
Medication for Postpartum OCD
Alongside therapy, medication can also be quite beneficial. Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed medications for different types of OCD, including postpartum OCD.
SSRIs help increase the level of serotonin hormone, a neurotransmitter that regulates mood. Elevation in the serotonin level helps in getting rid of the intrusive thoughts and compulsive behavior that a person with postpartum OCD suffers from.
Self-diagnosis should be avoided, as it can lead to more problems. It is advisable to consume a drug prescribed by a professional healthcare person. They could help assess the patient’s symptoms, health conditions, the severity of OCD, etc. beforehand.
Self Care for Postpartum OCD
Engaging in different self-care activities like – mindfulness, exercise, etc. can help calm down compulsiveness and tone down intrusive thoughts. Self-care strategies are proven to be very efficient in treating mental conditions like OCD and promote overall well-being.
Mindfulness techniques like – meditation and deep breathing exercises help reduce stress and calm the mind, which helps to get rid of the constant intrusive thoughts. Physical activities like – walking, jogging, yoga, etc. can help uplift the mental state and promote well-being.
Other than these, a person should focus on having a balanced diet, plenty of sleep, keeping themself hydrated at all points of time, and not overwhelming themself with extra work.
Alternative Treatments for Postpartum OCD
Alternative treatments refer to those methods which lie outside the general area of psychotherapy and medication. While alternative treatments may not be thoroughly studied or supported by enough medical evidence as conventional treatments like cognitive-behavioral therapy (CBT) and medication are, some individuals find them helpful in addition to their primary treatment or as standalone interventions.
Some of the alternative treatments for postpartum OCD include-
Nutritional Supplements for Postpartum OCD
According to medical research, some nutritional supplements, such as – N-acetylcysteine (NAC) and omega-3 fatty acids, are known to alleviate the symptoms of OCD in some individuals.
Acupuncture for Postpartum OCD
Acupuncture is a Chinese traditional medicinal method in which thin needles are inserted in some specific body parts, such as – fingers, which help stimulate the CNS (Central Nervous System). It helps reduce anxiety and uplift the mood, as reported by some patients.
Herbal Remedies for Postpartum OCD
Certain herbal remedies, such as St. John’s wort and passionflower, have been studied for their potential benefits in reducing anxiety and improving mood. However, the safety of these for OCD is not well-established, and individuals should exercise caution when using them, especially in conjunction with other medications.
Animal-Assisted Therapy for Postpartum OCD
Emotional Support Animal therapy involves a trained therapy animal, for example – dogs, horses, etc. Spending time with such animals helps in uplifting the mood and makes one feel less compulsive. It is particularly beneficial for people who enjoy the company of animals.
Meditation for Postpartum OCD
Meditation has proved to be beneficial for people with OCD, as per several researches and studies. It helps in overcoming anxiety, managing stress, and cultivating mindfulness.
While meditation may not directly target specific OCD symptoms, such as intrusive thoughts or compulsive behaviors, it can help individuals develop greater awareness of their thoughts and emotions, allowing them to respond to them in a more balanced and accepting manner.
There are several types of meditation which can help individuals affected with OCD, like –
Mindfulness Meditation for Postpartum OCD
Mindfulness meditation includes focusing on the present moment and being non-judgemental towards oneself. This can help in lessening the stress and the intrusive thoughts.
Focused Attention Meditation for Postpartum OCD
This includes focusing on a single thing, which can be an object, breathing, etc. This trains the mind to focus properly and not get overridden by other thoughts. It helps strengthen the cognitive control of one’s mind.
Body Scan Meditation for Postpartum OCD
In this type of meditation, an individual needs to focus on his/her body movements and sensations from head to toe. This helps a person to become aware of their stress, thoughts, and compulsiveness which can facilitate them to overcome the feelings.
Loving Kindness Meditation for Postpartum OCD
This involves generating feelings of love and compassion towards oneself and others. It helps reduce the feeling of loneliness and form healthy connections with others.
Therapy for Postpartum OCD
CBT (Cognitive Behavioral Therapy) is the primary therapeutic approach for treating OCD. CBT is based on the idea that our thoughts, feelings, and behaviors are interconnected, and by changing our thoughts and behaviors, we can change how we feel. CBT for OCD consists of two main parts:
Exposure and Response Prevention (ERP) for Postpartum OCD
This is a behavioral therapy technique in which patients are made to deliberately face situations that are known to trigger their obsessions. The therapist then helps the patient to refrain from engaging in compulsive behavior while the confrontation lasts. Through repeated exposure to such situations, the patient learns to tolerate distress without acting compulsively.
Cognitive Restructuring for Postpartum OCD
This involves identifying the intrusive thoughts that occur for a person with OCD and challenging them. This helps the person to develop more balanced perspectives and reduce their OCD tendencies.
By working with a trained therapist, a person affected by OCD learns to overcome their compulsive behaviors, and intrusive thoughts and get hold of important practical skills that helps them to confront their fears, obsessions, etc. and as a result, overcome OCD gradually.
Yoga for Postpartum OCD
Practicing Yoga offers a beneficial approach to managing overall health, which includes mental health as well. Through a combination of physical postures, breathing exercises, and mindfulness techniques, yoga can help individuals reduce stress, alleviate anxiety, and cultivate greater self-awareness.
Physical postures, also known as ‘asanas’, help relieve the body which in turn influences blood circulation in a good way. Better blood flow can help lessen stress and anxiety.
Breathing exercises help in calming the Central Nervous System (CNS) which helps the mind to get rid of unnecessary intrusive thoughts and stress. Overall, it helps an individual to calm down and positively arrange their thoughts.
Practicing mindfulness meditation during yoga sessions can encourage individuals to cultivate present moment awareness and observe their thoughts and emotions without judgment.
Mindfulness skills help individuals with OCD, observe their obsessive thoughts and compulsive urges with greater clarity and detachment, reducing their power and influence over their behavior.
Overall, yoga offers individuals with OCD a comprehensive approach to managing symptoms by addressing the interconnectivity of the mind, body, and breath. Individuals can develop greater resilience, reduce stress, and improve their overall quality of life by integrating yoga into their daily routines.
Supplements for Postpartum OCD
After consulting medical personnel, an individual can take the following supplements to help overcome OCD.
N-acetylcysteine (NAC) for Postpartum OCD
NAC is a precursor to glutathione, which is a powerful antioxidant that plays a role in reducing stress and regulating neurotransmitter levels in the brain. Some studies suggest that NAC may be beneficial for individuals with OCD by modulating glutamate levels and reducing symptoms of compulsivity.
Omega 3 for Postpartum OCD
Generally found in fish oil supplements, Omega 3 is considered an essential nutrient with anti-inflammatory properties. Research states that it helps in improving neurotransmitter levels in the brain.
Inositol for Postpartum OCD
It is a naturally occurring compound that helps in cell signaling and neurotransmitter regulation. It also helps in reducing obsessive thoughts and compulsive behaviors.
Probiotics for Postpartum OCD
These are beneficial bacteria that help in uplifting the overall health of an individual.
Vitamin D for Postpartum OCD
Vitamin D deficiency has been linked to mood disorders, including depression and anxiety. According to some studies, it has been concluded that people who have less exposure to the sun (the main source of vitamin D), are more prone to developing OCD, than people who have more exposure.
It should be noted that one should not solely rely on supplements for treatment of OCD. These can be used in addition to therapy to boost the treatment process.
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References
- Perinatal Obsessive–Compulsive Disorder: Epidemiology, Phenomenology, Etiology, and Treatment
- The Basics of Postpartum Obsessive Compulsive Disorder (OCD)
- A Case Series of Women With Postpartum-Onset Obsessive-Compulsive Disorder
- Diagnosis and Treatment of Postpartum Obsessions and Compulsions That Involve Infant Harm
