Postpartum OCD
Postpartum OCD can cause intrusive thoughts and anxiety in new mothers. Specialized treatment from board-certified psychiatrists and postpartum OCD therapists combines medication and therapy for effective, compassionate care
“Postpartum OCD does not mean you are a bad mother—The intrusive thoughts are simply the OCD latching onto your worst fears, not a reflection of your love or ability to care for your baby.”
Postpartum OCD is a distressing condition, presenting with postpartum intrusive thoughts, obsessions, and compulsions, often about contamination or harm to the baby, that occurs after giving birth. A postpartum OCD therapist can be crucial in helping mothers manage these symptoms effectively. Postpartum Obsessive Compulsive Disorder (OCD) is often left undiagnosed and untreated, despite its serious consequences for the mother, baby, and family.
Postpartum OCD can be a frightening and confusing experience for new mothers. As per a study published in the Journal of Affective Disorders, at least two to three percent of new mothers experience postpartum OCD.
However, the most important thing to remember is that having postpartum OCD symptoms does not mean that you will harm your baby. This condition can be easily managed with treatment, making mothers feel better and more connected to the baby.
What is Postpartum OCD?
Obsessive Compulsive Disorder (OCD) occurring after childbirth is called Postpartum OCD. Research shows that pregnant women, or women who have recently given birth to a baby, are at higher risk of developing OCD symptoms. A postpartum OCD therapist can help individuals manage these symptoms effectively. This condition typically occurs during the first six to eight weeks after childbirth, when the body returns to its usual state.
Postpartum OCD and Intrusive Thoughts
Postpartum OCD is characterized by intrusive and worrying thoughts that repeat frequently and get worse as they progress. For example, A new mother with this anxiety disorder may feel a constant urge to check whether the baby is still breathing. She may also be extremely concerned about the baby catching a virus or disease, finding herself washing and rewashing baby items like bottles to get rid of germs.
Types of Postpartum Intrusive Thoughts
- Intrusive thoughts about killing or harming the baby – violent intrusive thoughts are especially distressing to the mother. So far, there are no recorded cases of mothers with violent intrusive thoughts actually harming the baby.
- Intrusive thoughts about being a bad mother.
- The mother presents with intrusive thoughts that she will contaminate the baby, for example, through breast milk.
- Intrusive thoughts that the baby’s utensils are contaminated or will be contaminated by germs on the floor.
- Intrusive thoughts about dropping the baby.
- Sexual thoughts about the baby.
- Intrusive thoughts about SIDS – intense fear the baby will die.
Postpartum Intrusive thoughts can influence behavior, such as:
- Making sure everything is done right and there is no room for mistakes.
- The mother may feel the constant urge to check whether the baby monitor is functioning properly or feel like she might harm the baby because of her poor decisions.
Such intrusive thoughts make it very difficult to take care of the child. Although the mother has absolutely no intention to harm the child, she may be afraid she may do it accidentally or feel so ashamed of the intrusive thoughts that she does not feel she deserves to be a mother. The self-loathing can affect the ability to take care of the child, which is why working with a postpartum OCD therapist can be beneficial.
Studies have shown that mothers with postpartum OCD are hypervigilant about the baby’s safety and are not likely to act on these thoughts.
Postpartum OCD Specialist
As postpartum OCD is often misdiagnosed, contacting a board-certified and licensed mental health professional, such as a psychiatrist or postpartum OCD therapist, is imperative. If symptoms have been causing distress and interfering with daily life for more than two weeks; if the obsessions and compulsions are time-consuming and causing disruption in career and relationships, it is necessary to receive a diagnosis.
Psychiatrists at GABA Telepsychiatry are licensed and board-certified, with a passion for helping young mothers through the postpartum period.
Board Certified Psychiatrist with Multiple State Licenses MBBS (MD)
Dr. Valeria Serban is a board-certified neuropsychiatrist with 20 years of professional experience and a keen passion for treating mental health illnesses using modalities such as therapy and medication management. She’s an expert in diagnosing and treating most mental health conditions with extensive experience with conditions such as anxiety, bipolar disorder, depression, dementia, obsessive compulsive disorder (OCD), mood disorder, panic disorder, postpartum depression, and psychosis, among others.
Dr. Serban has worked extensively in general adult psychiatry and geriatric psychiatry. She treats psychiatric illnesses associated with neurological conditions such as migraine, epilepsy, concussion, stroke, Parkinson’s, multiple sclerosis, sleep disorders such as narcolepsy, and other neurological conditions.
Dr. Serban has a kind and compassionate approach to patient care. She utilizes a combination of medication management and psychotherapy to help treat various types of psychiatric illness and age-related cognitive decline.
Dr. Serban is well-known for her warm and friendly personality and provides patients with a safe and comfortable environment for easy recovery and symptom management. She constantly researches different treatment options and works with her patients and their families to find the one that best suits their requirements.
Dr. Serban is multilingual and speaks fluently in six languages: English, Romanian, Italian, French, Spanish, and German.
Medical School
University of Medicine and Pharmacy “Carol Davila” Bucharest, Romania
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University of Medicine and Pharmacy “Carol Davila” Bucharest, Romania
Master of Philosophy (M.Ph.) – Neuroscience
NYS Institute for Basic Research, New York
Internal Medicine Residency
Temple University Hospital, Pennsylvania
Neurology Residency
Temple University Hospital, Pennsylvania
Doctor of Philosophy (Ph.D.) – Neuroscience
NYS Institute for Basic Research, City University of New York – Graduate Center
Clinical Neurophysiology Fellowship
Massachusetts General Hospital – Harvard Medical School, Massachusetts
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American Board of Psychiatry and Neurology (ABPN)
Electromyography – American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM)
Neuromuscular Medicine – American Board of Psychiatry and Neurology (ABPN)
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Board Certified Psychiatrist in New York & New Jersey (MD)
Dr. Tony Isaac is an experienced double Board Certified Psychiatrist with a keen interest in evaluating and treating mental health illnesses such as insomnia, panic attacks, depression, anxiety, OCD, bipolar disorder and schizophrenia.
Dr. Issac specializes in addiction recovery treatments and medication management and uses a combination of psychotherapy and sensitive medication titration to help his patients achieve a collaborative treatment plan. Using both medication and non-medication techniques, Dr. Issac focuses on recovery and healing, thereby improving the overall mental health of his patients and helping them live a fuller and happier life.
Dr. Issac is popular among his patients for being very kind, respectful, empathetic, articulate, patient, and always willing to listen. He conducts suicide assessments and acute stabilization, which includes working with the family and employer to provide the required care and support.
Medical School
St. George’s University: School of Medicine
Psychiatry Residency Training
Richmond University Medical Center: affiliate of Mount Sinai Health Network
Bachelors of Science (B.S.) in Psychobiology
Binghamton University – State University of New York
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American Board of Preventative Medicine – Addiction Medicine, Board Certification
American Board of Psychiatry & Neurology – Psychiatry, Board Certification
Board Certified Psychiatrist with Multiple State Licenses MBBS (MD)
Dr. Gundu Reddy is a Board Certified Psychiatrist with over fifteen years of experience practicing clinical psychiatry experience. She also has ten years of experience practicing forensic psychiatry. Dr. Reddy has trained in medication management, psychodynamic psychotherapy, and cognitive behavioral therapy.
Dr. Reddy is interested in integrative psychiatry and believes multiple factors should be considered when evaluating and treating a patient. This, as per Dr. Reddy at includes genetic and developmental factors, medical illness, nutrition, hormones, and environmental and dynamic factors.
Dr. Reddy believes that it is extremely critical to understand psychodynamic conflict and the causes of symptoms while prescribing medication, family, or relationship therapy, understanding psychodynamic conflict and causes of symptoms as will help enhance the quality of care. Apart from psychodynamic training Dr Reddy also has a background in integrative psychiatry and treatment resistance.
Medical School
The United Medical Dental Schools of Guys Kings and St Thomas’ at King’s College London
Psychiatry Residency Training
Mount Sinai School of Medicine, New York
Psychodynamic Psychotherapy Training
NYU Psychoanalytic Institute
Board Certification
American Board of Psychiatry Neurology
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Postpartum OCD Symptoms
While symptoms of postpartum OCD may be unique for each woman, the two most common symptoms are concerns about contamination and the fear of harming or injuring the baby. These temporary fears stem from hormonal changes and are more common when it is a woman’s first child.
When such symptoms start interfering with daily life and make it uncomfortable, they can be signs of postpartum OCD. A postpartum OCD therapist can help mothers identify and manage these symptoms, which may start appearing during pregnancy or at delivery.
Some other symptoms may be:
- Keeping the obsessions hidden from others due to a fear of being hospitalized or diagnosed with psychosis
- Compulsions to resist irrational fears, which may include constantly checking on the baby, demanding reassurances, praying repetitively, or obsessive cleaning
- Feeling overwhelmed with obsessions and compulsions
- Exhibiting signs of postpartum depression
- Avoiding some activities like changing the diaper, bathing, or carrying her down the stairs
- Needing a helper or partner nearby due to a fear of hurting the baby
- Finding it difficult to take care of the baby
- Trouble falling asleep because of obsessions and compulsions
Ironically, mothers with postpartum OCD are very sensitive to anything that may trigger child abuse, whether sexual or physical.
Obsessions in Postpartum OCD
DSM-IV-TR states that obsessions can be “ideas, thoughts, impulses, or images.” The most common obsessions women experience with postpartum OCD are:
- Unwanted thoughts about hurting the baby, such as throwing or dropping her
- Unwanted thoughts about stabbing or suffocating the baby
- Concerns about harming the baby due to carelessness
- Disturbing thoughts of sexually abusing the baby
- Scared of making poor decisions for the baby
- Fear that the baby will catch a disease
- Fear of exposing the baby to environmental pollutants, toxins, and chemicals
New mothers experiencing postpartum OCD are aware of such intrusive thoughts but have hardly any control over them. Just like baby blues, this condition is likely underdiagnosed due to the shame, embarrassment, and fear of losing the baby. Most women are reluctant to open up and often suffer silently, though seeking support from a postpartum OCD therapist can make a significant difference.
Compulsions in Postpartum OCD
The most commonly experienced compulsions in postpartum OCD are:
- Getting rid of sharp-edged objects like scissors and knives
- Avoiding changing diapers out of fear of sexually abusing the baby
- Avoiding feeding the baby out of fear of poisoning her
- Rejecting certain medications out of fear of harming the baby
- Deliberately avoiding watching the news about child abuse
- Continuously monitoring oneself about inappropriate sexual thoughts
- Seeking reassurance from family members that the baby is not abused or harmed
- Recalling the events of the day to ensure that nothing wrong has happened with the baby
The symptoms of postpartum OCD are also easily confused with depression or anxiety. As there is limited awareness about this condition, it goes unreported or is misdiagnosed.
Postpartum OCD Causes
Like other psychiatric conditions, postpartum OCD is not known to have an exact cause. The onset of this condition is associated with a woman’s mental health history and other factors, such as genetics and nutritional deficiencies. Some women may find it helpful to consult a postpartum OCD therapist to better understand and manage their symptoms.
Some causes of postpartum OCD are:
Genetic Factors
Various twin and family studies have shown that postpartum OCD has a strong genetic component. Women with a family history of OCD are more likely to develop postpartum OCD after childbirth. Having a close relative with OCD triggers a woman’s genetic predisposition through hormonal or psychological challenges.
Previous History of OCD
Individuals who have received a prior diagnosis of OCD are at higher risk of developing postpartum OCD. A study suggested that over 30 percent of women with a history of OCD experienced a surge in symptoms during the postpartum period, especially with intrusive thoughts about harm, contamination, or the well-being of their baby.
Nutritional Deficiencies
A deficiency of key nutrients like B vitamins, vitamin D, omega-3 fatty acids, magnesium, and iron can impair brain function, inflammation, neurotransmitter balance, and stress response. Therefore, adequate nutrition is essential for physical and mental recovery during postpartum. Proper nutrition can reduce the risk of developing postpartum OCD or mitigate the severity of its symptoms.
Environmental Factors
Environmental factors, such as stressful life events, lack of sleep, traumatic childbirth experiences, etc., can contribute to the onset of postpartum OCD. It is common for new mothers to go through financial difficulties, health complications, or relationship problems. Another key environmental trigger is sleep deprivation due to the baby’s feeding schedule and frequent awakening during the night. Societal and personal expectations of ‘being the perfect mother’ can also intensify obsessive thoughts related to postpartum OCD.
Postpartum OCD Treatment
New mothers need to undergo screening and diagnosis for postpartum OCD. When thoughts become unwanted and obsessive and start interfering with day-to-day life, they should be addressed with the help of a qualified postpartum OCD therapist. Early treatment can prevent the mother-baby bond from getting damaged. Early diagnosis and treatment can prevent the involvement of welfare agencies like Child Protective Services.
Postpartum OCD treatment has not been studied extensively. It is conducted in the same manner as OCD, with necessary adaptations for the postpartum period. There are generally two approaches to treatment, namely cognitive behavioral therapy (particularly ERP) and pharmacotherapy.
Amongst available antidepressants used for major depression, selective serotonin reuptake inhibitors (SSRIs) and clomipramine, a tricyclic antidepressant, are recommended as the first-line treatment for postpartum OCD. Some other forms of psychotherapy, such as couples therapy and hormone therapy, also help people work on their intrusive thoughts in a non-judgemental and safe environment.
Postpartum OCD Medication
Therapy is highly beneficial in treating feelings of shame, guilt, and anxiety associated with intrusive thoughts. However, therapy usually does not make distressing symptoms of postpartum OCD go away. There is a lot of evidence suggesting that postpartum OCD is usually hereditary and, in most cases, has a biological component.
Typically, the best results for rapid resolution of obsessions and compulsions occur with the following medications:
1. Serotonin Reputable Inhibitors
There are many different classes of serotonin reuptake inhibitors, all of which can be beneficial for postpartum OCD. SSRIs treat anxiety associated with postpartum OCD as well as reducing the frequency and even eliminating intrusive thoughts.
As postpartum OCD typically requires a higher dose of medication than depression to eliminate intrusive and compulsive thoughts, it is better to take the one with the best side effect profile. Side effects of SSRIs can include reduced sex drive and low motivation.
2. Tricyclic Antidepressants
Tricyclic antidepressants are the gold standard for the treatment of postpartum OCD and can produce dramatic reduction or elimination of intrusive thoughts. In some people, they can cause weight gain and are unsafe in overdose or are not always a first line.
3. Serotonin Modulators
Serotonin modulators can cause a dramatic reduction in the symptoms of postpartum OCD. They typically cause fewer sexual side effects than SSRIs.
4. Mood Stabilizers
Mood stabilizers that work on the glutamate system can cause rapid resolution of postpartum OCD symptoms. Medications that increase circulating dopamine can help with postpartum OCD symptoms.
5. Stimulants
For individuals with postpartum OCD, stimulants can help alleviate symptoms but must be used with extreme caution and are typically reserved for specific situations like presentations or exams. When there is a dual diagnosis of postpartum OCD and ADHD, stimulant use is generally advised to be limited.
6. Atypical Antipsychotics
Some atypical antipsychotics can sometimesdramatically improve postpartum OCD symptoms due to partial agonist effects on the dopamine receptor.
Ultimately, many medications are safe, non-addictive, and work extremely well for the treatment of postpartum OCD.
Sometimes, finding the best medication for you takes a little trial and error. Everyone’s receptors and physiology are different. Careful titration under medical supervision is needed to ensure you are on the right medication. The end goal should be maximum symptom relief with minimum side effects.
Sometimes, a combination of two medications is needed to produce optimum effect and minimum side effect profiles, as high doses of one medication can lead to side effects in some individuals.
There is no one-size-fits-all solution to postpartum OCD medication, and individual tailoring is the key to optimum treatment outcomes. Often, a combination of therapy, such as working with a postpartum OCD therapist, and supplements for postpartum OCD works better than medication alone.
Supplements for Postpartum OCD
A psychiatric disorder like postpartum OCD may be further aggravated by nutritional deficiencies in the body. Therefore, intake of nutritional supplements is usually recommended for patients in addition to conventional treatments.
Vitamin D for Postpartum OCD
Vitamin D is vital for immunity modulation, antioxidant processes, and inflammatory responses. It also aids in brain functioning and nervous system processes such as neuroprotection, neurotransmission, differentiation, and proliferation. Studies have demonstrated that vitamin D deficiency is linked with neuropsychiatric disorders including depression, autism, schizophrenia, and OCD.
Magnesium for Postpartum OCD
Magnesium plays a crucial role in regulating stress and anxiety levels. Low magnesium levels have been linked to increased anxiety and restlessness, and supplementation may help reduce these symptoms in postpartum OCD.
B Vitamins for Postpartum OCD
B vitamins, particularly B6 and B12, support brain function and mood regulation. They may help reduce symptoms of anxiety and depression in mothers experiencing postpartum OCD.
Zinc for Postpartum OCD
Zinc deficiency has been associated with mood disorders and anxiety. Supplementing with zinc may help alleviate some of the emotional stress experienced by mothers with postpartum OCD.
Omega-3 for Postpartum OCD
Omega-3 fatty acids, particularly EPA and DHA, are known for their brain-boosting and anti-inflammatory properties. Some studies suggest that omega-3 supplements can reduce symptoms of depression and anxiety, offering support for postpartum mental health.
N-Acetylcysteine for Postpartum OCD
N-acetylcysteine (NAC) has shown promise in treating OCD symptoms in some clinical studies. Its antioxidant properties may help regulate glutamate levels in the brain, which are thought to play a role in OCD.
Inositol for Postpartum OCD
Inositol, a type of sugar related to B vitamins, has been found to reduce anxiety and OCD symptoms. It may help regulate serotonin activity in the brain, providing relief for postpartum mothers dealing with obsessive-compulsive thoughts.
Therapy for Postpartum OCD
The combination of medication and therapy is considered the most powerful in the treatment of postpartum OCD. Many types of therapy, such as cognitive behavioral therapy, exposure and response prevention therapy, psychodynamic psychotherapy, and acceptance and commitment therapy, may be used as a treatment.
Psychodynamic Psychotherapy for Postpartum OCD
Psychodynamic psychotherapy is a treatment option which helps the patient explore unconscious thoughts and emotions to resolve her current psychological difficulties. For postpartum OCD, psychodynamic psychotherapy focuses on unresolved conflicts, early attachment issues, and defense mechanisms, which contribute to the obsessive thoughts and compulsive behaviors experienced by new mothers.
For example, a new mother may unconsciously fear that she is not a capable or good enough mother, leading to obsessive thoughts about harming her baby. Through therapy, the mother can explore the origins of these fears, which may be rooted in her own childhood experiences, relationships with her parents, or societal pressures around being a “perfect mother.”
CBT for Postpartum OCD
Cognitive Behavioral Therapy (CBT) is one of the most successful types of therapies used to treat postpartum OCD. CBT for OCD involves educating the patient about the condition, its causes, the patterns of obsessions and compulsions, and the benefits offered by therapy.
The psychiatrist or therapist may encourage the mother to maintain a journal to understand her intrusive thoughts. The journal may be used to keep track of her intrusive thoughts and compulsive behaviors. CBT helps in identifying negative thought patterns and changing them.
Another form of CBT is Mindfulness-Based Cognitive Therapy (M-BCT), which combines the practice of mindfulness with CBT. It teaches the mother to be aware of her thoughts and emotions without any judgment. By removing self-judgment, it becomes easier for the mother to lessen the effect of intrusive thoughts and compulsive behaviors.
ERP for Postpartum OCD
Referred to as the gold standard treatment for OCD, Exposure and Response Prevention (ERP) therapy is a type of CBT that exposes a person’s fears. She is taught how to resist engaging in compulsive behaviors associated with postpartum OCD. This type of therapy helps in challenging and changing irrational thoughts.
ERP for postpartum OCD focuses on exposing the patient to the source of anxiety. For example, a psychiatrist may ask the patient to increase the amount of time between instances of checking up on the baby. With this approach, the psychiatrist will teach her how to manage stress and distress during this time.
ACT for Postpartum OCD
Acceptance and Commitment Therapy (ACT) focuses on accepting negative thoughts and feelings instead of resisting them. It allows the patient to engage in behavioral changes that align with her values, lessening the power of thoughts.
For example, if a mother suffering from postpartum OCD is afraid she might hurt her baby, a postpartum OCD therapist using ACT will teach her to accept that intrusive thought and not try to change it. By practicing acceptance, she may soon realize that it is merely a thought that does not require her to take any action, thus making it powerless.
ACT uses a technique called “defusion” to create space between the person and her thoughts. It emphasizes the fact that just because they are occurring in the mind, does not mean the thoughts are true. Intrusive thoughts and obsessions are simply words or images.
Hormone Therapy for Postpartum OCD
Hormone treatment can help alleviate postpartum OCD symptoms by altering hormone levels in the body. For example, women with increased levels of estrogen may opt for progesterone therapy. Certain therapies also balance the levels of growth hormone and pregnenolone (a steroid hormone).
Hormone replacement procedures use bioidentical formulations to address the imbalances in hormone levels and duplicate the body’s natural hormones. A postpartum OCD therapist or an endocrinologist may help in addressing the need for hormone treatment in treating postpartum OCD.
Alternative Treatment for Postpartum OCD
While therapy and medication are first-line treatments for postpartum OCD, working with a postpartum OCD therapist and exploring alternative treatments such as yoga and meditation can offer additional benefits.
Mindfulness for Postpartum OCD
Practices that promote mindfulness can help mothers stay present and grounded, reducing the impact of intrusive thoughts. These techniques strengthen present-moment awareness and foster a non-judgmental approach to thoughts and emotions.
Exercises such as mindful movement, body scan meditation, and breathing practices can significantly alleviate symptoms of anxiety and OCD in new mothers. The calm and balance these methods encourage can assist in managing intrusive thoughts and the impulse to act on them.
Yoga for Postpartum OCD
Yoga is a gentle and holistic approach to reducing stress and promoting relaxation. The incorporation of yoga into a postpartum self-care routine can be effective in managing anxiety symptoms and improving mood.
Postpartum yoga is a modified and low-intensity yoga practice designed to help the body recover after childbirth. This form of yoga can offer various benefits, such as balancing energy levels, lowering blood pressure, and reducing anxiety. It also reduces irritability, muscle tension, and blood pressure.
Exercise for Postpartum OCD
Exercise helps reduce stress, improve sleep quality, and balance neurotransmitters, which can prevent the worsening of postpartum OCD symptoms. Physical activity reduces cortisol, a hormone that plays a major role in the body’s stress response.
Exercise, particularly aerobic activities like jogging, cycling, and walking, alleviates tension and helps new mothers manage their anxiety. Exercise also increases endorphins, dopamine, and serotonin – the ‘feel good’ chemicals which help lift mood and combat postpartum OCD symptoms.
Acupuncture for Postpartum OCD
Acupuncture is an ancient practice rooted in traditional Chinese medicine. It can offer a natural approach to alleviating postpartum OCD symptoms by restoring balance and improving the body’s energy systems.
Acupuncture is performed by inserting fine needles into specific points on the body, which channel the body’s vital energy. In Western medicine, acupuncture is believed to stimulate nerve endings, which can lead to the release of neurotransmitters like dopamine and serotonin.