Thoughts are Only Thoughts: The Truth About Postpartum OCD

By Krista Post, Licensed Psychologist & Clinical Director at The Postpartum Counseling Center

postpartum mood disordersWhat would you think if your friend told you she was having thoughts of drowning her child…and that she could not get those thoughts out of her head? Or how do you think it would feel to be completely incapable of leaving your infant’s side—even foregoing sleep—for fear she might die of SIDS?

These kinds of scary and intrusive thoughts and the behaviors that accompany them—which can honestly be as simple as relentless, debilitating germaphobia and an unhealthy overuse of hand sanitizer—plague approximately 7% of postpartum women. These types of thoughts and fears are associated with postpartum obsessive-compulsive disorder (PP-OCD).

We don’t hear much about PP-OCD. Why? Well, for one, what mother wants to admit she has hidden all the knives in the house or stopped bathing the baby in order to protect him? Women who have these horrifying thoughts assume they are going crazy. They fear that telling could lead to being committed, or having their children taken away.

The actual risk that a woman who is having these terrifying thoughts might act on them is zero to nil.  Thoughts are only thoughts and in the case of PP-OCD, they are a manifestation of anxiety—an extreme form of the anxiety faced by all new mothers.

When a woman is in a state of worry about her thoughts and images, this is actually a “good” sign. It distinguishes her from someone who may actually have serious symptoms of psychosis. With postpartum psychosis, women are living outside of reality. When they become violent, they are acting on delusional beliefs that harm makes sense and is necessary. This condition only occurs in 1-2 of 1000 women, and only 4-5% of those have delusions related to harming themselves or their babies.

Maternal worry is “normal”.  We all have worries about our loved ones and our children in particular. A mother suffering from PP-OCD, however, experiences intensified worry and has a hard time letting go of the worries and fears in her head.  She may even avoid certain activities and situations in order to avoid or reduce her  worry and anxiety. For example, the thought, “What-if I shake or choke my baby?” may lead her to use the infant carrier more. Sadly, she may pick up her baby less for fear of “snapping.”

This “obsessive-compulsive” experience is the result of a body-mind chemistry that is set on “high alert.” Clearly, the disorder makes it hard to tap into the rich and abundant joys of motherhood, let alone lead a normal life.

The good news is that there is treatment available to help settle and reduce a person’s anxiety chemistry. Increasingly, OBs and midwives are aware of these symptoms and able to provide relief; and many cities have therapists who are skilled in treating and supporting mothers with PP-OCD through the use of talk and behavior therapy.

If you or anyone you know is experiencing the disturbing and consuming thoughts associated with PP-OCD, please reach out to your doctor or a skilled therapist. There is no shame in what you are going through and you are not alone!