Postpartum OCD – Causes, Symptoms & Treatment

Postpartum OCD diagnosis is common and about 9% of mothers (1) do get OCD symptoms within 6 months of childbirth. Many new mothers experience uncontrolled intrusive thoughts about their baby’s well-being just after childbirth. Their obsession revolves around the fear of harming the baby.

The typical motherly concerns soon turn into overthinking and excessive fears; in the context of either accidentally harming the baby, or concerns related to germ contamination. Some mothers also doubt their parenting abilities and tend to get distressing thoughts that rob their inner peace.

To worsen the symptoms, compulsive habits develop where the mother washes her hands multiple times and insists everyone use a sanitizer before touching the baby. Moreover, she may not allow anyone with an infection to come near the baby, and so on. These are normal only to a certain extent.

Study findings (2) have shown that intrusive thoughts in postpartum OCD are quite common. Many mothers are unable to respond well to their baby’s needs due to this overwhelming anxiety.

Causes of Postpartum OCD

There is no one or two causes that can lead to postpartum OCD. Usually, there are combinations of factors that can lead to developing this mental health problem after childbirth. The common ones are 

1. Hormonal Changes During Pregnancy And OCD

Study findings hint towards an interplay of estrogen and serotonin in causing postpartum OCD (3). Due to the increase or decrease of estrogen hormone post-delivery, the serotonin levels get affected. Since serotonin regulates mood, it impacts the mother’s overall emotions. She tends to overthink and gets anxious about her baby’s well-being.

2. Mental Stress

Lack of proper sleep after childbirth adds to maternal stress. Moreover, physical pain can also feel overwhelming. Sometimes, caring for the newborn and additional responsibilities at home can also cause anxiety and lead to postpartum OCD symptoms.

3. Genetic Factors

The chances of developing OCD after childbirth are notably higher when a family member, particularly a close relative such as a parent or sibling, has the disorder. Studies have confirmed that if the new mother develops OCD symptoms after the birth of her baby, it could be because of a heredity connection (4).

Symptoms or Identifying Factors of Postpartum OCD

While every case of postpartum OCD is unique, the general symptoms are usually divided into two parts: obsessive fears and their corresponding compulsive actions.

1. Typical Obsessive Fears

Some of the stressful thoughts related to harming the baby include the following. While every case of postpartum OCD is unique, the general symptoms include

• Fear of unintentionally hurting the child
• Thoughts of intentionally hurting the child such as fear of dropping the baby from a high place, stabbing the baby with a sharp object, drowning the baby in the bath, or suffocating the baby with a pillow
• Constantly imagining the baby dead
• Obsession With Baby’s Cleanliness
• Refuse to breastfeed the baby for fear of passing toxins or germs passing onto the baby
• Fearing that some wrong decision about baby care may be taken that might be fatal for the baby
• Blaming self unrealistically if baby catches a disease
• Fears related to baby not breathing or responding
• Fears of others doing something wrong with the baby. Consequently, the mother always keeps an eye on baby
• Fears related to forgetting the baby

2. Typical Compulsive Actions

As the obsessive thoughts are emotionally draining, the mother may try to engage in compulsive behaviors just to lessen her anxiety and mental restlessness.

• Repeated hand washing and sanitization all over
• Constantly monitoring baby’s breathing pattern and overall vitals
• Mentally replaying or reviewing past scenarios related to baby care, just to ensure that she did everything right
• Compulsively checking the baby while asleep just to ensure that the baby is well (because of excessive fear that the baby will die in sleep)
• Wanting excessive reassurance from people around that the baby is alright
• Feeling the need to throw away sharp objects like scissors or knives to avoid hurting the baby

Risk Factors For Developing Postpartum OCD

Some factors can increase the chances of developing OCD symptoms after childbirth. Women who have pre-existing OCD symptoms before pregnancy can develop these symptoms more intensely postpartum. Some women may develop signs of this mental illness just after giving birth. However, others may start showing their symptoms within 12-26 weeks of delivery (5).

Other risk factors include –

• The mother with a history of either anxiety, OCD, or depression (5A)
• Close family members with this mental health problem
• First-time mothers are at risk
• Stress at home or financial hassles
• Pregnancy-related complications
• Lack of sleep and physical fatigue

Diagnosing Postpartum OCD

Postpartum OCD should be diagnosed by a mental health professional that involves the below-mentioned protocol

• Understanding the case history of the mother
• Knowing the pre-existing mental health issues (if any) of the mother
• Doing a thorough mental status examination on one-to-one interaction with the mother
• Assessing the mother’s response towards her pregnancy journey
• Talking to family members; just to get an idea of the relationship pattern at home
• Considering the duration of the illness
• Understanding the severity of the symptoms

Treatment Options For Postpartum OCD

Postpartum OCD is a treatable disorder. A few standard treatment measures are in place (6) such as 

1. Cognitive-behavioral Therapy (CBT)

These are of various kinds, such as Cognitive Restructuring and Exposure and Response Prevention. In some of these techniques, the mothers are asked to talk about their feelings and are challenged as to the validity of these thoughts. Sometimes stories are written based on the mother’s intrusive thoughts about harming the child and these stories are used as tools to “expose” the mother to her obsessions

2. Serotonin Reuptake Inhibitors

These are medications (as opposed to CBT, which is a mental tool-based treatment) used to cure OCD. However, its effects on the breastfeeding child are not yet known; therefore needs to be used with caution. Medications should be taken only if advised by the doctor.

3. Couples Therapy

New mothers with this mental illness can benefit from couples therapy. This therapy aims to educate the new mother and her family members about the condition; so that they know what to expect if symptoms start showing off after the baby’s birth. Moreover, it can be used to improve relationships at home, reduce stress, and improve happiness in the household.

Self-Help Tips For New Mothers Suffering From OCD

It is not good to suffer in silence if you are getting unwanted thoughts and worrying too much about the well-being of your baby. You can always help yourself by

1. Accept the fact that you are not alone who is suffering. So, stop blaming yourself
2. Learn to take good care of your physical health by eating healthy and having a good amount of sleep
3. Practice patience and educate yourself on Postpartum OCD to consciously work towards preventing obsessive thoughts.
4. Share childcare duties at home to lessen your responsibilities and create time for relaxation.
5. A few moments of meditation practice can calm down your overwhelming emotions. Practice yoga or mindfulness every day to improve inner strength and resilience.

When to Consult A Doctor For OCD?

It is best to consult a doctor if the symptoms get severe and the mother shows extremes of compulsive behaviors that are hard to manage. Moreover, if quality of life is worsening for all the family members, medical help is advised instantly.

Postpartum OCD can be easily managed by timely treatment and adequate family support. New mothers can navigate toward healing very easily; only they need to have patience and resilience to walk through the struggles happily. They have the power to build a brighter, healthier future for themselves and the new baby.

FAQ’s

1. How Long Does Postnatal OCD Last?

The duration of postnatal OCD can vary from one woman to another. In some cases, symptoms may last for several months, while in others, they can persist for years. Seeking professional help, such as therapy and medication, can greatly aid in managing and reducing the duration of postnatal OCD symptoms.

2. Can Postpartum OCD Be Cured?

Postpartum OCD can be effectively treated and managed with the right interventions. Seeking professional help, such as therapy and medication, can significantly improve symptoms and provide relief. With appropriate treatment and support, many individuals with postpartum OCD experience a significant reduction in symptoms and can go on to lead fulfilling and healthy lives.

3. Do Mothers With Postpartum OCD Have Postpartum Depression?

Not necessarily it happens this way. There are similarities in the signs of postpartum OCD and postpartum depression; however, all the symptoms do not match. Postpartum OCD tends to have more anxiety and fear associated with it; while postpartum depression involves mood swings. Both conditions may not occur together.

4. Are There Any Alternative Therapies For Postnatal OCD?

Yes, there are methods such as mindfulness, and meditation practices that can enhance the well-being of the mother suffering from postpartum OCD. However, these methods cannot be considered as a substitute for standard therapies and medications.

References

1. High Prevalence and Incidence of Obsessive-Compulsive Disorder Among Women Across Pregnancy and the Postpartum – PubMed – [https://pubmed.ncbi.nlm.nih.gov/34033273]
2. Obsessive-compulsive symptoms, intrusive thoughts and depressive symptoms: a longitudinal study examining relation to maternal responsiveness – PubMed – [https://pubmed.ncbi.nlm.nih.gov/31431052/]
3. Role of serotonin in obsessive-compulsive disorder – PubMed – [https://pubmed.ncbi.nlm.nih.gov/9829022/]
4. Genetics of obsessive-compulsive disorder – PMC – [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8477226/]
5. Obsessive–Compulsive Disorder in the Postpartum Period: Diagnosis, Differential Diagnosis and Management – Verinder Sharma, Christina Sommerdyk, 2015 – [https://journals.sagepub.com/doi/10.2217/WHE.15.20]
6. Perinatal Obsessive–Compulsive Disorder: Epidemiology, Phenomenology, Etiology, and Treatment – PMC – [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10323687/]