The baby blues are a very, very real thing. So is postpartum depression, which is more than just a little case of new mom sadness. Postpartum depression (PPD) can lead to feelings of inadequacy, and can cause a lack of bonding between mom and baby, and even self-harm, harm to the child, or suicide. Luckily, awareness of the topic in recent years has increased, and there’s even a center focused solely on perinatal mood disorders.
My biggest fear during pregnancy wasn’t stretch marks, pain, or discomfort — it was PPD. I heard so much about it that I was convinced it would happen to me, and I probably asked my midwife how I could prevent it at every appointment. During all of these conversations, no one ever mentioned that depression may not be the only mood disorder that is triggered by giving birth.
A lesser-known effect of new motherhood is the onset of anxiety disorders like obsessive compulsive disorder (OCD). Just like the baby blues doesn’t always equal full-blown PPD, a desire to be neat and tidy or upset when your house is a mess doesn’t mean OCD.
Only 2 to 3 percent of people suffer from OCD, but a new study in The Journal of Reproductive Medicine has shown 11 percent of new moms experience these symptoms. Postpartum OCD tends to come on rapidly and is often centered around a new mom’s obsessive thoughts about accidentally hurting her baby or undesirable thoughts of intentionally causing harm to her baby. These repetitive and intrusive thoughts can include things about worry the baby could die in her sleep or choking and not being able to save her, or they could include thoughts of dropping, shaking, yelling, or drowning the baby. Most women with postpartum OCD do not actually act on these thoughts, meaning they resist the thoughts even though they are obsessive.
That’s the “obsessive” side of OCD: thoughts the postpartum mother can’t get rid of or doesn’t want to have. The “compulsive” side is constantly checking on the baby during the night, praying over and over, and continuously looking up “symptoms” on the internet.
If you’re thinking these sound like normal new parent behaviors, you’re right — they are. A main difference here is that these behaviors interfere with normal life. I likely checked my baby monitor every six seconds when my son was a newborn and sleeping in his room for the first time, but it wasn’t interfering with my ability to function- it was normal new mom behavior. I still worry that he’s not breathing when he’s not moving in his crib. He’s so active during the day that it’s hard to picture him being still and OK, but again, lots of parents do that and it isn’t causing bigger problems. Postpartum OCD is much more than those day-to-day worries.
The exact cause of postpartum OCD is unknown. One thought is that it’s an effect of hormonal changes during pregnancy, particularly oxytocin and progesterone. Another theory is that it’s normal new parent thoughts taken to a heightened level, due to the sudden onset of responsibility — meaning that negative thoughts about your baby are normal, but people who experience postpartum OCD don’t accept that.
So what can new moms do if they’re experiencing symptoms of postpartum OCD? Get treatment! Treatment for postpartum OCD is the same as traditional OCD: medication and talk therapy. Specifically, serotonin reuptake inhibitors (the same medication used to treat some depression) and cognitive behavioral therapy are effective in treating the disorder. It’s not yet known what the effects of medications may be on a breastfeeding baby. Although it’s important for mothers to get the help they need, doctors caution against using medication to unnecessarily treat normal behavior and feelings.
The previously cited study also found that half of the moms with postpartum OCD had improved by six months, although some moms were just beginning the onset at that time. Approximately 75 percent of moms with postpartum OCD also experienced depression.
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