It's normal to worry about your baby or occasionally have an upsetting thought about your little one's health and safety. But if you frequently experience intrusive thoughts and find yourself engaging in repetitive behaviors, you may be suffering from postpartum obsessive-compulsive disorder (OCD).
Postpartum OCD may develop for the first time after pregnancy and childbirth, or postpartum changes might exacerbate an already-diagnosed case. Here’s more about this illness, including the signs to watch for and the ways postpartum OCD can be treated.
What is postpartum obsessive-compulsive disorder (OCD)?
Postpartum OCD is an anxiety disorder that can crop up around the time of childbirth, causing women to experience unwanted thoughts or repeated behaviors, known as obsessions and compulsions. OCD that develops after the birth of a child is rare and affects fewer than 3 percent of new moms.
Postpartum obsessive-compulsive disorder is often misunderstood, as some new mothers might not have a full-blown case of OCD but still experience some symptoms.
What's more, signs of postpartum OCD can resemble postpartum generalized anxiety — which is more common, affecting up to 15 percent of moms and a few new dads — so it can be difficult to distinguish between the two conditions.
What causes postpartum obsessive-compulsive disorder (OCD)?
The causes of postpartum obsessive-compulsive disorder aren’t fully understood, but experts believe that OCD in general may have a genetic component and, in some cases, can be learned from others.
Potential risk factors include:
- Having a personal or family history of OCD or anxiety
- Hormonal changes that take place during and after pregnancy
Pregnancy and the postpartum period are greatly affected by changes in certain hormones, particularly progesterone and oxytocin. Research suggests that oxytocin and the neurotransmitter serotonin have an effect on OCD, so fluctuating levels of these hormones may put new mothers at a higher risk of developing symptoms.
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The many physical changes your body goes through during pregnancy and the postpartum period can also impact an existing case of OCD.
What are the symptoms of postpartum obsessive-compulsive disorder (OCD)?
In general, obsessive-compulsive disorder features obsessions (persistent, unwanted thoughts) and/or compulsions (repetitive behaviors). Although people with OCD usually experience both obsessions and compulsions, some may just have one or the other.
Obsessions might include a fear of germs or intrusive thoughts of something bad happening, while compulsions could take the form of checking behaviors or a need for household items to be organized in a specific way.
Symptoms of obsessive-compulsive disorder that develop in the postpartum period typically focus on the baby and her wellbeing, and can include the following types of obsessions and compulsions:
- Extreme worry that your baby could fall, choke, be dropped or die suddenly
- Fear of being alone with your baby
- Intrusive thoughts of something terrible happening to your baby
- An extreme need to keep your baby's clothes and accessories tidy and symmetrical
- Checking behaviors, such as constantly looking in on your baby while she's sleeping
- Obsessively praying to protect your baby
- Feeling the need to count or repeat phrases relating to your baby in a certain pattern
How does postpartum OCD differ from postpartum anxiety?
It can be difficult to tell the difference between postpartum anxiety and postpartum obsessive-compulsive disorder, in part because OCD is a type of anxiety disorder, and the two conditions share many of the same symptoms, such as extreme fear. It's also possible for a new mom to have both postpartum anxiety and OCD.
- Postpartum anxiety is characterized by excessive worry, fear or dread after having a baby and becoming a new parent. This condition is somewhat common: 10 to 15 percent of new moms experience postpartum anxiety, and women who also have postpartum depression may be more at risk. In addition to excessive worry, moms suffering from postpartum anxiety may experience racing thoughts, an elevated heartbeat, a persistent feeling of being on edge, feeling agitated or jittery, and trouble falling or staying asleep.
- Postpartum obsessive-compulsive disorder can include many of the same symptoms of postpartum anxiety, such as extreme worry, but OCD symptoms take the form of obsessions and/or compulsions. Obsessions may include extreme fears or disturbing, frightening thoughts related to the baby and her health, while compulsions are repeated behaviors that you feel like you "have" to do. These intrusive feelings can interfere with daily life, causing a new mother to repeatedly check on the baby or obsess about her safety (as in, the baby falling, choking or drowning).
Symptoms of postpartum OCD may last longer than postpartum anxiety. One analysis of more than 450 women found that of those with depression, 20 percent also had anxiety and 26 percent exhibited OCD signs. But by the time their child was 6 months old, anxiety symptoms had eased while the OCD symptoms continued.
How is postpartum OCD diagnosed?
Diagnosing an obsessive-compulsive disorder in the postpartum period can be tricky, in part because symptoms may mirror other conditions such as postpartum depression and postpartum anxiety. In fact, some experts believe that up to 30 percent of new moms with postpartum depression also have OCD. And as with other postpartum mood disorders, moms with postpartum OCD may feel hesitate to open up about their symptoms.
If you think you are experiencing symptoms of postpartum OCD, reach out to a practitioner right away. Your doctor can screen you for postpartum OCD (as well as other postpartum mood disorders such as postpartum depression, anxiety and postpartum PTSD) and refer you to a mental health care professional.
How is postpartum OCD treated?
It's important for moms with postpartum obsessive-compulsive disorder to know that they're not alone and the condition is very treatable.
Treatment options for postpartum OCD are generally the same as having OCD at any other time. Depending on how mild or severe your symptoms are, a combination of cognitive-behavioral therapy and medications (often antidepressants like serotonin reuptake inhibitors, or SSRIs) may be recommended.
In general, SSRIs are considered safe to use during pregnancy and while breastfeeding, but always discuss your options with your physician. You may also benefit from techniques such as meditation, relaxation exercises and mindfulness training.
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