Perinatal Obsessive Compulsive Disorder
Updated: Sep 24, 2018
Many mothers experience intrusive thoughts of harming their child. A large number will feel too frightened or ashamed to tell anyone and therefore never seek help. Overcoming the fear of talking about intrusive thoughts is the first step to accessing the support that is available.
In the time that I have been back at work from maternity leave I have encountered three cases of Post Natal Obsessive Compulsive Disorder (OCD). This struck me as quite a significant number in such a short time and inspired this to be my first blog post. In fact, more women will experience OCD in the perinatal period than in the non-perinatal population.
Often, I find that the mothers I meet with Perinatal OCD are very reluctant to tell me about the thoughts they are having, this is of course understandable. Not only are the intrusive thoughts distressing, but the idea of sharing these with someone else causes additional anxiety, a fear that "no one will really understand" and people will think "I am a bad mother" "they might take my child away". This can mean that mothers will suffer in silence with intrusive thoughts and not seek the help that is available to them. Whilst it is great that people are more aware of OCD now after widespread media coverage, phrases like "I am a bit OCD" from people who like a clean and tidy house or ordered sock drawer are not helpful, this trivialises OCD and does not really capture the true nature of OCD. I hope to provide a brief introduction into what OCD is and encourage any mothers suffering with intrusive thoughts to come forwards and seek support.
What are intrusive thoughts: the obsession bit
Intrusive thoughts are unwanted thoughts, images or doubts that pop into your mind out of the blue and do not fit with your own personal values or beliefs (they are ego-dystonic). Intrusive thoughts usually involve themes of harm or danger towards those you care about.
Some examples of intrusive thoughts, images or doubts I have heard form Mothers include:
Dropping the baby
Stabbing the baby
Throw the baby down the stairs or off other high edges such as bridges or escalators
Poisoning the baby
Suffocating or drowning the baby
Cutting off a finger of other extremity
Just reading or writing these statements feels distressing, let alone having these thoughts come into your mind regularly which causes a huge amount of anxiety for the mother. Particularly because these thoughts are then interpreted by the mother to be accurate and true. Additionally, an overinflated sense of responsibility makes the mother feel like “it will be all my fault because I thought it” or “having these thoughts must mean I am an awful parent”.
Given that one of the key features of OCD is an overinflated sense of responsibility it is no wonder then that when a new baby is born, the most precious things you have ever had to be responsible for, that your sense of responsibility goes through the roof.
Compulsions: the doing bit
The second part of OCD is the compulsions. The intrusive thoughts and overinflated sense of responsibly drive the mother into action, to do something to reduce the chance of the perceived danger happening. For example, a mother who has thoughts that she might drop the baby may refuse to carry her child anywhere unless they are strapped into a car seat. A mother who fears they will drown the baby may only wash the baby in a very small amount of water. These compulsions or safety behaviours may start small but can escalate because they do not stop the intrusive thoughts from happening. One mother I met removed all the knives from the house for fear that she would hurt one of her children.
The OCD bully starts small but will always demand more and more from your compulsions. Eventually it can take a hold on all areas of life impacting not only mother but children and family too.
What can I do if I think I have OCD
If having read this you feel that you might be suffering with perinatal OCD, don’t delay, there is support available. Cognitive Behavioural Therapy is an evidenced based treatment for OCD recommended by the National Institute for Clinical Excellence (NICE) and provided for free through the NHS.
Reach out to a loved one or friend
Talk to your GP, midwife, or health visitor
Refer to your local Improving Access to Psychological Wellbeing Therapies (IAPT) service - perinatal cases are prioritised and should be seen within 2 weeks. Most accept self-referrals, you can search for your local service using this site: https://www.nhs.uk/Service-Search/Psychological-therapies-(IAPT)/LocationSearch/10008
If you prefer to speak to a therapist privately find a Cognitive Behavioural Psychotherapist through the BABCP register of accredited therapist. http://www.cbtregisteruk.com/Default.aspx
Remember that you are not the only mother to experience this and most importantly no one will take your baby away from you because you have distressing intrusive thoughts.