“What is Postpartum Obsessive-Compulsive Disorder (OCD), and What does it Mean about how I’ll Treat my Baby?”

Postpartum depression has, for good reason, garnered more attention in the media and more resources in communities of late. However, postpartum OCD is not often discussed and, unfortunately, misunderstood by many. So what is postpartum OCD, and what does it mean to suffer from it?

What is postpartum OCD?

Postpartum OCD is the onset of obsessions (intrusive, repetitive, upsetting thoughts) and/or compulsions (repetitive and impairing behaviors) around or shortly after the birth of a baby. Unlike typical OCD, which may involve obsessions about symmetry, cleanliness, or making mistakes, postpartum OCD almost always involves thoughts and images about harming the baby, either intentionally or inadvertently. For example, a parent experiencing postpartum OCD might have thoughts or images of shaking or smothering the baby, sexually molesting the baby, drowning the baby during a bath, or pushing the stroller into traffic. Needless to say, these thoughts are terrifying to those who experience them. Associated compulsions may involve repeatedly checking on the baby, reciting prayers or mental rituals, seeking reassurance from others, or avoiding being alone with the baby. Although new moms are more likely to experience postpartum OCD, new dads can develop the disorder as well

Do people with postpartum OCD typically hurt their babies?

NO! Having postpartum OCD does not mean that you are likely to hurt your baby. Occasionally a story in which a mother harms her child makes headlines and horrifies most who read about it. However, the mothers in these stories are typically suffering from postpartum psychosis or another disorder, NOT postpartum OCD. The difference is that those with postpartum OCD are appalled and sickened by thoughts about hurting their babies, while those with postpartum psychosis might not be. That is, a mother with postpartum psychosis might have delusions (or strongly held strange or paranoid beliefs) that make harming the baby seem like an appropriate, logical, or necessary course of action. Postpartum psychosis is very serious, can be very dangerous, and is very different from postpartum OCD. Postpartum OCD sufferers should take solace in knowing that the fact that they are so upset by thoughts about hurting their babies suggests that they are very, very unlikely to actually do so.

Is there help available for people with postpartum OCD?

Postpartum OCD can be torturous for those suffering from it. Fortunately, there is effective treatment available. In addition to medications that help treat OCD, cognitive behavioral therapy (CBT) is used to manage the symptoms associated with the disorder. A typical course of CBT for OCD involves education about the disorder; thinking skills to help modify thinking traps that arise related to having the disorder (e.g., the mistaken belief that a woman suffering from postpartum OCD is a “bad mother”); and Exposure with Response Prevention, which involves gradually exposing oneself to situations that elicit obsessions, while preventing oneself from engaging in the related compulsions. Principles of mindfulness, with a focus on nonjudgmental observation of one’s thoughts and feelings, can augment CBT for OCD as well.

What should I do if I have disturbing thoughts related to my baby?

It is important to note that the types of obsessions experienced by people with OCD are not qualitatively different from thoughts that people without OCD sometimes have. In other words, LOTS of new parents experience upsetting, unwanted, and even aggressive thoughts toward their babies.  The difference is that people with OCD are unable to dismiss these upsetting thoughts as unintentional or meaningless. For someone suffering from postpartum OCD, the upsetting thoughts come back again and again and are often accompanied by problematic behaviors or avoidance.

If you’re bothered by upsetting, scary, or disgusting thoughts pertaining to your baby, there is no need to suffer in silence. Speak to a trusted healthcare provider or seek out a cognitive behavioral psychologist and/or a psychiatrist who can help. Know that you are not alone and that you don’t have to endure the weight of OCD unassisted.

To learn more about how CBT can provide you with relief, please call 212-335-2100.