Thanks to our guest blogger, the OCD and Anxiety Center of Minnesota (OCDMN), for this post. OCDMN is a clinic located in the Twin Cities area that provides services for individuals with OCD and related disorders. The clinic is owned and operated by Jayme Kolbo, Erin Venker and Emily Risinger. These therapists are highly trained in Exposure Response Prevention (ERP) and aim to provide more knowledge on the benefits of ERP through education, advocacy, and therapeutic practices. Sign up for their newsletter or check out their website for more information.
NOTE: If you are experiencing anxiety or feel something is not right with your mental health, please consult your physician.
When Parenting Stress Turns Into Perinatal OCD
Pregnancy and parenting come with many changes and mixed emotions. Just as with pregnancy anxiety, some postnatal anxiety is normal. Resuming activities of daily living, managing hormone changes, recovering from pregnancy, as well as assuming responsibility for another life can come with challenges. It is common for a new parent to feel excitement, trepidation, and complete fear all in one breath. So, what distinguishes normal worry from problematic parenting anxiety? Let’s explore the difference between normal parenting stress and anxiety versus perinatal Obsessive Compulsive Disorder (OCD).
OCD in parents is also called: Maternal OCD, Paternal OCD, Postnatal OCD, Prenatal OCD, Perinatal OCD, and Pregnancy OCD. OCD affects 3-5% of new mothers and parenting anxiety affects about 6% of pregnant women and 10% of postpartum women (Postpartum Support International). Fathers may also experience these symptoms, although the estimated percentage is unknown.
Symptoms of OCD include recurrent intrusive, unwanted thoughts, images, or impulses that cause distress. Repetitive compulsive behaviors accompany the intrusive thoughts and are aimed at reducing distress and/or preventing something terrible from happening, which may also include avoidance behaviors (International OCD Foundation).
For pregnant mothers, expecting fathers and new parents, common obsessive/intrusive thoughts include:
- fear of harming baby
- fear baby might become sick
- fear baby may die in sleep
- fear mother or father may no longer be able to care for baby
- fear of poisoning baby by accident (spoiled milk, inferior materials for toys/clothes, carbon monoxide)
Here are some specific examples of intrusive thoughts reported by parents in therapy:
- What if I step on my baby?
- What if I throw my baby down the stairs?
- What if I throw my baby off the balcony or over the stair railing?
- What if I get so sleep deprived that I lose control and hurt my baby?
- What if I have/develop postpartum psychosis?
- What if I don’t love my baby?
- What if going back to work means I do not love my baby?
- What if I’m not a good parent and mess up my baby?
- What if the doctor finds out I am having these thoughts and they take my child away?
Often new parents are terrified to share these obsessive worries with others or disclose them to a therapist for fear that they might be reported to authorities or social services. This fear is understandable, and there is no evidence of an individual acting on intrusive thoughts. Intrusive thoughts cause distress (anxiety, fear, disgust, guilt, shame) and are ego-dystonic, meaning they are not in line with the individual’s beliefs, values, or who they are/want to be as a person. Many parents with intrusive thoughts are so fearful of acting on the unwanted thoughts that they act quite the opposite and go to extreme lengths to care for and protect their baby.
These extreme lengths are called compulsive behaviors. Common compulsions reported by parents with intrusive thoughts include:
- excessively washing baby multiple times
- excessively washing clothes, bottles, breast, and other things used to care for baby
- checking online for information/excessive research and reading
- making extra doctor’s appointments
- checking baby’s temperature multiple times with thermometer or hand
- asking for reassurance (“Is this safe? Did I do that right?”)
- excessively checking baby’s breathing
- tasting milk
- checking how they feel when interacting with their baby
- avoidance of holding baby in certain locations of the home
Parents who have a history of OCD are at higher risk for developing postpartum OCD. There may also be a genetic component that increases risk, but how OCD and other anxiety disorders develop is complex and cannot be attributed to just one factor.
Parents who experience these thoughts know they are irrational. Treatment is possible and Perinatal OCD is temporary. Consider finding a therapist trained in treating OCD if you notice a negative impact on functioning, if it all feels unmanageable or completely overwhelming, if you feel unable to move on from intrusive/worry thoughts, if you are spending an excessive amount of time trying to prevent any small chance of something bad happening, if you are experiencing excessive distress that doesn’t seem to go away or get better, and/or if you just think it might be helpful to have a safe space to talk about your worries and learn how to cope more effectively with them. Getting help does not mean you are a bad parent, does not mean you are weak, does not mean you are incapable, and does not mean anything bad about you as a parent or person. You don’t have to wait to be in a crisis to reach out. Everyone can use a little extra support sometimes.
OCD is not the only anxiety disorder that can occur during pregnancy or after birth. Generalized Anxiety Disorder and Panic are among other anxiety disorders that can impact parents.
Generalized Anxiety Disorder (GAD) is characterized by excessive or constant worry about a variety of things, racing thoughts and trouble concentrating, trouble sleeping and eating, inability to sit still/relax, irritability, and physical symptoms including muscle tension, GI issues, headaches, stomachaches, and/or shakiness. GAD becomes problematic when it interferes with your ability to function in daily life and interact with/enjoy your baby/life. It’s common for parents with GAD to become easily overwhelmed by almost anything, want to avoid people/places/things, become easily irritated, attempt to be over-controlling, and to catastrophize. GAD differs from OCD in that excessive worry is not obsessive in nature but is generalized; anxiety latches on to a variety of different situations instead of obsessively focusing on a few main fears. GAD also does not include compulsive behaviors, although avoidance and over-thinking is common in both disorders (https://ppsupportmn.org/).
OCD and anxiety can also lead to panic. Panic attacks are sudden, intense surges of anxiety that can include pounding heart, sweating, shaking, shortness of breath, feelings of choking, chest pain/discomfort, nausea, or abdominal distress, feeling dizzy or lightheaded, chills or heat sensations, numbness or tingling, feelings of being detached from reality, fear of losing control, and/or fear of dying. Some panic attacks may lead to intense fear of having future panic attacks due to the intensity and impairment in functioning.
If you are struggling with intrusive thoughts, excessive worry, and/or panic, help is available. Find a therapist who specializes in treating OCD and related anxiety disorders using Cognitive Behavior Therapy and Exposure and Response Prevention. Being pregnant and having a baby are huge life events that have an impact on life in a variety of ways. You do not need to have a diagnosis to ask for help managing the stress associated with prenatal and post-natal care. Practicing how to ask for help now will reflect as a great modeling opportunity to show your child to use their resources in the future.
- Good Moms Have Scary Thoughts by Karen Kleiman, MSW
- Overcoming Unwanted Intrusive Thoughts By Sally M. Winston, PsyD and Martin N. Seif, PhD
- Overcoming Harm OCD Jon Hershfield, MFT
- The Art of Good Enough: The Working Mom’s Guilt-Free Guide to Thriving While Being Perfectly Imperfect By Dr. Ivy Ge
You are not alone. Stay Brave!