While postpartum depression and anxiety are widely recognized, perinatal obsessive-compulsive disorder (OCD) often flies under the radar. This condition can be as challenging as postpartum depression and anxiety, and understanding its symptoms is crucial for seeking appropriate help.

What is Perinatal OCD?

Perinatal OCD is a form of obsessive-compulsive disorder that can occur during pregnancy or within the first year after childbirth. It is characterized by persistent, intrusive thoughts that provoke significant anxiety. These thoughts are often related to fears of harm coming to the baby or oneself. Because symptoms can overlap with general anxiety and there is no specific screening tool for perinatal OCD, it is frequently overlooked during diagnosis.

Symptoms and Manifestations

Perinatal OCD manifests through distressing, unwanted thoughts about causing harm to the baby. These thoughts can become overwhelming and lead to compulsive behaviors designed to prevent the feared harm, often consuming the individual's daily life.

The disorder can present in various ways:

• Fear of Deliberate Harm (41%): Worries about intentionally harming the baby.

• Contamination or Accidental Harm (29%): Fears about germs or accidents affecting the baby.

• Ordering/Arranging (6%): Compulsions related to organizing the environment to prevent harm.

• Religious Obsessions (3%): Concerns that might involve religious or moral aspects.

• Repetitive Checking (3%): Repeatedly verifying that the baby is safe.

It's essential to understand that having these distressing thoughts does not mean one will act on them. The thoughts are separate from actions, and a mother who experiences them typically has no intention to harm her child. If the thoughts cause significant distress and the mother is actively taking steps to protect her baby without delusions or hallucinations, the risk of harm is very low.

Understanding the Cycle

Perinatal OCD follows a distressing cycle:

1. Obsessive Thought: Persistent and intrusive thoughts about potential harm.

2. Anxiety: Elevated stress and fear due to the intrusive thoughts.

3. Compulsive Behavior: Actions taken to avoid perceived threats or reduce anxiety, such as excessive checking or cleaning.

4. Temporary Relief: Short-term reduction in anxiety after performing compulsive behavior.

Imagine Bethany, a new mother who is paralyzed by fear that her baby might develop cancer due to environmental factors. Bethany's daily life is consumed by these fears, leading her to obsessively check the air quality inside and outside. Every room has an air purifier and she is constantly opening and closing windows and doors, regardless of the weather, in order to reduce volatile organic compounds (VOCs) in the air. If the air quality index is anything less than "green," she refuses to step outside, missing out on necessary outings and fresh air.

Bethany's home is a constant whirlwind of cleaning rituals. She scrubs every surface multiple times a day (and then worries that the chemicals in the cleaners are toxic), obsessively sterilizes bottles, pacifiers, and toys, and throws away food she deems even slightly old, fearing pathogens. Her fear of germs drives her to avoid all public spaces, isolating her from friends and family, and she spends hours scrutinizing food labels, second-guessing each item she considers for her baby and feeling inconsolable when she feels that her baby hasn’t hit the necessary protein, iron, or fiber goals she read about.

These compulsions create a relentless cycle of stress and isolation. Bethany's constant vigilance leaves her exhausted and overwhelmed, making it nearly impossible for her to enjoy daily activities or engage in normal life. Her relationships suffer, and her own well-being deteriorates as she is trapped in a loop of anxiety and compulsive behaviors.

Seeking Help

If you’re struggling with symptoms of perinatal OCD, it’s vital to seek support. At Roots & Branches, our therapists specialize in perinatal mental health and can help you identify and break free from this debilitating cycle.

SUMMARY

Perinatal OCD is an often overlooked condition that can occur during pregnancy or the first year postpartum. It involves persistent, intrusive thoughts, usually about harming the baby, which lead to compulsive behaviors like excessive cleaning or checking. These behaviors offer only temporary relief, trapping mothers in a cycle of anxiety and stress. For example, Bethany, a new mother, obsessively monitors air quality and cleanliness, isolating herself and feeling overwhelmed. Recognizing the signs and seeking specialized help is crucial. At Roots & Branches, therapists provide support to break the cycle of perinatal OCD.