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What Is Postpartum OCD?

Scary thoughts often pop into the heads of new moms and dads.  “What if the baby’s not breathing?”  “What if I drop him?”  But sometimes, new parents are horrified by their own incessant thoughts of hurting or losing the baby.  Psychologist Dr. Ellen Hendriksen explains Postpartum Obsessive Compulsive Disorder (OCD).

By
Ellen Hendriksen, PhD
September 27, 2013

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Let's take a look at the cases of two patients who have come to my office recently:

Patient #1: Shelly

Shelly is a first-time mom of 2-month-old Aiden.  She loves him with all her heart.  Shelly had a tough delivery and there were some frightening moments when Aiden’s breathing was touch-and-go.  A few days after birth, Aiden’s doctors pronounced him totally healthy, but Shelly still can’t shake the feeling that his breathing is defective.  She worries non-stop that he’ll die of SIDS.  She’s convinced he’ll stop breathing and no one will catch it in time to save him. 

As a result, Shelly watches him constantly during naps to make sure he’s still breathing.  At night, she wakes up to check the bassinet a few times an hour, her heart pounding until she sees him stir or feels him exhale.  In her worst moments, she wakes Aiden up just to reassure herself he’s alive.  She’s exhausted but can’t rest.  Shelly’s husband is concerned that she’s overdoing her monitoring.  She knows she’s out of control but can’t stop.

Patient #2: James

James is a new dad of 3-month-old Caitlyn.  James and his wife live in a fifth-floor apartment with a lovely balcony overlooking the city.  A few days after coming home from the hospital, James took Caitlyn out on the balcony to get some fresh air.  Out of nowhere, a horrible thought popped into his head.  He pictured himself throwing Caitlyn off the balcony.  Alarmed, he rushed inside and gave Caitlyn to his wife.  He knew the idea didn’t make sense and that he would never do it, but he couldn’t get it out of his head.  

The next day, while slicing tomatoes for a sandwich, he suddenly pictured himself stabbing Caitlyn with the knife. Over the last few weeks, he’s pictured himself doing these things over and over.  Now, whenever the thoughts return, his heart pounds and he breaks into a sweat.  He’s convinced he’s a monster. The harder he tries not to think about it, the more he pictures himself hurting her.  In the past few weeks, he hasn’t touched Caitlyn.  Afraid he’ll hurt her, he won’t feed her or change her diaper.  His wife is angry and keeps asking what’s the matter with him.  James swears to himself never to tell anyone of these thoughts because he fears he’ll be locked up or Caitlyn will be taken away from him.

What Is Postpartum OCD?

Postpartum OCD (Obsessive Compulsive Disorder) is a condition that can strike both moms and dads, like Shelly and James.  

Almost all new parents have strange or upsetting thoughts that cross their minds from time to time, such as, “What if I drop her?” or “What would happen if I shook him?”

In postpartum OCD, however, the thoughts feel out of control, are extremely distressing, and persist even when parents try to brush them off.  When unwanted thoughts are intrusive, inappropriate, and relentless, they are called obsessions - the “O” in OCD.

Common themes of postpartum OCD include, but are certainly not limited to:

  • hurting the baby on purpose (like James’s intrusive thoughts)
  • suffocation or SIDS (like Shelly’s intrusive thoughts)
  • unacceptable sexual scenarios
  • losing the baby
  • accidents
  • contamination or illness

Obsessions go hand-in-wringing-hand with compulsions - the “C” in OCD.  Here's how...

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