What is Perinatal OCD and How Can It Be Treated?
This article will take you through all you need to know about what perinatal obsessive compulsive disorder (OCD) is, how it can affect a mother, and how it can be treated. We’ll also cover ways in which you can help yourself if you think you have symptoms of perinatal OCD.
Content
The basics
What is perinatal OCD?
Perinatal refers to the period when a woman is pregnant and up to a year after she gives birth. Perinatal OCD refers to OCD symptoms which are experienced during this time period. You might also hear the terms antenatal or prenatal, these mean during pregnancy but ‘before birth’. Alternatively you might hear postnatal or postpartum meaning ‘after birth’. Perinatal covers this entire time period, both prenatal and postnatal. Studies show that perinatal OCD affects, “1% of women in pregnancy and 2.9% of women in the postnatal period.”
Perinatal OCD can mean that someone who didn’t have OCD previously develops OCD in pregnancy or after their baby is born. It can also mean that someone who has OCD but has been in remission, has a recurrence of their symptoms. Someone who has ongoing struggles with OCD can also find that their symptoms worsen during the perinatal period.
Perinatal OCD is categorized by both obsessions and compulsions. Obsessions are recurrent intrusive thoughts which the mother will find very distressing. Compulsions are the actions the mother takes to try to ‘cope’ with these obsessions. Obsessions and compulsions in perinatal OCD tend to revolve around the baby. The International OCD Foundation explains that, “Perinatal OCD is characterized by intrusive unwanted thoughts (i.e., obsessions) about aggression toward or a fear of contamination of the infant.”
What causes perinatal OCD?
Scientists aren’t completely sure what causes perinatal OCD. However, they believe that the drastic change in hormone levels experienced during the perinatal period play a vital role. Theories suggest that these hormones may influence a change in the chemical activity in the brain, in the same way as displayed within other anxiety disorders.
Experts also believe that the rise in the hormone oxytocin which facilitates the bond between mother and child, can create an over-protection response. This can manifest in obsessions and compulsions to try to control the anxiety which comes along with it.
Additionally, psychological factors which come as a natural part of pregnancy can play a part. The increased sense of responsibility and tendency to be more alert to threats can lead to increasing anxiety. This anxiety can lead to obsessional thoughts.
Those who already have mental illness, and who have already struggled with OCD, may be more vulnerable to re-experiencing OCD symptoms during times of big changes and stress, such as that of having a new child.
All new mothers have anxious and intrusive thoughts: they’re completely natural and don’t mean anything. Mothers without perinatal OCD might find these thoughts mildly upsetting, but typically allow the thoughts to pass without attaching much meaning to them. However, those with perinatal OCD will attach great significance to these thoughts. They’ll believe that they make them a bad person and find them very distressing. This significance attached to the intrusive thoughts, is what leads them to be obsessions.
How does perinatal OCD affect mother and baby?
Perinatal OCD can be extremely distressing for the mother. At a time when she should be able to enjoy her pregnancy and her new baby, and focus on bonding, she is instead overtaken by severe anxiety and at times, even terror. Obsessions can make the mother feel as though she is a terrible person and a bad mother, which can plague her and feed into the OCD cycle.
Compulsions themselves can take up a great deal of time and get in the way of daily functioning. All of these factors can interrupt the mother and baby bond. The International OCD Foundation explains that, “Attachment and bonding between mother and infant may become disrupted, with potential negative impacts on infant development.”
The mother may struggle to allow anyone else to take care of her baby, or to let anyone help them with the baby’s care even in their presence. They may fear that the other adult will not stick to the ‘rules’ that OCD has set out in her mind in regards to how the baby must be cared for. This can even apply to the father, which can be very distressing and also disrupt his bond with the child. This can also mean that the mother is absolutely exhausted, not allowing anyone to help her and having to try and keep up with the usual care of a baby as well as her own compulsions.
Other women may find that they avoid their baby and refuse to interact with them, because it will trigger their obsessions. They might avoid their baby altogether and leave other loved ones to take care of the child, or they may not want to be alone with the baby. Unfortunately, this markedly impairs the bond between mother and child, and can negatively affect the baby’s development.
Obsessions in perinatal OCD
Obsessions are recurrent intrusive thoughts which are very distressing in nature, and which the mother attaches great significance to. They may feel that these thoughts make them a bad person, that their baby is in danger, and fundamentally feel that they need to do something to deal with these thoughts. Obsessions will be accompanied by very high anxiety and emotional distress.
These intrusive thoughts can be experienced in various ways. The charity OCD UK explains that obsessions, “take the form of persistent and uncontrollable thoughts, although obsessions can sometimes be persistent images, impulses, worries, fears or doubts or a combination of all these.”
Most commonly the individual may be aware that these thoughts are irrational and know that they don’t line up with what they really think, but the thoughts are so vivid and ‘real’ that they feel impossible to ignore. Sometimes the individual may be unaware that these thoughts are not grounded in reality.
Perinatal OCD obsessions can vary in severity and type in each individual, but all tend to center around the baby. It’s important to note that these obsessions do not reflect what the mother actually feels or thinks: it’s the OCD talking. This article from Maternal OCD states that obsessions in perinatal OCD tend to focus around, “significant fear of harm coming to the infant, with worries frequently focused on accidentally or deliberately harming the child or the child becoming ill.”
We’ll take a look at some of the more common obsessions experienced in perinatal OCD.
Contamination
Contamination obsessions in perinatal OCD are very common. Contamination obsessions focus around the idea of something or someone being contaminated with germs, dirt or another harmful substance (such as chemicals).
These obsessions might center around the mother fearing that they themselves are contaminated, either during pregnancy or afterwards, and that this is going to lead to their baby becoming ill. It could also involve fearing that the baby is contaminated or ‘dirty’.
Mothers with perinatal OCD might fear that others around the baby, whether it be loved ones or strangers, may be contaminated and make their child ill. They may also fear that their home (either specific ‘dirty’ areas, or the whole home) is contaminated.
Harm and sexual
The mother may be plagued with images, thoughts, and fears that they are going to harm their baby. This might be fear of them carrying out deliberate physical or sexual harm to their baby. For example, if they’re giving the baby a bath, an image of drowning the baby may flash through their mind. Another example is if they’re holding their baby, and find themselves picturing throwing them. Understandably this can be one of the most distressing types of obsessions for mothers.
They may also fear that they will accidentally harm their baby. For example, they might fear that they will accidentally expose their child to chemicals, medications, or toxins. They might fear that they will accidentally drop their baby, or not prepare their milk in the right way. They might fear making a decision (such as feeding the baby the wrong food), which will have a fatal outcome. There are many scenarios which can be feared, and all can be very upsetting for the mother.
Order or symmetry
The mother may have a strong urge or need to have things in a specific order or lined up symmetrically. This will typically focus around the baby’s belongings, such as arranging their clothes in a specific order. They might feel that they need to repeatedly put the baby’s things in the right order until it ‘feels right’. It’s likely they will become very distressed if this order is disturbed. They will fear that something awful is going to happen to the baby if this order isn’t maintained.
Losing control
It’s common for a mother with perinatal OCD to fear losing control. This might be fear of losing control of themselves, and in doing so accidentally harming the baby or upsetting them. It may be fear of losing control and acting on other obsessions (such as a harm obsession).
They may also fear not being in control of a situation involving others around their baby, and what will happen as a result. For example, they might fear a loved one will not hold the baby in the ‘right way’, and that they will be unable to control the situation. They may also fear losing control of themselves in front of others, and doing or saying something which will make others think they’re a bad mother, and which they will be ashamed of later. Of course, it’s not possible to be in control of others, or of yourself, all of the time. This reality only increases stress and anxiety around this obsession.
Perfectionism
The mother may have an urge to have everything in the home and around the baby absolutely perfect. They may want to have things ‘just right, and are likely to get very upset if anything seems imperfect. They may strive for a ‘feeling’ of things being perfect. It’s also common to fear forgetting to do things perfectly, or to fear losing something.
It’s also common for these obsessions with perfectionism to make it hard for mothers to make choices about themselves or their baby, for fear of choosing something which won’t fit in with their ideas of perfectionism. Of course, it’s not possible for things to be perfect so this can be very stressful for all involved.
Physical illness
A mother with these obsessions will fear that themselves (particularly while pregnant) or their baby, is going to become physically ill. This is separate from contamination obsessions, as it doesn’t focus around germs or dirt. Instead, this focuses around the idea that ‘something is wrong’ with their body, or the baby, or that they will develop a serious physical illness which could be fatal.
In pregnancy, this can cause the mother to be hyperaware of all of her bodily functions, looking for signs of something wrong. For example, she may focus a great deal on her breathing, and find it difficult to pull her attention away from this. This can be distracting and distressing. After pregnancy, this may focus on bodily functions of the baby and a hyperawareness of the baby’s health.
Superstitious
Superstitious obsessions may cause a mother to gravitate towards ‘lucky’ numbers, words, phrases, or colours, and to gravitate away from those they perceive as ‘unlucky’. They may fear that the use of things which are unlucky will lead to something terrible happening to their baby.
They might also be drawn towards specific superstitious actions, such as knocking on wood, and fear that if they don’t do so, their baby will be harmed. These obsessions can be all consuming and feel terrifying.
Compulsions in perinatal OCD
Compulsions are the actions someone with OCD takes to try to ‘cope’ with their obsessions. They may carry out compulsions to try to lessen anxiety caused by their obsessions, or to try to ‘prevent’ something bad happening as a result of their obsessions.
Unfortunately, compulsions actually feed into the OCD cycle. Compulsions may reduce anxiety in the very short term, but the anxiety quickly returns, and often much stronger. This leads to the individual needing to carry more and more compulsions to try to cope with their rising anxiety.
Just as with obsessions, compulsions in perinatal OCD can come in many forms. Someone may experience multiple types of compulsions, or only one. They will vary in severity depending on the individual, and even vary for one person over time. They often vary in reaction to outside stimuli, such as stress levels.
Perinatal compulsions may correlate directly with an obsession, for example washing and cleaning in reaction to contamination obsessions. However, they can also seem not to ‘match up’ with obsessions at all, for example focusing on arranging things in a specific order to prevent harm coming to the baby.
Compulsions can be both overt, meaning they are carried out physically, or covert (also known as mental compulsions), meaning they are carried out within your mind. All compulsions have a significant negative impact on the mother’s life. They can take up a great deal of time, be highly distressing, and interfere with their ability to function.
We’ll take a look at some of the more common compulsions which may be carried out by a mother with perinatal OCD.
Avoidance
Many women with perinatal OCD will avoid anything which could trigger their obsessions or compulsions. As we mentioned earlier, for some women this will manifest as avoiding spending time with their baby. If you have obsessions around harm, you might hide anything you could harm your baby with, such as knives around the home. If you have sexual obsessions, you might avoid changing your baby’s nappy or giving them a bath.
Reassurance seeking
Some mothers with perinatal OCD may try to repeatedly seek reassurance from others. This may be from a loved one or from a medical professional. They may ask over and over again for reassurance that they are a good mother, and that they wouldn’t harm their baby for example. They might ask for reassurance that they haven’t carried out any harm to their baby. They may seek confirmation that they are doing things ‘correctly’ or ‘perfectly’.
Checking
Checking is a very common compulsion. This can refer to checking something visually (such as looking to check you’ve locked the door) or physically (in our example, trying the door handle to confirm it’s locked). This may apply to anything relating to the baby.
A mother may repeatedly check that the baby is breathing for example. Alternatively, they might check that they’ve turned all appliances off in the home, so they don’t accidentally cause the baby harm. They might continually check that the baby’s bottle is at the right temperature, or that they’ve changed the baby’s nappy.
Checking can take up many hours of the day, as most mothers will need to recheck multiple times until things ‘feel right’. As we know, compulsions actually worsen anxiety so this can be an unachievable task. Understandably, this can be very disruptive to daily functioning.
Repeating
A mother may need to repeat a task a specific number of times, or until it ‘feels right’. This might be dressing and undressing the baby multiple times, or picking up the baby and putting them back down until they feel they’ve done it ‘right’. If they pick up a bottle and put it down on the table, they may need to repeat this action until the sound of the bottle meeting the table ‘sounds right’. Repeating compulsions can be very time consuming.
Arranging and symmetry
The mother may organise the baby’s belongings in a specific order or in specific places, and become very upset if this order is disrupted in any way. This is typically in relation to ‘order and symmetry’ obsessions. This could be arranging the baby’s clothes in the wardrobe in a specific order, perhaps by colour. It could be placing the baby’s toys in specific places where they ‘belong’, or needing to put their keys in a specific place each time they return home with the baby.
Washing and cleaning
Washing and cleaning is a common compulsion, particularly in relation to contamination obsessions. The mother may repeatedly wash themselves to ensure they’re clean and do not contaminate the baby: this might involve taking multiple showers each day, or washing their hands repeatedly. Often this is to the point that their skin becomes raw. Some mothers will even use substances to clean themselves that are harmful, such as bleach, in their efforts to ‘feel clean’.
They may wash, clean, and sterilize areas of their home until they feel it’s clean enough for the baby. Once they’ve given birth, the mother may excessively clean the baby to ‘ensure’ cleanliness. This could entail giving them multiple baths a day, always wiping them down, cleaning their hands, or excessively cleaning them during nappy changes. This can unfortunately lead to distress for the baby as well as skin irritations.
The mother may also feel the need to compulsively wash the baby’s belongings, such as washing their clothes repeatedly, constantly sterilizing bottles, or cleaning the baby’s room. They might also clean any area of the home that the baby is going to touch, to ‘prevent’ them coming to harm through contamination.
Counting
A mother with counting compulsions may need to carry out actions a specific number of times. For example, they might need to change the baby’s nappy five times every time they do so. They may need to count out loud to a specific number as they carry out a task. They might also have ‘lucky’ and ‘unlucky’ numbers which they favour or avoid respectively.
Mental review
A mother may go over their daily tasks in their mind to ‘ensure’ that they have not caused harm to their child, either accidentally or deliberately. They may also review memories, to look for ‘evidence’ that they are not a bad person and would not hurt their baby. As with our other compulsions, the reviewing progress can go on for a long time and make it tough to focus on anything else.
Rumination
Rumination refers to excessively focusing on an intrusive thought, going over it repeatedly in your mind. A mother may focus their obsession for long periods of time, thinking it over repeatedly and exacerbating their anxiety.
Prayers and mantras
A mother with perinatal OCD may repeat a specific phrase to try to stop something bad happening as a result of their obsessions. They might pray to a religious figure to be forgiven for their obsessions, or pray that they will not act on their obsessions. This can take up a great deal of time and be very upsetting. Just like other obsessions, this feeds into the OCD cycle.
Self-punishment
For some with perinatal OCD, particularly if they have obsessions around harm, they will feel a tremendous amount of guilt. They will be sure that they are terrible people and be filled with shame. This can lead to self-punishment, wherein the mother repeatedly tells herself just how bad of a person she is, and actively thinks horrible things about herself. This compulsion attempts to cope with this guilt by punishing yourself for having these thoughts.
Risk vs reality
It’s vital to know that a mother struggling with thoughts of harm or of a sexual nature towards her baby, is not a risk to her child! Obsessions do not reflect how the mother truly feels or thinks, and are not a reflection on her true personality. In fact, mothers with perinatal OCD are so ashamed and frightened of their obsessions exactly because they don’t reflect their personal beliefs or their true thoughts.
This article from the Royal College of Psychiatrists on perinatal OCD clearly states that, “Although mothers with OCD may fear harming their baby, they are not a risk to their babies. There are no recorded cases of people with OCD acting on their obsessional thoughts.”
The International OCD Foundation explains that, “What distinguishes mothers with OCD from women who actually do harm their children is that women who do harm their children are typically psychotic and often under the influence of delusions or hallucinations wherein they may not feel particular anguish or conflict over these wishes.”
So even if your OCD is telling you otherwise, although your obsessions are distressing, they do not mean you are a bad person, and they don’t mean you’re going to harm your baby! Many mothers don’t reach out for help for fear of how they will be perceived: it’s so important to seek help because that’s how you can overcome your OCD.
Even though obsessions and compulsions can interfere with the mother and baby bond, this doesn’t mean you are a bad mother if you have perinatal OCD. You’re doing your best to try to cope and protect your baby, in the best way you can at the moment. With the right help, you can reclaim the happy mother and baby relationship which OCD has taken from you.
Comorbid mental illness
Some women with perinatal OCD may also struggle with another mental illness. This can make things more complicated, but just as with perinatal OCD, these conditions can be effectively treated.
Postnatal depression
Postnatal depression refers to depression experienced after childbirth. It affects between 10 to 15 in every 100 women after giving birth. Postnatal depression shares the same symptoms as depression at any other time of life, including very low mood, fatigue, and a sense of hopelessness.
Just as depression and OCD often go hand in hand, so do postnatal depression and perinatal OCD. The good news is, that they can both be treated together and as one eases, the other tends to ease also.
Postpartum psychosis
Postpartum psychosis is the most severe mental illness which can affect a mother after giving birth. It entails either a very high or very low mood. It’s common for mood swings to happen rapidly between high and low, and the individual will often appear erratic, be acting out of character, and be hard to understand.
Psychotic symptoms mean that the mother is likely to: “believe things that are not true (delusions) or see or hear things that are not there (hallucinations).” This can be very frightening for the individual and for their loved ones. Postpartum psychosis requires immediate treatment as it can be dangerous. Most commonly this treatment will be on an inpatient basis. Thankfully, the condition can be treated very effectively and most women make a full recovery.
Now that we’ve covered what perinatal OCD is and how it can affect the individual, we’ll take a look at how it can be treated. Although this can be a very debilitating mental illness, there are a range of very effective treatments which can help a mother to overcome their OCD and move forward with their life with their new child.
Medication
If you are already on medication for existing OCD or another mental illness, your doctor or mental health professional may discuss lowering or stopping your medication while you’re pregnant and breastfeeding. They may also talk to you about changing medications to one which is safer for the baby. This is because some mental health medications can pose a risk to your developing baby, but these risks vary and it’s important to weigh them up against the risk for your own safety and mental wellbeing during and after pregnancy.
If you develop OCD for the first time during the perinatal period, your doctor may talk to you about starting medication. These will typically be selective serotonin reuptake inhibitors (SSRIs). SSRIs are a type of antidepressant also used to correct the chemical imbalance in the brain often seen in anxiety disorders like OCD. They can ease symptoms and when used in conjunction with psychological therapy, can be effective for OCD patients.
The International OCD Foundation explains that, “Overall, SSRIs are considered to be relatively safe for use in pregnancy and lactation; when compared with the risks of untreated anxiety, the consensus is that medications should be used in those whose OCD symptoms are getting in the way of their day-to-day functioning.” However, SSRIs do carry some risk during pregnancy, so it’s important you do your research and talk things through thoroughly with your medical professional to make the right choice for you.
Cognitive behavioural therapy (CBT)
CBT is one of the primary treatments for OCD. CBT is a psychological therapy, meaning a talking therapy. It works to help patients identify negative thought patterns and behaviours which are perpetuating their OCD, and instead helps them to replace these with more positive helpful thoughts and behaviours. CBT can be helpful in treating perinatal OCD, however some mothers may struggle with the therapy.
Exposure and Response Prevention (ERP) is a type of CBT which is typically much more successful in treating those with perinatal OCD. ERP works to help mothers gradually face fears and obsessions, without responding with compulsions. This is done in a very manageable way, starting from the least feared obsession and working up to more difficult obsessions. As mothers see that nothing bad happened when they didn’t carry out a compulsion, their anxiety begins to fall and they begin to break the OCD cycle.
Often medication will be combined with CBT to bring the best results for mothers with perinatal OCD. At the end of the therapy, you will be taught ways to continue using the skills you’ve learnt to prevent and manage relapse in the future. This article from Maternal OCD explains that, “The general idea is that, by the end of therapy, sufficient understanding, skills and knowledge of OCD and OCD prevention will have been gained so that the patient can act as their own therapist.”
You may be able to access CBT through a referral from your doctor, through your local mental health team if you are already under their care, or through an online OCD treatment programme.
Mindfulness
Mindfulness helps to reduce stress and promote relaxation by focusing on being in the present. All the senses are engaged during mindfulness to keep you grounded in the here and now. This can be done through guided meditation, guided visualization, and more. Mindfulness can help to ease anxiety, improve sleep quality, and allow mothers to regulate their emotions more effectively.
It’s common for mindfulness to be used in conjunction with CBT techniques to treat perinatal OCD. Mindfulness can help patients to experience those feelings of discomfort and acknowledge them, but reduce the urgency to respond with a compulsion. This article from the OCD Centre of Los Angeles states that, “For a woman with Perinatal / Postpartum OCD, the ultimate goal of mindfulness is to develop the ability to more willingly experience their uncomfortable thoughts, feelings, sensations, and urges, without responding with compulsions, avoidance behaviors, reassurance seeking, and/or mental rituals.”
Perinatal mental health service
Depending on where you live, there are specialized services for those experiencing mental illness during the perinatal period. If you were already under the care of a community mental health team for existing mental illness, you are likely to be referred here as standard when you become pregnant. They will take over your care and monitor you, to ensure you stay as mentally healthy as possible. If you weren’t already under the care of a mental health professional, your doctor may refer you here if they feel it would be useful.
This service is typically within a local hospital, which you will usually attend as an outpatient. You will likely see a perinatal psychiatrist, who is a psychiatrist specially trained in helping patients with mental illness cope during pregnancy. You may also see specially trained nurses and therapists within the unit. They will regularly monitor you, set out a treatment plan, and give you the support you need.
Mother and baby units (MBUs)
Again depending on where you live, there are mother and baby units within local hospitals. These are specialized wards where you (and your baby if you’ve given birth) will stay as an inpatient if your symptoms are severe and you need more intensive treatment.
The staff there will help to keep you and your baby safe while treating your symptoms. They aim to help you better manage your illness so that you can go home with the skills you need to keep coping moving forward. The mental health charity Mind explains: “The MBU can give you treatment and support for your mental health problem. They can also support you in developing parenting skills and bonding with your baby.”
Crisis teams
If you are already under the care of a mental health team, you will likely already have the phone number of a crisis team. If not, you may be given one through your doctor or be able to find a local crisis team you can call.
Crisis teams are out of hours services you can call if you feel unsafe or need immediate help. They will help to assess you and help you cope until you are able to see your doctor or mental health team. They may also be able to pinpoint you to local perinatal mental health services which can help you.
Perinatal mental health support groups
You could attend support groups with other mothers who are struggling with their mental health. These may involve group therapy, or simply group support where you talk about your problems. Often having others to listen who really understand can be invaluable. They may offer advice and guidance, or just be there to support you.
Some support groups may be perinatal OCD specific, while others may be focused on general perinatal mental illness. They’re often run by local mental health services or mental health charities. Your doctor or mental health team may be able to pinpoint you to local support groups, or you may be able to find details online.
Perinatal OCD helplines
Mental health charities often have general helplines for those with mental illness. Some may be there simply to listen and allow you to get things off your chest. Others may offer advice and pinpoint you to local resources that can help you. Some OCD charities may have specific helplines for perinatal OCD which can provide more information and access to helpful resources.
Local mental health charities
As well as helplines, some local mental health charities may offer other types of support. This can include help with finances and housing; volunteers who help with practical tasks and emotional support; parenting courses and education; and more. You can ask your doctor or mental health professional about these services, or do an internet search to see what’s available locally.
How can you help yourself if you have perinatal OCD?
If you have perinatal OCD it can be a really scary and worrying time, but there are steps you can take to get help and manage your symptoms. Things can get better and you can get through this.
Seek treatment
The first thing to do if you have symptoms, is to seek help. It might feel like the last thing you want to do, especially because you might feel ashamed of the thoughts you’re having. However, it’s vital you do reach out for help, because that’s how things get better.
If you’re nervous you could start by talking to a loved one, and asking them to go with you to your doctor. Your GP should be your first point of call, unless you are already under a mental health team. When you reach out, be honest and open about what you’re going through. Even though it’s hard, it will be worth it in the end when you get the help you need.
Monitor your symptoms
It’s also always a good idea to monitor your symptoms. You could jot them down and note how severe they are, when they affect you and how, and whether they’re in reaction to any specific triggers. This can help the professionals to get a clearer view of whether you have perinatal OCD and how your symptoms are affecting you. It allows them to get you the help you need more effectively.
Find support
As well as getting professional treatment, it’s important you have as much support as possible during this time. Reach out to loved ones and let them know what you’re going through. Allow them to be there for you and to help you. You could also search for local support groups or call helplines as we mentioned earlier, or find support from others who know what you’re going through online.
Be kind to yourself
Although your OCD will be trying to convince you to do otherwise, try to be as kind to yourself as possible. Remind yourself that your OCD does not make you a bad person or a bad mother. You’re doing the best you can. Be gentle and compassionate with yourself.
Keep a list of contact numbers on hand
Sometimes when we’re in a confused and distressed mindset, it can be hard to remember who to reach out when we need help. Keeping a list of contact numbers on hand can prompt you to reach out for help, and make it easier to do so. You could include phone numbers of loved ones, of your crisis team, helplines, and any other numbers you feel will be useful.
Use distraction
Distraction is a great coping tool. Try to keep yourself busy and focus on proactive, positive outlets as much as you can. If you find yourself consumed by negative thoughts, try to shift your mindset and do something which lifts your spirits: you could go out for a walk, change the room you’re in, or put on some upbeat music for example. This can be easier said than done, but can be a useful habit to develop.
Practice self care
Self-care refers to anything we do to take care of our physical and mental health. This can be things like trying to keep a regular sleep routine, eating well, exercising, and practicing good personal hygiene. Although it may be tough to do at first, try to make time for self-care in the best way you can. It really can make a difference to mental health, even if it feels trivial at the time.
Practice relaxation techniques
Relaxation techniques can be very helpful to help you reduce stress and anxiety. These centre around mindfulness which we discussed earlier. You could set aside time to meditate, to practice breathing exercises, or do some visualization. You can find plenty of guided relaxation exercises online.
How can loved ones help a mother with perinatal OCD?
Perinatal OCD doesn’t only affect the individual: it can be very distressing for those around them. You might want to help your loved one but be unsure how to do so. There are ways in which loved ones can help their partner, family member, or friend. You can use this information if you have a loved one with perinatal OCD, or you could pass it on to a loved one if you’re a mother struggling with perinatal OCD.
Do your research
Take your time to do some research about OCD and perinatal OCD specifically. This helps you to be informed and understand what your loved one is going through in the best way you can. Understanding how OCD works can help you to be more supportive and empathetic, especially when your loved one displays behaviour which might be challenging for you.
Offer to go to appointments
Encouraging your loved one to get help is key; they need treatment in order to get better. You can gently encourage them to reach out and be supportive when they do. A great way to be there for them, is to go offer to go with them to appointments and be there for moral support.
Offer practical help
They may struggle to keep up with practical tasks because their compulsions take up so much of their time. You could offer to help them with practical tasks such as cooking and cleaning. However, it’s important to listen to them if they say mo, as certain things may trigger their OCD. This will be dealt with through therapy.
Be there to listen
One of the most important things you can do, is just be there to listen. It sounds simple, but just knowing someone they trust is there for them and having that opportunity to get things off their chest, can help your loved one to feel less alone.
Be actively involved in therapy
Close loved ones (especially partners) may be able to attend therapy sessions with their loved ones, or speak to their therapist to get guidance on how to help them. Unfortunately, (through no fault of their own), mothers with perinatal OCD often involve their loved ones in compulsions. You need to learn how to effectively help them to break that OCD cycle in a gradual way. It’s also important to be actively involved in ‘homework’ exercises between therapy sessions.
Make time for yourself
Lastly, it’s absolutely vital that you make time for yourself. You can’t be there for your loved one if you are not first taking care of your own physical and mental health. Make time for self care, relaxation, and rest.
It’s vital to remember that even though perinatal OCD can feel all consuming and unbearable, it can pass with the right treatment. You can get your life back and enjoy your life with your new baby.
References
Catherine Benfield, (2018), “Living with perinatal OCD.” British Journal of Midwifery, November 2018, Vol 26, No 11.
Neha Hudepohl, MD, Margaret Howard, PhD, (2014), “Perinatal OCD: What Research Says About Diagnosis and Treatment”. International OCD Foundation.
OCD UK, (2020), “What are obsessions?”
Maternal OCD, (2020), “About perinatal OCD.”
Dr Fiona Challacombe, Dr Maria Bavetta, Dr Lucinda Green, (2018), “Perinatal OCD”. Royal College of Psychiatrists.
OCD Center of Los Angeles, (2020), “Perinatal / Postpartum OCD – Symptoms And Treatment”.
Mind, (2020), “Postnatal depression and perinatal mental health”.