26 November 2012

Of my struggles with Postpartum OCD

While there's still a lot of work to do to educate the public about the realities of Postpartum Depression and raise awareness of this devastating mental illness, it is at least a phrase that most people are familiar with on some level, even if it's just "Oh yeah, I've heard of that..." on a basic level. What too many people are not familiar with at all is another PPMD called Postpartum Obsessive-Compulsive Disorder, or PPOCD.

I myself had never heard of it until I came across a blog post on Postpartum Progress listing the symptoms of PPOCD in "Plain Mama English".  This was during my bout with PPD back in 2009. It wasn't until a while down the road that I started thinking "Hey, maybe some of what I thought was PPD was actually PPOCD...". This was reinforced recently when I was reading a two-part guest post on Postpartum Progress about the mother's struggles with PPOCD (Part 1 and Part 2). I sat back in my chair with my mouth open going "Oh my gosh, Becky wrote my story! That's exactly what I dealt with!".

When I was at the ER and then being admitted at Laurel Ridge, of course I was asked if I was having thoughts of hurting or killing myself or my baby. I answered yes. What I realize now that I wish I had realized then was that what I was calling "thoughts of hurting/killing my baby" were actually intrusive thoughts, a signature symptom of Postpartum OCD.

I would have these thoughts just pop into my head from out of nowhere and they would terrify me, horrify me. For me, it revolved around the stairs. I would find myself thinking "What if I trip on the stairs and fall on her or drop her down the stairs?". It upset me so much that I would stay away from the stairs. There were instances where I actually changed my plans to not go out because it would have meant carrying her down the stairs and I was so afraid of what might happen.

An article titled Beyond the Blues: Postpartum OCD by Dr. Jonathan Abramowitz, Ph.D., ABPP goes into more detail of the symptoms of PPOCD and intrusive thoughts and the differences between PPOCD and Postpartum Psychosis. I found the entire article to be very informative and educational but one part in particular really stood out to me:
     My colleague Dr. Nichole Fairbrother and I have recently developed a psychological model of postpartum OCD. It begins with our finding that most new parents (mothers and fathers) experience unwanted infant-related thoughts (perhaps such thoughts have evolutionary significance). That is, we consider such thoughts as a completely normal and harmless part of early parenthood. The trouble begins, however, when a new parent mistakenly misinterprets these normal thoughts as indicating something very significant and threatening. For example, if a new mother misinterprets her violent thoughts as meaning that she is likely to kill her baby, or a new father who interprets his images of the baby dying as meaning that deep down he wants the baby to die. Why might someone misinterpret intrusive senseless thoughts as very significant? We think it has to do with the rapid increase in responsibility—which certainly is the case when one becomes a parent and gains the responsibility of caring for a helpless infant.
     When normally occurring postpartum thoughts are misconstrued as dangerous or very significant, it leads the person with such thoughts to become anxiety and fearful. Moreover, it leads to behaviors such as avoidance of the baby, seeking reassurance, and excessive ritualistic checking or praying. All of these behaviors are consistent with feeling threatened by upsetting thoughts about one’s child. Because these avoidance and ritualistic strategies seem to work (that is, no harm is committed), the new parent keeps on believing that the strategies have prevented catastrophe (when in fact, the thoughts are meaningless). Therefore, the strategy becomes a compulsive behavior, and the fear of acting on the unwanted obsessional thought remains intact (it is never disproven). Furthermore, when the new mother or father keeps their negative thoughts to themselves (“they would put me in the hospital if I told them about the thoughts I was having”), it further prevents them from learning that such thoughts are normal occurrences (other have them too).  
(Bolded added by me for emphasis) 
My third baby is 10 weeks old now and I've been having some of the same intrusive thoughts. It doesn't center around the stairs this time but it's usually when I'm walking through the loft upstairs while holding him and the thought pops unbidden into my head "What if I drop him over the side?". It horrifies me. I hold him tighter and move as far away from the half wall of the loft as I can get. I, in general, try not to walk close to it if I'm holding him.

I know on some academic level that the chances of me actually dropping him are EXTREMELY low but that doesn't make me feel any better. It still upsets me and makes my chest get tight. I hate these thoughts and I hate that I see myself again starting to change my actions to try to "avoid" my fears coming true.  Even writing about it makes my chest get tight and makes me feel a little panicky.

I debated writing and publishing this. It was a hard decision to make. I still struggle with "What if they take my kids away because I'm struggling with this stuff", even though I know better. I still struggle with "What if people read this and stop trusting me or think less of me?". It's difficult to actually put this all into words because if I avoid talking or thinking about it, I can pretend it doesn't exist.

So why am I writing about it?

Partly because I firmly believe that choosing to write about it helps me to take the power away from this bastard of PPD and PPOCD. Instead of letting it control me and what I write, *I* control what I write. Instead of giving in to the stigmas and fears, I strike at them and overcome them, I face them instead of hiding from them. I write about it because if it's out there, I can't keep putting off going to the doctor to see if they need to adjust my meds or something (my thyroid levels were already checked and I'm within normal limits). I write about it so that if there's someone else out there who's fighting this and feeling alone, maybe they'll read this and know that someone else is going through it too. I write about it so that people can comment and leave their support for me and for everyone else who's fighting this battle.

Lest anybody get unnecessarily worried, I don't have depression nearly at the level that it was at after my first pregnancy, thank goodness. I'm not stuck in that deep pit that seems hopeless to escape. In fact, I'm not really having any big issues with depression itself (the Zoloft seems to be keeping that pretty well under control). But I won't ignore the fact that there is something wrong because I know that it's something that can be treated. I won't let it control me, I will control it.

I am a survivor.

I am a fighter.

I. Will. Win.


  1. I think you're already a winner, Esther! You rock!

  2. Sweetheart, it had to be really hard to write this. I am so proud of you for fighting this. It's one day at a time, but I have faith in you.