Tag Archives: acceptance

Postpartum OCD

I wanted to share the reality of postpartum OCD and how it impacts many mothers, and not talked about enough!


What It’s Like To Survive Postpartum OCD

It’s not as well-known as postpartum depression, but for new moms it’s just as debilitating.

TAWS13 VIA GETTY IMAGES

 

Three weeks after Chelsea Elker gave birth to her second baby, she was overwhelmed by a thought that also felt something like an urge: What if she smothered him?

Elker, who was peacefully nursing at the time, had never experienced anything like that when her eldest was born, and was horrified.

From that night on, however, the disturbing thoughts kept coming.

As she buckled her newborn into his car seat, Elker worried: “What if I touch him inappropriately?” As she washed dishes she’d think: “What if I stabbed him?” Elker reassured herself that of course she would never hurt her baby, only to immediately question why, then, she’d even entertain such ideas in the first place.

“It’s hard to explain,” Elker, now 29 and a mother of three, told HuffPost. “I felt like, ‘If I’m thinking it, it obviously means I want to do these things.’”

In the last decade, awareness about postpartum depression has exploded as research has revealed it affects anywhere between 10 and 20 percent of moms. Likewise, knowledge about postpartum anxiety — which could affect up to 17 percent of new moms, according to some estimates — has also begun to spread among women and health care providers. Mothers struggling with anxiety and depression now at least have some kind of name and explanation for the things they are feeling.

For the smaller subset of mothers who have postpartum obsessive compulsive disorder, that kind of broad — or even broadening — recognition of their circumstances simply does not exist. “OCD” has become a watered-down term, an acronym thrown around in conversations about that friend who’s just a bit too fastidious or who is especially germaphobic.

But for mothers tormented by the condition, it signifies something much darker — a cycle of fears and behaviors that grabs hold of them and threatens to upend their sense of who they are in one of the most grueling, vulnerable moments of their lives. And many find it impossible to open up, gripped by fears that someone will take their baby away.

“It became 100 percent of my day and 100 percent of my nights,” Elker said. “I could be having a conversation with you and inside I’m thinking 1,000 different, terrible things.”

CHELSEA ELKER
Elker had been experiencing crippling symptoms of OCD for a few weeks when this picture was taken, though she says you never would have known it looking at her smiling face. 

Inescapable ‘Intrusive Thoughts’

In many ways, OCD — perinatal or otherwise — is simple to identify. Its signature symptoms are intrusive thoughts and fears (i.e. “obsessions”) and often rituals (“compulsions”) aimed at making those thoughts disappear.

Under the DSM-5 — the most recent version of the “bible” of psychiatry — OCD was given its own chapter and moved out from under the broader umbrella of anxiety disorders. There is no diagnostic distinction between OCD that begins during the postpartum period and at other times in a person’s life, though women who have experienced anxiety and OCD in the past are at higher risk of dealing with it again postpartum.

In new moms with OCD, however, the intrusive thoughts that are a hallmark of the disorder tend to center around one thing: their babies. Suddenly, a woman who longed for motherhood may be utterly convinced that something or someone — perhaps even herself — is going to hurt her child in ways she’d never considered before, either deliberately or through carelessness.

“I had a patient who presented at five or six weeks postpartum with her fourth baby, and she had a precipitous onset belief that she couldn’t be near knives,” Dr. Catherine Birndorf, co-founder of The Motherhood Center of New York, a clinic that specializes in perinatal mood disorders, told HuffPost. “She couldn’t be in the kitchen. She had visions of taking a knife and cutting her infant’s throat — and she was absolutely freaked out by these intrusive, violent images. That’s super common in perinatal OCD.”

Moms who experience those thoughts are almost immediately overcome by shame and horror, which is the primary way experts distinguish between OCD and postpartum psychosis, a rare, severe psychiatric emergency in which new moms can absolutely pose a threat to themselves and their babies.

“OCD is what we call ‘egodystonic’ in so much as it is upsetting and exhausting to have the thoughts and do the actions you do to try and make yourself feel better,” Birndorf explained. In postpartum psychosis, delusions and hallucinations take over.

Loretta Notareschi, 40, gave birth to her daughter in 2013 and had her first intrusive thoughts — about throwing her down the spiral staircase in her home— while she and her baby were recovering in the hospital. It wasn’t a hallucination or a desire, but it gripped her imagination nonetheless. She told a nurse who reassured her that she was probably just exhausted, but before she was discharged she had to meet with a social worker.

“I was triggered by all kinds of things, especially the spiral staircase or knives,” Notareschi told HuffPost. “Bathtubs. Being in the car. I would think, ‘What if I hurt her with that?’ Or, ‘What if I hurt myself with that?’”

Over time, she began to develop what she thought of as coping mechanisms, though later she learned they were simply the hallmark compulsions of her illness.

“To the OCD mind, they seem like brilliant ways to deal with your anxiety,” Notareschi said, laughing ruefully. “I decided in the first couple of days after my daughter was born that every time I had a scary thought I would have to repeat to myself a certain phrase, which was ‘Baby face, hairbrush, duckie.’ In my mind, it was going to neutralize the thought or magically make it OK.”

LORETTA NOTARESCHI
Notareschi was also in the throes of postpartum OCD when she took this happy-looking photo with her newborn daughter in 2013. 

An Adaptive Behavior … Gone Wrong?

Interestingly, research suggests that some elements of postpartum OCD may be adaptive. A 2013 study of roughly 400 women found that 11 percent of new moms were experiencing some obsessive-compulsive symptoms two weeks after giving birth. Six months later, nearly half of those women still had symptoms, while another 5 percent of moms had developed symptoms at that point.

That study asked if women were having any symptoms of OCD, not if they met the criteria for an actual diagnosis. But it raises the possibility that the prevalence of the disorder is much higher than the 2 percent that is often cited — and raises tricky questions about what’s normal (and what is not) in the minds of new mothers faced with the daunting task of keeping a helpless newborn alive.

“One of the most common obsessions is fear about germs, and some of the most common compulsions are checking behaviors and washing behaviors,” Dr. Dana Gossett, a professor of obstetrics and gynecology at the University of San Francisco California and the author of that 2013 study, told HuffPost.

“It’s not crazy to think that if a woman has a newborn, she might want the house to be clean and for people’s hands to be clean,” she continued. “It’s not unreasonable that she would want to check on her baby frequently to make sure he or she is OK. What happens in OCD is that is carried to a point where it is no longer logical or productive.”

And when those thoughts become intrusive and frightening, mothers become understandably fearful to come forward to share what they’re going through — and to be counted.

“We know depression is common. It’s well studied and there’s a lot less stigma now than there was 15 years ago around articulating feelings of sadness,” Gossett said. “Whereas if a mom says, ‘I’m terrified I’m going to burn down the house’ or ‘I’m terrified I’m going to shake my baby to death,’ there’s so much more shame and fear.”

And it is not unreasonable for women to worry that their babies could be taken from them, she added.

“One of the challenges about OCD is that it is less broadly known, so even OBs and pediatricians who are good about screening for depression are going to be less familiar and less comfortable with these diagnoses — and how to make that distinction between psychosis — so women get the help they need,” Gossett said. Postpartum Support International, an advocacy and education group, says that postpartum OCD is the most misunderstood and most commonly misdiagnosed of the perinatal mood disorders.

That is what makes postpartum OCD so heartbreaking. Like so many other mental health issues that crop up during the tumultuous postpartum period, experts say it is highly treatable with some combination of therapy, support, medication and time. But in a culture that demands moms cherish every exhausting moment of raising young children, admitting to frightening obsessions can feel impossible.

“I didn’t want to tell anyone, because all the media tells you with stories about women who hurt their babies is that if you think a thought, you want to act on it,” said Elker, who took more than a year to recover from postpartum OCD through a combination of intensive therapy and medication and has written extensively about her experience.

“But I didn’t want to hurt them,” she said. “I was so fiercely trying to protect them that I drove myself insane.”

Amazing OCD Podcast!

I came across a beautiful couple Julie and Andy, who both dedicate time out of their life to host a podcast around OCD and Anxiety. This has been a wonderful resource for many people, and makes you realize that other people are also going through what you are. The stories of the guests will leave you inspired and encouraged. I really love their podcasts, not only do they interview people who personally are suffering with anxiety, but they speak with professionals and loved ones of sufferers giving a broader understanding of the disorder.

The link to the podcast is:

http://coldflyer.com/

 

Video Journal

 

I suffer with anxiety and to elaborate more I suffer with OCD. In my previous blogs I speak about what OCD is, how it impacts someone, and what tools may help to combat the crippling anxiety. This week has been a tough week for me, I was experiencing a big spike in my anxiety, once the anxiety passed after a few days I was able to recalibrate and ground myself again. In this moment I wanted to create a reference point for myself for when my anxiety spikes again. I thought about how I was going to capture my ideas, and really communicate to myself in a rational way. I decided I was going to make a private video journal, in this video I would speak to my future self. I found this extremely effective because now I have a moment in time where I can refer back to and guide myself through my anxiety. Seeing myself so grounded and resilient to anxiety is truly empowering and has snapped me out of anxiously thinking. In the video I talk about my past few days of being suffocated by anxiety, I then move on to explain why it is so important to just accept the thoughts for what they are and not allow myself to label or “argue” with my anxiety. I go on to say how important it is to realize that I will never know anything with complete certainty, I wont even know what will happen 5 minutes from now. This was important for me to capture because a huge aspect of anxiety is the “what if” this happens and constantly wanting 100% certainty that it will not happen. Once that certainty is achieved at a level that my anxiety is content, it moves on to another subject matter and there in lies the vicious cycle of anxiety and obsessively wanting to achieve reassurance. In the video journal I remind myself of all the tools I have to tackle my anxiety, and I also address what anxiety is and why I am actually the one in the drivers seat not my anxiety. When anxiety takes over essentially “I” as the driver become the passenger, and it becomes very difficult to reassume the position of driver in these moments. I would highly recommend creating a video journal as a guide to help during times of anxiety provoking situations. It not only helps with combating anxiety, but it also is a great catalogue of showcasing personal growth.

Extinguishing the “WHAT IF”

Anxiety in the simplest definition is the idea of not knowing what will happen, and the fear of scenarios coming true. People with anxiety need to know with 100% certainty the outcome of a situation, an interaction or their future. The easiest way to combat anxiety is to come to terms with accepting that you will never know 100% and that is okay. In actuality no one will know a future event with certainty and the more we accept this notion the more manageable anxiety gets. I try and start my mornings by telling myself “today is going to be a good day, and I am okay with anything that happens”. The less attention I give my anxious thoughts the quieter their voice becomes, they want to steal the spotlight, and cripple your day by casting a shadow of doubt across all your thoughts. Sometimes anxiety can’t even be pinpointed to a specific event or thing but being anxious alone can trigger “why am I anxious now?”, “nothing is happening, I shouldn’t be anxious…is it because….this or this..”.

You may for example be thinking about an email your boss sent you asking to meet, rather then just simply waiting to meet anxiety strikes by casting fear and plays vivid scenarios of everything that could possibly go wrong in this meeting. These intrusive thoughts don’t stop until the meeting takes place and you get relief from knowing your meeting was not as intense as you played it out in your mind. This way of thinking intrudes on every interaction throughout the day, and can really send a sufferer into a spiral of intrusive thinking. The issue here is that so much time and energy is consumed by anxiety, and it really takes a toll on a person’s life. The next time intrusive thoughts pop up about all the terrible things that can happen try and combat it by saying, “I actually don’t know what will happen, and that is okay”. What I find most interesting about anxiety is that I build up scenarios so much in my head that when the reality happens for example- meeting the boss, the difference is profound. I magnify the outcome so much that it becomes extremely disproportionate to reality, I find relief when I have the reassurance of seeing what the real outcome is; however, I know that will only last a short moment before my mind jumps to the next unknown.

I am okay with not knowing what will happen, I along with everyone else in this world am unable to predict the future so when anxiety strikes and tries to tell me I can somehow control the outcome of the future I now realize how inaccurate that is.

 

“Surrender to what is. Let go of what was. Have faith in what will be.” – Sonia Ricotte

The Beauty In Imperfection…

Everyone who has experienced anxiety can relate to the idea of feeling like they are going crazy. Our emotions and life feel so out of control at times that it becomes hard to reconnect to our “true self”. I thought about this idea for a while, the idea of not feeling comfortable with having fears or anxiety, and I realized why am I trying to strive to be perfect? Why am I so hard on myself for being anxious? I find myself in this vicious cycle of being so critical on myself if I have unconventional thoughts, irrational fears or don’t feel happy. This judgment has manifested in to immense pressure to want to be anxiety free. I rationalize to myself that if I am not anxiety free I cannot feel content.

I sat on this idea for a while, and I realized something…being “perfect” or “normal” is boring…and not interesting or exciting at all! I recently watched an interview with David Lynch (one of my favourite film directors) with Patti Smith (a very talented musician) and they talk about the beauty of disarray. Smith describes her house and the lawn she has as full of dandelions, long grass and untrimmed roses, in her absence a well-intentioned neighbor cuts her grass, trims her roses and gets rid of all the weeds. She was distraught to find her lawn made perfect, she embraced the natural chaos and loved every part of her lawns imperfections living harmoniously together. This story really resonated with me; I for so long was aiming to extinguish my anxiety not realizing that there is something breathtaking in being not perfect.

It is through the eyes of imperfection, that unique creative expression can be cultivated. I now try and embrace myself as I am and that has relieved a lot of pressure, and made me accept that I am only human. A human that is complicated, living in a life that is complicated and that is beautiful.

The Imp of the Mind

The Imp of the Mind by Lee Baer beautifully outlines the struggle sufferers go through. Baer a leading expert in the field of obsessive compulsive disorder shares his professional and personal insights. I highly recommend this book to anyone who is impacted by intrusive thoughts.

An illuminating and accessible guide to the kinds of thoughts that create extreme fear, guilt, and worry, The Imp of the Mind provides concrete solutions to a tormenting and debilitating disorder. Including special sections on the prescription medications that have proven effective, it is “a beautifully written book that can be a great help to people who want to know what to do about obsessions” (Isaac Marks, M.D., author of Living with Fear: Understanding and Coping with Anxiety)

Some beautiful quotes from the Imp of the Mind:

The Imp of the Perverse will try to torment you with thoughts of whatever it is you consider to be the most inappropriate or awful thing that you could do. To illustrate this point, each of my patients whose thoughts are summarized below (many of whom you’ll meet in later chapters) told me that his or her particular bad thoughts focused squarely on whatever was for him or her the most inappropriate, awful, or shameful thing he or she could think of doing:3”

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