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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.”

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 hidden beast of anxiety…

In a new piece for the Players’ Tribune, Corey Hirsch opens up about his struggles with mental health issues. (Ryan Remiorz/CP)

A great article by

For a long time, Corey Hirsch was overcome with dark thoughts.

In a new piece for the Players’ Tribune, the former NHL goaltender opens up about his struggles with mental health issues.

At age 22, Hirsch seemingly had it all: He’d earned an Olympic silver medal with Team Canada, and, as the New York Rangers’ third goalie, he’d been part of a Stanley Cup championship. But the goaltender felt suicidal. As he describes it in the Players’ Tribune, it was a feeling of overwhelming darkness disconnected from his outer life. “Darkness. Pure, relentless darkness,” Hirsch writes. “For no reason.”

The pain was so bad that, while with the Rangers, Hirsch tried to break his hand, hoping to be sent home to Calgary.

After the morning skate, I grabbed an extra stick blade from the bin and stuffed it in my bag. When I got back to my hotel, I sat on the edge of the bed in silence and took out the blade.

My plan was to break my hand and hide the injury until the next day at practice. That way, I could go down after taking a shot, and the team would send me home to recover without knowing what was really going on. In those days, the blades were wooden and heavy as hell. I smashed the blade against my left hand three or four times, as hard as I possibly could.

The Players’ Tribune

It didn’t work. Hirsch ended up with a badly bruised hand instead, and he stayed with the Rangers right up until the team hoisted the Cup. The next day, he promptly flew home.

Hirsch’s struggles continued, and he was traded to the Vancouver Canucks. On an East Coast road trip, Hirsch pulled a trainer aside to ask for help. After one meeting with the team’s psychologist, Hirsch finally had a diagnosis: obsessive compulsive disorder.

Having a diagnosis came as a huge relief. Finally, he thought: “I am not insane. I am not a bad person. I am not weak. I have an illness, and there is a treatment.”

His key message? “A mental health issue is not a sign of weakness.”

For hockey players, struggles with mental health can be especially difficult to reveal. But Hirsch implores anyone who can relate to his struggles to find hope.

“There is a light, however faint, in all this darkness,” he writes. “There is help out there for you.”

To read more of Corey Hirsch’s story:

http://www.theplayerstribune.com/corey-hirsch-dark-dark-dark/

Amazing story from Varun Gwalani

Amazing video from Varun Gwalani! So brave of him to share his struggles with OCD, and show that sufferers are not alone. Please take the time to read his story, and watch his video. I was truly inspired by his courage and efforts to spread awareness.

https://www.thequint.com/health-fitness/2016/11/24/stereotype-obsessive-compulsive-disorder-bleak-picture-monster-varun-gwalani-mental-illness-ocd 

The other day, I heard someone say, “She kept yelling at me when my room was untidy. She’s so OCD, man.”

As someone who is actually so OCD (Obsessive Compulsive Disorder), I was understandably annoyed. I didn’t turn around and go on a tirade about how offended I was. I don’t do that when people use the term for their own purposes- Obsessive Comedic Disorder or Obsessive Christmas Disorder, or something else that’s clearly not obsessive.

I don’t do that because I know there’s no malice behind it, just ignorance.

To explain OCD simply, first remember that a large part of your brain’s job is to be a warning system, to detect possible threats, to remind you that something as simple as putting your hand to fire, or crossing the street without looking, will harm you.

Now imagine if this warning system, this most fundamental part of your brain, is broken.

Also Watch: Mental Heads: Stamping Out Stigma Around Mental Illness

With a broken system, you’re constantly scared of everything. Anything and everything around you can kill you. If not kill you, it can infect, hurt or damage you in some way or another. Most of the time, though, it’s not just you that it’s affecting. Your parents, your family, your friends, all of them are in supposed danger, if you and you alone don’t do what your broken brain compels you to do.

That’s what OCD is.

There are more than ten different kinds of OCD, and every case of OCD has a high chance of being severe and debilitating to the point that it affects everyday life.

Even those “funny” pop culture stereotypes of people with OCD tics become less funny when you pull back the curtain and see the reality. Repeated hand-washing becomes slightly less funny when your mind compels you to do it over and over again, till your skin strips off your fingers, but you still can’t stop. Counting steps while walking, or having to shower several times because of germs sounds funny, until you realise that the person doing it believes that their life physically depends on it. And why shouldn’t they? Why should you believe your brain is lying to you?

These are all symptoms of different kinds of OCD, which include morality OCD, checking OCD or sexuality OCD. When you have OCD, that’s exactly what your brain is doing. And after a point, you can’t distinguish between what is you and what isn’t. With that, we come to the kind of OCD that I have. It’s called Aggressive OCD. What does that do? Well, it’s really fun: It gives me visions of death.

So when I encounter ignorance, what I try to do instead is to the set the record straight- What exactly does being obsessive or compulsive mean?

Let me answer that by telling you the story of one day in my life.

My eyes open. It’s 4 a.m. Or is it p.m.? I look around. The curtains aren’t drawn, the sky outside is dark. It’s night. Not that it matters much to me. I had fallen asleep for a few minutes before I was jerked awake again by a stabbing. It wasn’t a stabbing pain in any part of my body; it was more like my brain had conjured up an image of my oldest friend stabbing me in the throat. I yawn.

I turn over on my cool, comfortable bed in my big house and I try not to dream of death. I’m able to stop when I’m awake but I need to sleep. I can’t control it while I’m asleep. So I’m simultaneously tensing my body in fear and anxiety, while trying to relax it enough to fall asleep.

I finally fall asleep without knowing. I say without knowing not because I didn’t know when I fell asleep, but rather that my dreams are so vivid and impactful that when I wake up in a few short hours I was more tired than when I went to bed.

I lay in bed for a few minutes, scrolling through Facebook, waiting for the noise and the chaos of my mind to surge once more. Right on cue, they do, and I get out of bed. There’s no need to “steel” myself or “force” myself to get out of bed. Do you have to steel yourself for the sun to rise? It just does. In the same way, the monster in my brain will always be whispering and screaming.

I look into the mirror to brush my teeth and my throat is cut, it opens up before my eyes. I continue brushing. I am boiled alive before I step into the shower. I step in. An image of sprawling intestines from a dead body flashes before my eyes. I eat my ketchup-soaked omelet, the reds melting together.

I am done. I have delayed enough at home. I have to go out into the world, doesn’t matter for what. The monster licks his lips with relish, a visible smacking sound resounding in my head. I roll my eyes.

In the streets is my monster’s favourite weapon: Vehicles. Vehicles off all kinds. Get in a cab and the cabbie will have a secret gun to blow your head off. Ooo, maybe it could be one of those glowing-light cabs. Brains would look so nice splattered on them.

Trains? Everyone on the train is a murderer, rapist, cannibal. Your friends will die over and over before your eyes, your monster will feed on this chaos in your brain, you will suffer. You get the picture.

I get home, staggering and drained. I start writing about this monster and I am still haunted by the inescapable fact that the monster is made in my image.

This monster is made up of thoughts that I couldn’t possibly conceive of myself, but they still come from my own mind. That is what true obsession is: An inability to control your own thoughts. It will be hammered into you every minute of every day until you wish you were numb to it, but you aren’t.

And it’ll make you want to blame yourself. Because the same place that controls all your basic functioning, is also the place that’s rife with corruption. Medicines help me. Therapy helps me. But I don’t know if that guilt and anger I still hold at myself for not being able to control something that is out of my control, will ever fade.

(Varun Gwalani is a TEDx speaker, author and mental health advocate. The First Storyteller, his second novel, is based on his experiences with Aggressive OCD. Twitter: @varunug)

Intrusive Thoughts

 

We have all on occasion experienced an involuntary disturbing thought or violent image which leaves us upset and confused — these are called “intrusive thoughts.” Aaron Harvey, who battled these on his own for over 20 years, has launched an intrusive thoughts website to help people with OCD. According to the website, as many as four out of five people experience such thoughts. However, for some, the repetitive nature of these troubling thoughts may be a symptom of certain forms of Obsessive Compulsive Disorder.

Many try to ignore these thoughts and push them out of their head, but that can make them even worse and more frequent. Attempting to repress the thoughts instead of addressing them can lead to heightened anxiety and depression, questioning of one’s character and abilities, creating isolating behavior. Often, those who are tormented by intrusive thoughts are too embarrassed or ashamed to share them or seek help. Intrusivethoughts.org delivers, through a stylish website, carefully curated facts and statistics, videos, information on different types of OCD symptoms and personal stories. It also elaborates on treatment through counseling, yoga, mindfulness and healthy eating techniques. Here, Aaron Harvey seeks to fill the void for an online community forum, which will help educate and provide support and treatment.

Aaron Harvey, a creative marketing entrepreneur, wrestled with these thoughts for over 20 years before being diagnosed. He began having intrusive thoughts when he was 13. “I started to have a lot of graphic violent images in my head that I couldn’t understand. It produced a lot of anxiety and led to panic attacks and constantly questioning my character,” he told Refinery 29. “Any time I would try to escape them, they would get more violent and more graphic.” This vicious cycle is common of many types of OCD. As it says on the website, “for 1 in 50 the fear becomes much harder to dismiss… These thoughts repeat over and over, faster and faster, making the fear we might act more real.”

Aaron Harvey credits the essay “Pure OCD: a rude awakening” by Rose Bretécher with finally providing him with some relief and hope. His suicidal thoughts and anxiety had become unbearable, leading him to search for help online. After wading through immense amounts of psychological studies and treatments, Bretécher’s article published in The Guardian was a breath of fresh air. It addressing the issue head on and with humor, “She forever changed, if not saved, my life,” Harvey told Market Wired.

Harvey saw the need for more approachable information on the disorder, and founded the not-for-profit Intrusive Thoughts, Inc. which launched the website as an “educational hub.” The site is essentially built to appeal to his younger self. “My goal is to capture me when I was 13 and I started to experience this,” he described to Refinery 29, “so that next 13-year-old doesn’t have to spend the next 20 years figuring out what the hell is going on and thinking that they’re a bad person.”

There was a clear opportunity to use my professional skills to create a resource with a youthful look and tone of voice that also humanized the experience of living with intrusive thoughts, promoted a holistic treatment plan and elevated conversations about mental health in the media,” Harvey said, commenting on the approachable and smart design of the website.

This important tool will provide relief to the many who suffer, and help them feel part of a greater community. Harvey hopes to create similar websites for all mental illnesses in the future.

Images: OscarKeyes/Unsplash, ChristopherSardegna/Unsplash, JayWennington/Unsplash, JenelleBall/Unsplash