Tag Archives: thoughts

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.”

Radio host suffers with OCD

Amazing story written by Trevor Dineen of CBC speaks about his personal struggles with OCD.

http://www.cbc.ca/radio/nowornever/living-with-obsessive-compulsive-disorder-1.4424547/cbc-radio-host-reveals-his-personal-struggle-with-ocd-1.4424557

By Trevor Dineen

When I walk into an airport bathroom, like I did last week on my way to Vancouver, I hear the flushing, running taps and hand dryers. But I also hear something else.

“You have to pump the soap 25 times and then wash your hands 25 times. Don’t miss any numbers. Don’t skip any pumps. Oh and do that whole cycle 25 times and then you can leave.”

Now why on earth would I do all of that?

“Because if you do, you won’t die.”

Welcome to the inside of my brain. I have obsessive compulsive disorder. I’ve had it for over 15 years. And to be honest, it almost took my life.

When I was 22, I basically lost everything because of it. One day my brain decided to start telling me that if I did these small compulsions, I wouldn’t die. So I did, because honestly, I didn’t want to die. But then these small compulsions got bigger and the routines got more complex.

The next thing you know, it was taking me 90 minutes to get in and out of a bathroom. It would take me 75 minutes to get into bed. I’d have to walk around cars 25 times when I got out of them. I had between 200-300 compulsions that took up four to five hours of my day.

I quit my job, dropped out of school, and pulled away from all my friends. I was wasting away, mentally and physically. A year and a half went by and all I did was get worse. Finally my parents found me collapsed and crying on their basement floor. It was Christmas Eve and and I had just finished doing all of my routines and compulsions in front of my entire family and relatives.

It was my rock bottom.

My mother, Carol Dineen, eventually opened up to me about how terrified she and my father were in those moments. “Watching my son deteriorate to the point where we knew if we didn’t get you help, we were going to lose you,” she said. “I knew that in my heart. That’s why it was so important to find you help.”

Trevor Dineen (CBC)Help, in my world, came in the form of Dr. Willows. He’s a psychiatrist at Seven Oaks Hospital in Winnipeg. He’s the one that saved my life.

When I had the chance to revisit him recently, he told me, “You presented with the perfect illness. You came in with everything people say about OCD. Because you had everything. Remarkable obsessions, very time-consuming compulsions and hours upon hours of routines.”

Without him, and the months of cognitive behaviour therapy that he guided me through, I don’t know where I would be today.

But it’s not gone. I still have compulsions. They rear their ugly heads whenever I get stressed or I’m concerned for someone I love. But overall, they’re much more manageable now. I know I’ll always have them. A handful or more will always linger, and I have to be okay with that. It’s just become a part of who I am.

And it’s a part I’m okay talking about. Because at the end of the day, I hate the idea of anyone ever feeling as lonely and as scared as I did. So hopefully, this helps. Even a little bit.


Resources:
Anxiety Canada

Canadian Mental Health Association

OCD Canada

Book Recommendations:
Freedom from Obsessive Compulsive disorder: A Personalized Recovery Program for Living with Uncertainty (updated edition), by Jonathan Grayson

The Boy Who Couldn’t Stop Washing: The Experience and Treatment of Obsessive Compulsive Disorder, by Judith L. Rapoport

When Once Is Not Enough, by Gail Steketee and Kerrin White

Stop Obsessing!: How to Overcome Your Obsessions and Compulsions, by Edna B. Foa, and Reid Wilson

nOCD

nOCD is a great app to use during treatment with or without a therapist. I have been using it for over 6 months now and have really felt the impact the app has. It allows you to input your triggers, track your progress, do exposures and even share it with your therapist. I would really recommend this app to anyone who is suffering with OCD, it also gives you the encouragement to get through those tough exposures and delay the compulsion. What I also like most about the app is that you can look back and truly see your progress and if things have become less triggering for you.

The link is below:

https://www.treatmyocd.com/

 

 

Dr.Jonathan Grayson

 

Dr.Jonathan Grayson is an expert in the field of OCD, he has contributed tremendously in patient treatment. This a beautiful explanation of how it feels for someone who has OCD. It can be extremely difficult and uncomfortable opening up to loved ones about the disorder, especially since there is a lack of understanding in the mainstream media. This video is a great way to have someone engage in having a preview of what a sufferer experiences.

 

 

The Horror of Thought Spirals

OCD can be extremely sneaky, a common fear I have is “what if this isn’t OCD”? “What if I am wrong, and I actually have something to be worried about”? or “even if there is a 0.000000000001% chance of this terrible thing happening, I am not willing to take that risk”. This type of doubt is extremely common with OCD, we get to a place where we finally have our thoughts labeled as OCD and before we know it we have OCD telling us that well what if your wrong…and the thought spiral starts all over again.

OCD is a disorder that revolves around uncertainty and doubt. A sufferer gets trapped in these thought spirals, because the discomfort and anxiety caused by not being 100% certain. This pushes the sufferer to carryout compulsions to feel relief. A tool that can be used in these moments, is reminding yourself of the following:

  1. No one can predict the future
  2. Life is uncertain (that is the nature of how the world works)
  3. This is OCD *Even when OCD makes us questions whether this is OCD taking that leap of faith that unequivocally this is OCD will help tremendously from getting sucked into the thoughts
  4. Remind yourself that you don’t want OCD to take more away from your life

It’s extremely hard to do this, especially in moment of intense fear and anxiety. OCD can make us question who we are, what we are capable of doing and take away from precious moments and experiences in life. Taking the leap to trust that I have OCD and this is how the disorder works will help create distance from the thoughts. The ultimate goal is to get to a place no matter how uncomfortable, no matter how risky we do not cave and forget that this is OCD.

I try and incorporate this in my meditation every morning, to try and anchor myself before the start of the day. I find even putting a reminder on my phone through out the day that comes up encouraging me to not do compulsions has also helped.

Just remember that OCD is separate from you, and the thoughts, fears and uncertainty is OCD so the second we have doubt that too is OCD.

 

 

Great Article about Louise Casemore

Ghost River's solo show, OCD, brings affliction out into the light

Writer, director and performer Louise Casemore is adamant conditions like Obsessive Compulsive Disorder and addictions are no laughing matter. She does concede, however, that they can be approached with humour if handled carefully.

In 2015, Casemore created and performed in a show called OCD for the Edmonton Fringe. It was awarded Edmonton theatre’s Sterling Award for outstanding new Fringe work and was Theatre Alberta’s pick of the Fringe that year.

Casemore says her goal in creating OCD was always “to bring a light touch to a heavy subject.”

She said she was prompted to create the show when she noticed a growing trend of treating mental illness and addiction far too casually.

“I noticed a T-shirt that defined OCD as Obsessive Christmas Disorder.

“A friend who had battled alcoholism said he was annoyed that people threw the term addiction around so lightly when he understood what it really meant,” recalls Casemore who had battled Obsessive Compulsive Disorder when she was a teenager.

“I wanted everything to be perfect, which produced some tics and compulsions that were pretty annoying for other people. Back then, sitting down to a meal with me could be pretty exasperating. I’d be rearranging everything on the table.”

She also knows people battling OCD who can’t drive a car and can’t sustain a relationship “which is why I was very cautious in creating my show. It needed to respectful and honest.”

Her solo show is based one-third on her personal experiences. Another third was created from extensive research on the disorder, including interviews with doctors, therapists and sufferers.

“The final third is pure fiction and that’s where I could really bring in a comedic touch.”

She says her show is “much more than me just standing on stage speaking a diary. It’s storytelling and performance and it has some poetry in it.”

She also points out, though there is definitely structure to the show, it is loose enough to allow people to react or even interact if they feel the need to and they definitely have.

Casemore jokes that since its premiere at the 2015 Edmonton Fringe Festival, she has toured OCD to “dirtbag bar basements,” cavernous concert halls and everything in between.

“I’ve wanted to bring it to Calgary, but I just haven’t had any breathing room.”

Casemore has been busy as the artistic associate for Ghost River Theatre, as well as the artistic director for her own company, Defiance Theatre.

Ghost River and Defiance will present Casemore in OCD at the West Village Theatre (2007 10th Ave. S.W.) Feb. 1-10 with a pay-what-you-can preview on Jan. 30 at 8 p.m. nightly. There will be a 2 p.m. matinee on Feb. 3 and an 8 p.m. student performance on Feb. 6 with a talkback following that show.

Tickets are $25 with $20 tickets for artists and $15 tickets for seniors and students.

Tickets and further information are available on ghostrivertheatre.com

Letting Go

I have been having a bad month of anxiety & OCD, I feel like I have completely relapsed and the intrusive thoughts have become so intense that I am back to square one. My intrusive thoughts have caused me so much grief and sadness that all my tools I have learned have somehow slipped my consciousness and I have been in the belly of the beast.

At times I feel in control, and other times I feel completely overwhelmed by anxiety and worry. I thought to myself if this continues I don’t think I can function properly, and the urge to want to just stay in my room indefinitely provides me with comfort. As if quarantining myself would somehow lead to me being free of anxiety.

I forgot that I have dealt with this monster many time before, and the idea of  a quick fix or a “cure” just does not exist. I forgot that in order for this to become easier and better I have to force myself to face it head on and push myself through hard work. I forget that I now have to incorporate this into everyday life, it has to become a lifestyle change. Just like going to the gym is hard work, I have to exercise my mind and implement all my tools that I have learned.

The thoughts become so loud, that it can become self consuming the key is to not have any judgment NO MATTER how intense and unpleasant the thoughts may be. It is the balance between accepting the discomfort and loving the self that will ultimately free the grip of anxiety.

Anxiety exists regardless if it is invited in, and my fundamental flaw in my current approach is that I have re-entered the cycle of wishing and praying that my anxiety could just vanish. The notion of that is counterintuitive to my growth, because it assumes anxiety is capable of vanishing everyone has anxiety it is part of being a human being. The sooner I accept that as truth the less power anxiety has. The sooner I embrace anxiety, and stop going to war with myself the sooner I can feel a beautiful inner balance.

Discipline is so important when dealing with anxiety, the discipline to know that it is just anxiety, and the discipline to proactively use tools such as meditation, journals, mindfulness etc. will ultimately create an automatic thought response to counteract anxiety.

Going back to the example of the gym, at the beginning the idea of going to the gym can be so daunting,  especially if you have not gone in years.  The first few weeks seem excruciating, and many people quit never to come back because of the intensity and emotional obstacles they face. But if you stick through it eventually you’ve created a habit and your routine automatically incorporates going to the gym as a natural part of your day. You also start to feel better, enjoy it and even desire to go. This is the same idea for anxiety, the beginning will be so much work, and extremely uncomfortable and intense but eventually it will become an automatic part of your natural life.  A big lesson I learned is during good times I have to keep putting the effort in, just because I feel amazing does not mean I can just revert back to not working hard, that was my downfall this time and I have now been able to catch it. It is easy to slip back into old ways of thinking especially when things have settled down. The motivation for change decreases as the intensity of suffering decreases.

Consistently working on being present and mindful will create a beautiful inner happiness that glows and circulates throughout the entire body. The simple yet complicated practice of letting go…without fear or ruminating.