A Therapist Shares Her Personal Experience with Postpartum OCD

It's turning out to be postpartum OCD/Intrusive Thoughts Week here at Postpartum Progress. This wasn't planned, it's just that I'm hearing from so many of you who are going through this illness, so I'm sharing just a few of the stories I have received. This one is from Tina …

I am a horrible person. I don't deserve to be a mother.

This was the thought I tortured myself with when I starting having fears that I would hurt my daughter early last year. Once I finally gave in and told my doctor about my fears, I learned that this awful experience had a name: intrusive thoughts, or overwhelming fears that I found impossible to ignore. I was sure I was a danger to my daughter and should be immediately hospitalized. My doctor (and everyone else I told) completely disagreed. They never for a moment worried about the welfare of my daughter; the primary concern was always my suffering and how to help me alleviate it. That made no sense to me. Couldn’t they see that I was a ticking time bomb that could go off any minute?! I did everything I could to avoid being alone with my beautiful new baby, as her safety was my only priority.

I so badly wanted to crawl under my bed and never come out. In those early days, I would have given anything to be a “normal” mother with “normal” concerns like sleep deprivation and not showering for two days. Instead, I had been catapulted into a nightmare that I never saw coming. The shame was a physical presence that I carried with me everywhere I went. After my medication started working and the overt anxiety decreased, I looked happy and well-adjusted to other people. I felt like I was playing a role: the “perfect” mother who had never had terrible thoughts of harming her daughter. I would shudder when I would think of how horrified other mothers would be if they knew the truth, and how they would hurry to keep their children away from me.

I later learned that this disorder had strong roots in the anxiety I had before I got pregnant. I had always been a “worrier”, battling fears of certain doom hiding in every corner. I didn’t recognize these thoughts as irrational worries fueled by anxiety; I thought I was the “normal” one, and that those people that didn’t obsessively worry about every little thing were the ones taking their life in their hands. It was the terrifying experience of being afraid I might hurt my daughter that forced me to look at my thinking pattern and investigate ways I could change it. That was quite a revelation — I can change the way I think and then I can feel better? You would think that a therapist with ten years of experience treating anxiety in other people would have had this concept down, but it was my strange belief that it applied to everyone but me.

Determined to find a way to out of this nightmare, I stayed on my prescribed medication, and set about reading everything I could about this disorder. I especially craved stories of recovery from postpartum OCD that would give me hope that the nightmare would end one day. Having identified that my fears of hurting my daughter were actually a symptom of a bigger issue, I also started doing self-help work designed to change my reaction to these horrible thoughts. After all, they were just thoughts. I was the one giving them power by assuming that thoughts and actions are the same thing. Coming to understand this reality gave me an amazing insight: I was not a defective mother; I was a person with anxiety that could learn to control it and move on with my life.

I can obsess later.

This is my new way of thinking. Just over a year later, I have gained control over my intrusive thoughts, and they no longer run my life. I still have moments of uncertainty when the old fears creep in, but I give myself permission to put those thoughts away for the time being and get back to what I was doing. I can always go back to obsessing later on if I feel the need. The very act of acknowledging my obsessions puts me back in the driver’s seat of my own mind.

The energy I used to expend being terrified and making sure any time I was alone with my daughter was as limited as possible is now being used to teach her about the world. I marvel at her curiosity and revel in her love of life. Surviving this experience has made me appreciate just how blessed I am to be her mother. The shame that used to plague me has been turned into an inner strength that I have vowed to use to help other women find their way out of the darkness of postpartum OCD and into the light of recovery.

Postpartum Anxiety: A Multitude of Fears

Continuing with yesterday's theme of postpartum anxiety and OCD, thought I'd share this from reader Della P.:

"I was never depressed. I didn’t feel despair or hopelessness. I didn’t lack the connection with my first baby or my second. I loved them. I also worried myself sick. I obsessed. I made mountains out of molehills. Eventually, I became paralyzed by fear. Fear, anxiety, paranoia — I don’t really know the difference — overwhelmed me. I couldn’t differentiate my maternal instincts from my obsessive and intrusive thoughts. It was terrible, the worst time of my life. Fear is such a four letter word.

This fear, anxiety and paranoia that I was feeling was a totally treatable illness that I waited longer than I should have to deal with. Sure, it’s natural to worry as a mother, but when has it gone too far? I don’t know, but professionals do. Learn from me and receive the help that is out there waiting to make you better. Get the help you need that will allow you to feel joy in the role of motherhood. Just by reading this, I know you are taking steps, and I applaud you for that.

Now, Ihave learnedthat most of what I worry about never happens. There is great truth to the old acronym, F.E.A.R., standing for False Evidence Appearing Real. I also know I am good mother who feels peace and is so very grateful to be a survivor. It is all because I received the help and treatment I so desperately needed and because I now take care of myself and my little girls."

Some moms have the symptoms of both depression and anxiety. Some have one or the other. What matters is that, no matter what combination of symptoms we have, we get the help and support we need and deserve.

Postpartum Anxiety & Intrusive Thoughts: One Mom’s Story

We often talk about the intrusive thoughts of postpartum anxiety and postpartum OCD here on Postpartum Progress, things like envisioning dropping your baby down the stairs, or much worse. I recently heard from a reader who asked why we don't discuss the unwanted sexual thoughts that can sometimes be a part of intrusive thoughts. It was a great question, because it happens. So I invited Beth to share her story with us.

I was the expectant mother who read everything she could get her hands on about her unborn child. Before she was born, I had dutifully checked off each item that I would need for my new baby. My pregnancy was a breeze, and I felt proud of delivering a healthy 8-pound, 13-ounce baby girl “J.”

The first couple of months went as well as you could expect with a new infant. I was enjoying being a new mother and breastfeeding was going well, but J had a lot of gas and she wouldn’t nap due to acid reflux. I was having a hard time, but it was nothing out of the ordinary. However, other things outside of my daughter started affecting my anxiety levels. My grandmother was very ill and had been hospitalized, information I didn’t learn until after my daughter was born because my mother didn’t want to upset me. One month later she died. The other thing that made me more anxious was my husband’s new job required him to work more hours than we had originally planned, leaving me to do more by myself. We also didn’t have a lot of family and friends to help out on a regular basis. Emotionally I was already teetering, and then I had my first intrusive thought three months after my daughter was born. My world fell apart.

I was changing her diaper and a horrible thought of molesting my daughter flashed through my mind. I spent the next few days trying to understand why I would think such a thing. A normal mother would never think something like that. I thought that something was terribly wrong with me because only a terrible person who belonged behind bars would ever think of something that horrible. The more I worried about the thought, the more unsettled and anxious I got. The thoughts got worse and came at me more frequently. I remember praying frantically, thinking that some sort of evil spirit had taken me over. I withered in silence for a month or so before telling my husband. He tried to help me, but I couldn’t listen. I couldn’t even admit to him how bad it was. All the while, the thoughts got worse and more frequent.

In the meanwhile, I quit my job to stay at home with J. I joined playgroups and a local church, anything to stay busy, but being around other “normal” moms made me feel worse. What would they think if they knew the kind of thoughts I had? They wouldn’t want me to be around their children. They would think I was a horrible person.

Calling to make an appointment with a therapist was difficult. I was afraid that if I told her what I had thought that someone would take my baby away. Somehow I made the appointment and very slowly my story unfolded. I told her about my best friend’s family that I had become very close to at a young age. My single mom appreciated me having a friend whose family welcomed me into their home after school and during the summers. They were a good family who adopted and fostered children. They were active participants in their church. They had a large family and they welcomed me into it with open arms. When I was a teenager, my mother married someone that I didn’t get along with and I went to live with this family.

Shortly after I moved in, one of the girls told me that her father had sexually abused her. I confronted the parents, only to find out that it was true, and that it had not only happened to her, but many of the children. Then they asked me to keep this secret. So I kept it. To my detriment, I kept their secret. I was never abused myself and the abuse was not happening while I lived there, but it had happened. Knowing what had happened and not being able to talk about it, and on some level accepting it by keeping the secret, created a lot of fear and anger in my heart, but I couldn’t deal with it then. So I tucked it away.

All of this fear surfaced when I had J. I was so afraid that something like this could happen to her somehow. The fears didn’t make sense. I was not at risk to be an abuser myself, but none of that mattered. All that mattered to me was that I had had these terrible, unthinkable thoughts and that was enough damnation in my mind. I felt that because I had these terrible thoughts that I would forever be scarred and never the same again. I wanted so badly to take it back or get a do-over. I felt I would never be the mother that I could have been because of these unwanted, intrusive thoughts.

I was hesitant to take antidepressants because I was breastfeeding. But one day I had had enough. The thoughts were bad and I felt like it would never end. I was walking around the house crying and I picked up the phone and called my lactation consultant about going on meds. She supported my decision and I made an appointment with a doctor at my OB office. Luckily, he was very helpful and supportive. Unfortunately, I didn’t stay on that particular antidepressant because I felt out of it and thought it was too strong and didn’t want to pass it on to my daughter, so I went off and tried herbs and tinctures instead. They didn’t work.

Finally, after my daughter’s first birthday and encouragement from my therapist I got put on an antidepressant that worked for me. I started to notice a difference about a month later, and it got me over the hump. I felt like I could deal with this. Yoga and meditation practice has also been helpful in my recovery.

I am doing much better now. I am still having productive therapy sessions and the intrusive thoughts are much less frequent and bothersome. It’s the memory of my postpartum anxiety experience that is the most vivid in my mind. Now, I mostly obsess over how I’m doing and am constantly evaluating myself. I have had a few setbacks that, at the time, were devastating, but each time it was easier to get back up than the time before. I’ve learned to be more compassionate with myself, and I realize that it takes time to get completely better, but the difference now is that I truly believe that I will get there. Through this whole ordeal I can say that I have learned a lot about myself, and all of the work that I have done on myself is making me a better mother and a better person, and for that I am grateful.

Thank you so much for sharing your story Beth. It is possible for women to have unwanted thoughts of a sexual nature as part of their illness. These thoughts can happen regardless of whether you have a history of sexual abuse. It is important to know you are not alone, and you can get help.

When Postpartum Depression Beliefs Become Truths: On Self-Doubt

I believe that I have mentioned the quite amazing thing that happens in my psychotherapy practice week after week with moms who have postpartum depression: Themes emerge. Truly.

There will be a week when almost every mother I see is struggling with communication with her partner. Another week, the dance for nearly everyone I see is to the tune of the need for self-care and the seeming impossibility of this endeavor. One week I may have a handful of mamas wondering “where they went” once they became mothers and who are struggling with the overwhelming task of deciding who they would like to be. The next week, mom after mom is treading through the past in an effort to better understand her own experience in childhood so that she might have the courage to path new roadways for her own children. There are weeks where each mom is in tears. Weeks where laughter abounds. Sometimes it seems that the common topic is medication and the often complicated conversation about whether this choice feels appropriate. Other times the sessions abound with referrals to acupuncturists, psychiatrists, support groups, and nutritionists.

I mention this tendency for themes as a reminder that so often what you think you are struggling with alone while going through postpartum depress or anxiety is happening to the many women you pass in the street on your way here or there. These challenges are real. For many, many, many women.

This week’s theme? Beliefs. Not beliefs in the spiritual or religious sense, but the beliefs that become truths for so many women who are struggling during pregnancy or postpartum. One mom in my office believes that having a baby means that life is destroyed. One mom believes that she is not a good mom because she was unable to breastfeed. One mom believes that she should be happy because she has a healthy baby and a family who loves her. One mom believes that she should not take time for herself because “good mothers” want to be with their children all the time. One mom believes that she must be crazy and awful because she is having terrifying intrusive thoughts that she knows are wrong but she cannot turn off. One mom believes that she will be an unfit mother because she dislikes being pregnant and is not the glowing model of happiness as her belly grows. I could honestly go on. This has not only been a week of beliefs but also a week of intense struggle for the women who I see: of tears, frustration, and seemingly limitless self-doubt.

This is a place where it’s important to look at thought patterns and the way that they intrude in one’s ability to feel hopeful about themselves and their situations. You see, when the conversation really begins to unfold, it becomes a bit more clear that while each mom claims her belief to be a truth, the reality is not so. There are millions of women out there who are unable or who choose not to breastfeed and who are spectacular mothers. There are rooms full of women who have healthy children and loving families whose postpartum period is challenged by depression and/or anxiety. I think I can safely say that there is not one mother out there, struggling with a perinatal mood or anxiety disorder like postpartum depression or not, who wants to be with her children all the time, and moms who take time to fulfill their own needs away from the demands of parenthood will undoubtedly have so much more to give their children for it. There are many women who would never in a million years hurt their children but who are struggling with scary thoughts that deserve support. And, quite truthfully, the idea that every woman who is pregnant is a glowing model of happiness and optimism is a myth that I wish I could crush on the spot.

Beliefs are like well-tread pathways. They come from somewhere often deep inside and they can literally color the way that we all look at the world and at ourselves. They come from experiences, from messages our parents gave us, from society, and from the often unrealistically high standards we set for ourselves. And over time, these beliefs become so true to us that the line between belief and truth becomes blurred and tangled. The mom who thinks that having a baby means that her life is destroyed most likely has an absolutely valid reason for believing this. But it is helpful to ask where this belief came from — where did she learn this and, is it possible that this isn’t a truth at all and that with support and hard work she can create a new belief for herself?

And, yes, if only there was that magic button on the wall that we could all push to make things change instantly; To suddenly see things differently and create new truths for ourselves just like that. That button would be well worn, let me tell you.

No, none of this is as easy as that, I know. But beliefs can change. And they do, lacking big red shiny buttons and all. The journey through postpartum depression recovery, and that of related illnesses, takes us through many different places and it is important to remember that you really do get to choose what you want to believe to be true. For yourself and for your little ones.

What were/are the beliefs that you have/had that influenced the way that you felt about yourself and mothering?

Kate Kripke

Postpartum OCD: Does Having Scary Thoughts Mean You’ll Act On Them?

I got this email from Amy from Pretty Babies, and I identified so much with what she said that I wanted to share it with you (with her permission, of course):

“The entire trajectory of my recovery would have been different if I had known about the intrusive thoughts when I had my oldest. I thought that having the thoughts meant that I was capable of doing the things I thought about (in other words, if I thought about my kids drowning in the tub, I thought it meant that I WOULD drown them). I avoided getting help for months because I was afraid that “they” (my doctor, my husband, etc.) would take my daughter away if they knew what I was thinking. If I had known these sorts of thoughts were common, I would’ve been able to get help much sooner, but as a first time mother I had never heard of such a thing. Thank you for talking about this, so other moms don’t have to suffer the way we did.”

This is EXACTLY what happened to me when I had postpartum OCD. I had never heard of intrusive thoughts. I thought I was now a horrible monster, and I believed that since I was having these thoughts it must mean I could follow through on them. That was wrong, but no one ever told me that. I also thought my child would be taken away. I WISH, WISH, WISH this was discussed more. There’s no reason for mothers to continue to suffer.

If you have postpartum OCD or postpartum anxiety and have scary, disturbing thoughts known as intrusive thoughts it is highly unlikely you would EVER act on them. As Karen Kleiman writes in her new book Dropping the Baby & Other Scary Thoughts:

“When scary thoughts feel inconsistent with your belief in who you essentially are, your character, and your personality, they are referred to as ego-dystonic thoughts. When a thought is ego-dystonic, it is in conflict with whom you fundamentally believe yourself to be. This inconsistency creates piercing anxiety. However, this distress, as disturbing as it feels to you, provides reassurance that these thoughts are anxiety driven and not psychotic. In fact, your anxiety is an indication that you are aware of the difference between right and wrong.”

Breaking the Cycle of Scary Thoughts & Postpartum Anxiety/OCD … A Giveaway!!

When I had postpartum OCD in 2001, I had never heard of the illness with which I was eventually diagnosed. I had never heard of postpartum anxiety. I had never heard of intrusive thoughts.

Once I was fortunate enough to find out what was wrong with me, I got pretty pissed off. Why didn't anyone tell me??!?! Certainly it would have helped to have been warned ahead of time that I could experience scary thoughts. It would have saved me the horror of thinking I'd gone irreversibly "crazy" and would never be myself again. I would have reached out for help sooner and not have feared that I would be locked up forever or have my baby taken away from me. Couldn't somebody have at least mentioned it?

You'd think, nine years later, that most physicians would now be aware of the entire spectrum of perinatal mood and anxiety disorders, including postpartum anxiety and OCD, but they aren't. Still! Just the other day, Stephanie, who shared her story here with the post "Horror Movies In Her Head", informed me that her doctor just told her he'd never heard of postpartum OCD. It just shows you how much work we still have left to do.

Now, at least, we've got a book. A wonderful book! It's called Dropping the Baby & Other Scary Thoughts: Breaking the Cycle of Unwanted Thoughts in Motherhood. Written by Karen Kleiman and Amy Wenzel, it shares why we have such thoughts, how we can be certain we won't act on them and what we can do to get through them. You can buy it on Amazon! You can read it and see that you are not alone and that you're going to be okay. You can take it to your doctor, spouse, therapist, friend, patient and say "See! It's real. It's an illness. It's not forever."

I know that many of you are as pleased as I am that this book is now available as a source of information and support, so I'm excited to be able to give one away. To participate in the giveaway, please comment below (by no later than Tuesday, 8pm Eastern) by answering any one of the following questions (note: if you're on the Facebook page, you have to come and comment here on the blog to be eligible for the giveaway):

1) If you had/have intrusive or scary thoughts, what is one thing you did/do to manage them, or reduce their impact on you?

2) If you had/have intrusive thoughts, did you share them with anyone and if so, who? If not, why not?

3) If you had a copy of Dropping the Baby & Other Scary Thoughts how would it help you to help yourself or others?

On Wednesday morning I'll do a random drawing of the commenters to pick a winner! Good luck!

Oh, and P.S. I wrote the foreword to this book, which was a complete and total honor of the highest order!

Postpartum Anxiety & The Incessant Fear of Losing Your Loved Ones

I never used to think about death. As a teenager, I thought I was untouchable, invincible, like many teenagers are apt to do. I didn’t understand what it might mean to lose someone; I didn’t experience a death in my family until I was 24 years old. When I got married, though, overnight I became aware of the possibility of having something invaluable taken away from me. However, it wasn’t until I developed postpartum depression and anxiety that I became preoccupied with the topic. It began to fill my brain, taking on a life of its own and sometimes making it difficult to focus on anything else.

An obsession with death and dying can be a symptom of postpartum depression and anxiety, especially in those women with postpartum OCD. Of course, at the time I didn’t know this, so I just thought I was losing my mind. I had to check on my son at least twice before I went to sleep every night, and I often found myself getting out of bed to make sure the front door was locked, even though I always lock the door behind me when I get home. Every time we’d drive on the freeway, I would lock the car doors because I had a recurring waking nightmare about a door malfunctioning and me or one of my family members being sucked out of the car, kind of like in the movies when an airplane door is opened mid-flight.

At night, I would pray to God to keep my husband and son (and eventually sons) safe. Then I would lie in bed and panic — sometimes cry — thinking about having to go on with life without my husband or baby. It often took hours before I could sleep, and once in a while I’d find myself repeating over and over into thin air, “Please just keep them safe. Please just keep them safe. Please just keep them safe.”

I’d often think about my own death, too. Not in a suicidal way, just in a compulsive, hysterical way. What would my family do without me? What would happen to me? Would anyone go to my funeral? Who would dress my body? I didn’t want anyone to see me without clothes on. It’s almost funny in retrospect, but it was terrifying at the time. My stomach would be in knots for hours after one of my rounds of death thoughts.

Even now, though a great deal of my postpartum anxiety symptoms have abated, the fear of death and dying remains. This morning I cried for an hour after reading the blog of a woman whose son killed himself six months ago. I couldn’t stop myself from reading every entry from the last six months. She has two sons, and the oldest is gone now. I kept thinking of my own two boys and I swear, my heart stopped beating when I thought of one of them not being here anymore. I got up and went to my oldest son’s room; he was supposed to be napping, but was doing his usual routine of talking to himself to stay awake. I laid down next to him and asked him to hold me, and I told him that I loved him. He put his little arms around my neck and squeezed me so tight. I finally was able to stop crying, but I couldn’t stop the thoughts.

I’m not sure when this will go away. Perhaps it’s just a part of my personality now, like my love of reading or loud laugh. I don’t want to let it rule me, though. Sometimes I’m so paralyzed by worrying over my mortality that I don’t have time or energy to appreciate the time I have here on this earth. I suppose I need to take what’s good about this part of postpartum anxiety and run with it, since I don’t know if it’s necessarily temporary. For example, I can’t hang up the phone with my husband or go to bed for the night without saying “I love you.” I have to say it to my kids every time we part, too. My husband asked me why I feel the compulsion to say that (even when I’m angry or annoyed with him), and I told him that if he or one of our children were to die suddenly, I would want the last words they heard to be “I love you.”

So maybe I’m crazy, but at least my family will never question my love for them. In the grand scheme of things, perhaps it’s worth the trade.

Alexis Lesa

How To Get Rid of the Intrusive or Scary Thoughts of Postpartum OCD

Ever had an intrusive thought? Diagnosed with postpartum OCDintrusive thoughts? Want to know how to STOP these awful images and thoughts?

The prolific and amazing Karen Kleiman’s new book is now available for pre-ordering on Amazon.com. It’s called “Dropping the Baby & Other Scary Thoughts: Breaking the Cycle of Unwanted Thoughts In Motherhood”. Her book, co-written with Amy Wenzel, explains what the thoughts are, why they are there and what to do about them. It comes out on December 10 (my birthday, ironically), but as far as I’m concerned it can’t come out fast enough! I know that so many of you have intrusive thoughts and will really benefit from Karen’s guidance and insight.

And … shhhh … I’ve got a fun little secret: I wrote the foreward. How exciting is that?! It was a ridiculously wonderful honor to be asked to write it, and I enjoyed being able to share a little bit of my experience.

I’m so excited about this book.

How Can You Make the Scary Thoughts of Postpartum OCD Go Away?

I want you to meet a Warrior Mom in the making. Everybody:say hello toBA. This blogger from Heir to Blair has been sharing her story of postpartum depression/anxiety and just wrote a post this week on what she does to try to halt those awfully scary intrusive thoughts. It's the same thing I did and I found it helped as well when it comes to intrusive thoughts. Go read it.

Keep kicking PPD's ass Blair!

Also, you can click here for more information on postpartum anxiety and intrusive thoughts.

Photo credit: © Boz Worthington – Fotolia

One Mom Learns To View PPD Treatment As If It Was For Cancer

Postpartum OCD survivor Angela Nazworth writes a very compelling description of her second battle with postpartum depression, OCD and anxiety on the website (In)Courage. She shares how she changed her perspective on how to tackle this monster, which hit her much worse the second time around, and also how her spirituality helped guide her through.

Many of her descriptions hit home for me, in particular the "what if" intrusive thoughts, the belief that your child will never love you, and the ability to go to sleep at first but after you get up to feed the baby you can't go back to sleep.

Here's a tidbit:

"I only stood becauseno chair could hold me. My legs shook visibly from the trembling sensation radiating from my waist down to my toes. I balled my fingers tight into fists and held them close to my chest in an effort to stop pinching my neck. I did not wish to appear even less stable, although next to the confession I had just made, I do not think it would have mattered. Beside me, my husband exhaled slowly and shifted his weight from foot to foot as he absorbed the words my psychiatrist spoke to him about me.

'This situation has dangerously escalated. If there has ever been the time to use the term nervous breakdown, it is now. Your wife needs to either be hospitalized or put under the close care of family members. If you are unable to make a decision, I am prepared to send staff from the local psychiatric hospital to your home this afternoon to have her committed.'"