Bill Meyer, facilitator for the pregnancy/postpartum support group at the Duke University Medical Center, sent me this article today from the Washington Post that appeared on March 7 about postpartum obsessive compulsive disorder (PPOCD). The article is called "Scary Thoughts" by Stacey Colino. (You may have to register to see the article – registration is free.) I suffered PPOCD during the birth of my first child and the article is definitely on target. Here are quite a few highlights that I think are important (the underlining is my emphasis):

"Indeed, some women … develop clinically significant symptoms of OCD during pregnancy or the postpartum period — a phenomenon that is vastly under-recognized, experts say.

While reliable statistics on postpartum OCD are lacking, the lifetime incidence of OCD in the general population is believed to be 2 to 3 percent. What distinguishes OCD symptoms from normal intrusive thoughts is partly the extent to which these ideas are anxiety provoking, irrepressible and persistent.

'To have a real obsession, it's an intrusive, unbidden thought, idea, or image that comes to your mind that you do not want and actively try to resist,' explains Gerald Nestadt, a professor of psychiatry at the Johns Hopkins Medical Institutions in Baltimore. 'You can't get rid of the thought' …

Some experts believe postpartum OCD occurs primarily in women who already have the condition, sometimes in a mild and undiagnosed form.

Complicating matters, postpartum depression and OCD often go together, but many women and their clinicians focus exclusively on the depressive symptoms. Yet a study at Case Western Reserve University in Cleveland found that postpartum depression is accompanied by obsessive thoughts in 57 percent of new mothers.

The extensive media coverage of mothers who kill their kids (as in the widely reported 2001 incident where Andrea Yates drowned her five children) makes some new parents with intrusive thoughts worry whether they're headed down a similar path. In most cases they are not. But just being exposed to such stories can fuel the thoughts, Abramowitz says. 'You read things in the news, and it's normal to incorporate that into your experience' …

There are key differences between obsessive thoughts and postpartum psychosis, explains Shaila Misri, a reproductive psychiatrist and director of the reproductive mental health program at BC Women's Hospital and Health Center in Vancouver, B.C.

Obsessive symptoms tend to be 'repetitive, unwanted thoughts that the person is aware are not normal even though she is unable to stop them,' she explains. With psychotic symptoms, 'the repetitive, unwanted thoughts are actually delusional, and the person who is having them believes they are real.' While women with OCD rarely harm their children, Misri adds, 'those with postpartum psychosis are in very real danger of doing so' …

Yet there's often a 'don't ask, don't tell' dynamic surrounding this subject in the physician's office, experts say. While many doctors screen for postpartum depression these days, few ask about intrusive thoughts, Misri says. Meanwhile, new mothers often feel guilt and shame and stay silent.

'A lot of times people are afraid to mention these symptoms because they think if other people knew, they'd lock them up or take the baby away,' Dell says. 'When I ask [new mothers] if they're having unwanted, intrusive thoughts, they are often quite relieved to hear that this happens to other people and that there are probably some biological reasons for this' …

Says Nestadt, 'The very sad thing is that many people who have experienced an onset or exacerbation of OCD during pregnancy or the postpartum period and didn't receive or respond to treatment may be unwilling to have other kids after the experience. . . . To have OCD and worry constantly day after day is dreadful.'"

That about covers it!! I had horrible thoughts; I knew they weren't real but they scared me to death; I thought I would never be the same; I was afraid to tell anyone because I thought they'd lock me up and throw away the key; When I finally got help I was relieved to find out what was really happening and that I would be ok; It turns out I probably had mild OCD my whole life, and it was simply exacerbated by pregnancy; I was very afraid to have another child, etc., etc. I hope you find this article helpful.

Tags: intrusive thoughts postpartum OCD postpartum psychosis PPOCD