In the past, it was always estimated that about 3% of postpartum women would get postpartum OCD. That number never made any sense to me, given how many of you with whom I speak about intrusive thoughts and other significant obsessive and compulsive symptoms. Plus, I had postpartum OCD, so I’m probably a little biased. 😉
A new study published in the Journal of Reproductive Medicine finds the number is much higher — one in ten new moms may have postpartum OCD. Researchers at Northwestern University watched 461 new mothers for OCD symptoms and found that 11% of moms had postpartum OCD symptoms — intrusive thoughts and compulsive actions like checking and rechecking on their babies or washing and rewashing bottles — at two weeks postpartum. Six months later, half of those who’d had the symptoms at two weeks still had them, and 5% had developed new symptoms of postpartum OCD. (This compares to an OCD prevalence in the general population of 3%.) The authors’ conclusion? If moms show postpartum OCD signs early, it is highly likely those symptoms will persist. Time to do a better job watching out for postpartum obsessive-compulsive disorder.
A different study published in the journal Pediatrics took a look at postpartum anxiety symptoms, noting that moms may be screened for postpartum depression but are not usually screened specifically for anxiety. The researchers from Penn State screened more than 1,000 moms using both the Edinburgh Postnatal Depression Scale and the State Trait Anxiety Inventory. They found 17% had anxiety and 6% had depression symptoms in the first few weeks postpartum, and that anxiety remained more common than depression even at 6 months postpartum. Their conclusion is, in part, that postpartum anxiety may be more common than PPD. With this particular study, I’m more interested in what happens down the line than what happens in the first two weeks. Was there some way to identify, among those who presented with anxiety symptoms early, which moms were more likely to have persistent anxiety and require treatment?
Wow. Wow, wow, wow. So interesting and, in a sense, reaffirming to read. I was so super frustrated that PPA/OCD was not mentioned in the literature I brought home from the hospital after having my babies, and that my providers never screened me for it… just for PPD. Yet, it seems like SO many moms I talk to deal with some sort of PPA/OCD, and most of them had no idea that’s even a “real” thing. I hope they continue with this research.
I agree with you 100% Jill. I’m very interested to see where all of this is heading.
Thank you for posting this. I wish I had known about this when I was suffering w/ anxiety after my first was born. Better late than never!
Great to have this research to support what I’m frequently seeing in my practice. The anxiety and OCD is so prevalent. Nice affirmation of anecdotal experience.
Thank you Katherine! As a recovered ppd OCD sufferer I cannot describe the personal hell that it is! So many mommas suffer in silence.
WOW. Thank you so so much for posting this. I wish this would have been done years ago, but like you all are saying…better late than never! I am so grateful for ladies like you who are sharing in their experiences. This research will flourish, I am sure. So necessary to keep going!
Thanks for sharing this. You always do a great job digesting what the latest research says.
As you know so very well, the treatment for OCD is not the same as general anxiety disorder or depression. Getting that diagnosis right at the outset is critical to the recovery of the mother. I’m optimistic these studies and your efforts will continue to raise awareness of OCD and Anxiety as separate conditions that warrant a different type of treatment!
Thank you for sharing this latest research Katherine. Do you know what screening tool was used to screen for OCD? Through the 2020 Mom Project, we’d like to share some recommendations on tools to use for screening OCD (as well as Anxiety & Psychosis). Hats off to the researchers who continue to dig in!
I don’t know Joy. They don’t say in the abstract and I don’t have access to the full study. I check various stories on the piece, and none mention which tool was used. It’s most likely this one (the YBOCS), but I’m really not sure: http://www.ocdcenter.org/symptoms/ybocs.php
Great findings and conversation – thanks, Katherine!!
I work on the clinical staff team for an Intensive Outpatient Program that treats anxiety disorders, including OCD, in Northern California. We use the Y-BOCs in all of our intake assessments with new clients to assess for OCD and regularly find that folks simply aren’t aware of their own compulsions (e.g., don’t know they are doing compulsions, just that they do some things to try to ease anxiety or feel better) or they haven’t even heard of OCD except in the context of repeated hand washing (which many OCD sufferers don’t experience). In addition, after starting treatment, we use the Y-BOCs Symptom Checklist to tease out the specific obsessive thoughts and compulsive behaviors each individual engages – simply because there are so many possibilities and each person’s experience with OCD is unique. One important caution I would offer is that the clinician needs to have a firm understanding of what the terms “obsession” and “compulsion” mean and how to explain them to the other person in order to administer the Y-BOCs accurately and ensure the respondent is answering as accurately as possible.
This is such an important topic – I’m delighted to see it being discussed!
Intrusive thoughts were probably the worst part of my postpartum madness. (Shorthand for depression & anxiety.) They were…terrifying.
I am so glad that there is more awareness now (3 & 1/2 years after my first baby) about PPA. During my first PP, my symptoms did not match either PPD or OCD, but now after having my 2nd child, my symptoms came sooner and are much greater strength. In addition, I can now identify my “sickness” as PPA.
Dear Katherine,
First off, I need to THANK you for creating Postpartum Progress, sharing your personal experiences, and providing a minitored, evidence/research-based forum for this terribly underserved population.
I’m a 38 year old, fully licensed clinical mental health counselor, and a first-time mom to an 8 week old precious angel, Marni Amorette.
I’m absolutely head over heels in love with her and my wonderful husband. AND…it’s incredibly important to write AND (not but) I have been BESIEGED with postpartum anxiety, specifically PTSD, OCD, and rage. It’s been horrifying for me, my husband and my parents.
As a professional counselor AND new mom, everyone around me assumes that I SHOULD’VE been or done the following things:
1. I SHOULD NOT have succumbed to any of this
2. I SHOULD be more RESILIENT than this
3. I SHOULD be happy…24/7
4. I SHOULD have diagnosed myself sooner
5. I SHOULD treat myself
6. I SHOULD NOT need to take medicine
7. I SHOULD NOT need to seek peer or professional support
Well, talk about a veritable shit storm of SHAME!
It’s an attack on me as a person, a brand-new mommy, and a professional mental healthcare provider. And it feels TERRIBLE.
Marni Amorette turned 8 weeks this Saturday, the day before Mothers Day, May 10, 2015. I mention this for 2 reasons: a) It took me THIS long to seek treatment and b) the pressure to be happy, especially on Mothers Day is CRUSHING.
One part of my brain, the part not currently ravished by PTSD, OCD and rage, RATIONALLY understands that something is terribly wrong and I AM NOT MYSELF. I CANNOT BE MY OWN COUNSELOR. I’m LUCKY that my training and education made it easier to spot the symptoms. But, I had to make the phone call to my ob-gyn’s social worker for help, ask my PCP for an SSRI, and have a very difficult conversation with my loved ones about this temporary illness…after WEEKS of battles, screaming, fighting and tears, asking for forgiveness, just to repeat time and time again.
My husband nearly left me and my parents nearly disowned me because of my behavior. And that’s the point: it’s the BEHAVIORS that hurt those we love. It’s so very challenging to explain to them how I’ve felt so they understood it wasn’t my intention to hurt them and MORE than that, I felt OUT OF CONTROL.
After a truly despicable start to my very first Mothers Day, I think I FINALLY got through to my family. After explaining, describing, apologizing and promising to change my behaviors, we were able to enjoy the day. I made a CONSCIOUS CHOICE TO LET GO AND BE HAPPY. And it actually worked, no alcohol necessary.
(I’m also a certified substance abuse counselir and know what alcohol and drugs can do for someone in a crisis as self-medication.)
This is CRUCIAL to mention here and now: The nurse at my OBG-GYN administered the Edinburgh PPD questionnaire at my 6-week follow-up. I scored moderate…BUT SHE DIDN’t do anything about it!
I took another assessment at my baby’s 2-month checkup…BUT SHE DIDN’T bother to look at it!
So, where do all of these ravaged women go to for the desperate help they need and deserve if they don’t even know what it is they’re going through? If they can’t describe their symptoms very well? If the healthcare establishment doesn’t do their due diligence?
It’s an atrocity that must be resolved. Motgers are important and their wellbeing is crucial for the wellbeing of their child and the people around them.
I’d love to help the cause! Let me know what I can do as a stay-at-home mom who’s also a mental health professional.
Dear Katherine, I understand your suffering and the stigma about motherhood and professional experience.i myself am a clinical psychologist and a 34 years mother of a six months daughter and I am suffering anxiety, OCD and terrible irrational fears….I have problems with my identity and self esteem and I want to have some clearness about what happens with me?!
Thank you very much for all these publications. I am a clinical psychologist and a mother of a six months beautiful daughter. I am experiencing OCD and hard anxiety for these six months. I am afraid that I could harm or kill my baby who I love so much or throw myself from 13th floor where I live.I am on psychotherapy and take medications but am still afraid to stay alone with my baby. the experience is terrible, no chance to feel happy from my motherhood:( I just want to know what is the reason for this mental suffering? Does it come from hormone dis alas e or the cause is deep in the unconscious? ! There is no conversation or experience in Bulgaria about this issues, and I am sure a lot of mothers are suffering not knowing what to do. my fears deepened a week ago when there were two cases on tv where mothers had killed their newborns….
Petia,
I’m so sorry you are struggling like this. I hope you are able to find the help you need there. Are you seeking help? Are you able to find a doctor who understands postpartum mental health?
I have a question about dealing with postpartum ocd. I spoke with my doctor and therapist about ITs and both assured me that women NEVER act on their ITs but if the amaydala (might be spelled wrong) causes split second responses to flight or fight before the frontal cortex or reason kicks in, couldn’t you act on your ITs before your reason kicks in? I felt like I was on the road to recovering but this depressing piece of info has definitely set me back.
Thank you so much for this. I’m currently struggling with postpartum anxiety (7-8 months after delivery), and it’s actually gotten worse over time. I’ve never had anxiety before, so dealing with it is causing more anxiety. I’m going to get checked out by a doctor, but in the mean time, it’s nice to feel like I’m not alone.
This is not so much reply as question. I was born in 1957. I was my mothers tenth and last pregnancy. Six of us lived, 1 still born and 3 miscarriages preceded my birth. This put a 5 year gap between myself and the second youngest
In the 1940’s and fifties, postpartum was considered a character flaw. Sanitariums administering electroshock therapy , and sedatives that rendered the patient unable to function were among the scant treatment approaches available. By the time mom had baby number three, she realized her severe postpartum was successfully treated by getting pregnant a,s,a.p.
Eventually her womb would fail and carrying the baby to term became less and less likely. To mother, that was blessed relief. She had gotten herself into a viscous cycle and was on the edge of incompetence raising the five children she had.
She got pregnant with me after four failed pregnancies in a row, she was reasonably certain I would not make it to term either. My birth was called a miracle by extended family. To mom, it was a betrayal against her by her body. To underscore this, her doctor forbade any more pregnancies. This time she would get no relief from the shackles that pulled her down.
This was not the best circumstance for anyone, least of all myself. I fell prey to non incestual sibling abuse beginning in infancy and continuing to today
by means of exclusion, isolation, invalidation and the overwhelming shame of not being loved by ones own kin.
I have been studying family dynamics for forty years, I remember when there was nothing published on nonincestuous sibling abuse. Emotional incest and triangulation had not yet been identified, and narcissism was not yet a cluster b personality disorder. In all my searching, I have not found any professional papers identifying a pattern of pregnancy to treat postpartum, yet huge families were the norm in that era. Can you suggest any studies I might find enlightening with regards to identifying mothers history not as an isolated case but rather belonging to a clinically identifiable pattern? Thank you for reading this. Standing by with interest for your reply.
This is a very good question and I wish we had an answer. I’m sorry that I’m now aware of anything to point you to, focused on this. We have not been heavily involved in research, and if we have, it hasn’t been focused on your particular question. I wish you all the best in finding your answers. Thank you for your story and thoughtful inquiry.