By: Sireesha Kolli, MD and Jessica Pizzo, LCSW
What Is Postpartum OCD?
Becoming a mother is a life-altering experience, filled with both joy and challenges. The physical recovery, sleepless nights, and overwhelming responsibilities can leave new mothers feeling exhausted. Societal pressures and unspoken judgments often lead many moms to struggle silently. Postpartum challenges are not uncommon—approximately 1 in 7 mothers (15%) experience perinatal mood and anxiety disorders (PMADs), including postpartum depression, anxiety, obsessive-compulsive disorder (OCD), or psychosis.
Research shows that a combination of psychotherapy and medication often offers the most effective relief for mothers facing postpartum mood disorders. In this article, we’ll focus on postpartum OCD, aiming to reduce the stigma and isolation many moms feel while offering insights into a collaborative, evidence-based treatment approach.
Postpartum Obsessive-Compulsive Disorder (OCD) is a type of perinatal mood and anxiety disorder that affects new mothers. It involves intrusive, unwanted thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) intended to alleviate the distress caused by these thoughts. Common obsessions include fears of accidentally harming the baby, even though these thoughts conflict with what the mother truly desires.
For mothers experiencing postpartum OCD, these distressing thoughts can interfere with their ability to care for their child. The compulsive behaviors—such as repeatedly checking on the baby—can take a toll on the mother’s well-being if left untreated.
What Causes Postpartum OCD?
While the exact cause of postpartum OCD is unclear, it is believed to arise from a combination of biological, psychological, and environmental factors. Hormonal changes after childbirth, such as fluctuations in estrogen and progesterone, can contribute to mood and anxiety disorders, including OCD.
Additional contributing factors include:
- Genetic predisposition: A family history of anxiety disorders, depression, or OCD increases the likelihood of developing postpartum OCD.
- Stress and trauma: Emotional stress from childbirth, societal pressures, and sleep deprivation can exacerbate the risk. A traumatic birth experience can also act as a trigger.
- Personality traits: Individuals with perfectionistic or detail-oriented tendencies may be more vulnerable to postpartum OCD, especially when faced with the unpredictability of caring for a newborn.
Recognizing these causes helps moms understand that postpartum OCD is not their fault—it’s a treatable condition that requires appropriate care.
Diagnosing Postpartum OCD
Diagnosing postpartum OCD can be difficult since its symptoms often overlap with other postpartum mood disorders, such as depression and anxiety. However, postpartum OCD is distinguished by the presence of intrusive, ego-dystonic thoughts (thoughts that conflict with the mother’s values) and compulsions.
Mental health professionals assess the frequency, intensity, and impact of these thoughts and compulsions on the mother’s daily life. Early diagnosis is crucial to ensuring the mother and baby receive the proper care and support.
Medication Management for Postpartum OCD
Once postpartum OCD is diagnosed, a comprehensive treatment plan that includes medication management may be recommended. Selective serotonin reuptake inhibitors (SSRIs), such as sertraline or fluoxetine, are commonly prescribed because they are well-tolerated and have a solid evidence base for treating OCD.
For breastfeeding mothers, it’s important to select medications with favorable safety profiles. SSRIs like sertraline are often preferred for their minimal risk to the infant. Mothers should discuss the benefits and risks of medication with their healthcare provider. If SSRIs are ineffective or not well-tolerated, other options, like serotonin-norepinephrine reuptake inhibitors (SNRIs) or augmentation with antipsychotics, may be explored.
Psychotherapy for Postpartum OCD
Psychotherapy is another critical component of treating postpartum OCD. Working with an affirming perinatal specialist can reduce shame and help moms realize they are not defined by their intrusive thoughts. Evidence-based therapies, such as Cognitive Behavioral Therapy (CBT) with Exposure Response Prevention (ERP) and Eye Movement Desensitization and Reprocessing (EMDR), are highly effective for reducing the frequency and intensity of intrusive thoughts.
Collaborating with a mental health professional can empower mothers to regain confidence, improve their ability to cope, and feel more present with their baby. Involving a support person, such as a partner or parent, can further enhance treatment outcomes.
Self-Care Strategies for Managing Postpartum OCD
While professional treatment is vital, small self-care strategies can help reduce stress and improve symptom management. Here are a few practical tips:
- Practice mindfulness: Simple deep breathing exercises or grounding techniques can help calm anxious thoughts.
- Incorporate movement: Gentle physical activity, such as walking or stretching, can relieve stress.
- Engage in sensory support: Use a weighted blanket or other comforting items to provide relief during moments of anxiety.
- Rest intentionally: Small acts of rest and self-care, like adding a protein shake to your morning routine or taking deep breaths, can restore energy and well-being.
Common Questions
Here are answers to some of the most commonly asked questions about postpartum OCD to help you better understand the condition and its impact.
How Long Does Postpartum OCD Last?
The duration of postpartum OCD varies from person to person. Symptoms may start during pregnancy or shortly after childbirth and, if left untreated, can persist for months or even years. Factors influencing the duration include the severity of the symptoms, how early treatment is started, and the individual’s response to therapy.
For some mothers, symptoms can improve within a few months of beginning therapy and medication. Others may require longer-term treatment to manage their condition. The good news is that postpartum OCD is highly treatable, and the sooner you seek help, the better the outcome.
Does Postpartum OCD Go Away?
With the right treatment, postpartum OCD can improve significantly. Many mothers find that their symptoms decrease or even disappear over time with a combination of therapies, such as CBT with ERP, and medication.
However, some individuals may require ongoing management to prevent symptom relapse. Early intervention and a strong support system can help mothers manage symptoms and regain confidence in themselves and their parenting.
Can Postpartum OCD Affect Bonding With the Baby?
Postpartum OCD can impact the bonding process between a mother and her child. The intrusive thoughts and compulsive behaviors associated with OCD may make it hard for mothers to relax and enjoy time with their baby. Feelings of guilt, shame, and fear can further strain this relationship.
Fortunately, with the right treatment, many mothers can rebuild strong emotional connections with their babies. Therapy and medication can reduce OCD symptoms, allowing the mother to feel more present and engaged in caring for her child.
How Can Partners Support Someone With Postpartum OCD?
Partners and loved ones play an essential role in supporting mothers with postpartum OCD. Here are practical ways to help:
- Emotional support: Be there to listen without judgment, reassuring the mother that she’s not alone.
- Encourage treatment: Gently support her in seeking professional help. Offer to assist with scheduling appointments or attending sessions.
- Promote self-care: Encourage small self-care practices, such as rest, relaxation, and mindfulness.
- Participate in therapy: If she’s open to it, attending therapy or support group sessions can help you better understand how to support her.
Patience, compassion, and involvement in the recovery process are key to helping mothers with postpartum OCD.
Conclusion
A collaborative approach involving both a psychiatrist and a perinatal therapist is key to managing postpartum OCD. Combining evidence-based therapies, medication, and self-care practices can help mothers reduce intrusive thoughts, regain control, and strengthen their emotional bond with their baby.
If you or someone you know is struggling with postpartum OCD, know that help is available. With the right treatment and support, you can embrace motherhood without the burden of fear or guilt. Reach out for help today and begin the journey to healing and recovery.
About the Authors:
Sireesha Kolli, MD, treats postpartum mental health disorders, including postpartum OCD, at Kolli Psychiatric and Associates (KPA). Learn more at www.kollipsych.com.
Jessica Pizzo, LCSW, is a perinatal mental health specialist offering expert care in evidence-based practices like EMDR and CBT. Connect with Jessica at https://www.bravemindspsychologicalservices.com/jessica-pizzo-lcsw/. Jessica also runs groups for new moms, you find information about by following this link https://www.bravemindspsychologicalservices.com/moms-group/
Treatment for Postpartum OCD in Monmouth NJ
Browse our best psychiatrists in NJ and find one that meets your needs.