Alice G. Walton, Contributor
I cover health, medicine, psychology and neuroscience.
Most people are aware of postpartum depression as a common and no-longer-shameful problem faced by mothers, and occasionally fathers, in the early post-baby months. In recent years, it’s become much less taboo to discuss the mental challenges that one battles during these early days of sleeplessness, worry, and massive life change.
But what many people don’t know is that in addition to postpartum depression, almost as many women suffer from other psychiatric problems, like postpartum OCD, plain old anxiety, and, more rarely, psychosis. How do these other problems differ from postpartum depression, and what should you look out for?
Postpartum obsessive-compulsive disorder (OCD) has recently been shown to be more prevalent than previously thought, and because its symptoms can be disturbing to the sufferer, it’s worth being aware of. About 1% of the general population suffers from OCD proper, but the number is much higher for women postpartum.
According to Dr. Kiara Timpano, who just published a study on postpartum OCD prevention in the Journal of Psychiatric Research, the incidence of postpartum OCD ranges from 2%-9%. People who already suffer from any kind of anxiety disorder are at greater risk of developing postpartum OCD. Its onset probably has to do with significant changes in the neuroendocrine (brain-hormone) system leading up to and occurring just after birth.
In regular OCD, sufferers often experience strong urges to perform certain repetitive behaviors (compulsions), and have repeated, unwanted, and negative thoughts (obsessions). In the postpartum version of the disorder, not surprisingly, the obsessive-compulsive thoughts generally revolve around the baby. They can range from being compelled to wash the baby repeatedly in order to stave off germs and infection to refusing to handle the baby for fear of dropping her.
Symptoms may also be more severe, with repeated negative thoughts about the baby, about oneself as a mother, or of causing harm to the infant. The severity of the symptoms varies from mildly bothersome to virtually unbearable. Some mothers live in constant fear that they will bring about serious harm to their baby, or even death.
Postpartum OCD is one of the family of anxiety disorders, and some women may suffer from postpartum anxiety without all the symptoms of OCD. One recent study found that almost 13% of the women sampled experienced general postpartum anxiety, as opposed to postpartum depression, of which 17% suffered. About 8% experienced both postpartum issues at once.
In the postpartum version, women may have many of the same symptoms as generalized anxiety, including feeling stressed, nervous, on edge, or apprehensive, particularly about baby-related activities; sleeplessness; excessive worry; shaky or panicky feelings; the inability to relax; and purely physical symptoms like shortness of breath, dry mouth, heart palpitations.
A more severe postpartum psychiatric disorder is known as postpartum psychosis, which affects about 1-2 women out of 1000. The disorder can set in within the first two to three days after giving birth, and up to a few months after (the average is a couple of weeks). Symptoms include severe mood swings – alternating mania and serious depression, confusion, disorientation, insomnia, confusion, delusions, and in some cases, auditory hallucinations.
Like many other brain and mood disorders, researchers haven’t pinned down the details of what causes this change in certain women, but it’s likely a combination of hormones, stress, brain chemicals, and genetic factors.
Luckily, there are effective treatments for postpartum psychiatric conditions. While the trend in psychological health has been increasingly to increase the drugs and decrease the therapy, research continues to show that various talk therapy methods, like cognitive behavior therapy (CBT) are extraordinarily effective. CBT, which is the current gold standard in psychotherapy has been used to treat everything from anxiety and depression to eating disorders, sleep disorders, and phobias.