Obsessive-Compulsive Disorder
What's wrong with me?
Obsessive-Compulsive Disorder (OCD) and Perinatal OCD share core features, including intrusive, distressing thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) aimed at reducing anxiety. However, perinatal OCD occurs specifically during pregnancy or postpartum and often centers around fears of harm coming to the baby, such as intrusive thoughts of accidental or intentional harm. While both conditions can cause significant distress, perinatal OCD is driven by the intense emotional and hormonal shifts of new motherhood, making it especially frightening for affected parents. Understanding these differences is key to ensuring proper diagnosis and compassionate, effective treatment.
Obsessive-Compulsive Disorder
Obsessive-Compulsive Disorder (OCD) is a mental health condition marked by intrusive, unwanted thoughts (obsessions) and repetitive behaviors or mental rituals (compulsions) performed to reduce anxiety. Common symptoms include excessive cleaning, checking, counting, or seeking reassurance, often interfering with daily life.
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Intrusive thoughts in OCD can follow various themes, including:
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Contamination – Fear of germs, dirt, or illness (e.g., "What if I get sick from touching this?").
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Harm – Fear of harming oneself or others, even without intent (e.g., "What if I lose control and hurt my baby?").
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Perfectionism – Need for things to be exact or symmetrical (e.g., "If this isn’t perfectly arranged, something bad will happen.").
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Religious/Scrupulosity – Excessive worry about morality or religious correctness (e.g., "What if I’ve committed an unforgivable sin?").
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Sexual – Unwanted thoughts about inappropriate or taboo sexual content (e.g., "What if I have an attraction I don’t actually want?").
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Existential – Obsessive questioning of reality or the meaning of life (e.g., "What if nothing is real?").
These thoughts are distressing and do not reflect a person’s true beliefs or desires.
Perinatal OCD
Perinatal Obsessive-Compulsive Disorder (OCD) is a form of OCD that occurs during pregnancy or postpartum. It involves persistent, distressing thoughts (obsessions) and repetitive behaviors or mental rituals (compulsions) aimed at reducing anxiety.
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Many new parents experience some degree of worry about their baby’s health and safety, but in perinatal OCD, these thoughts become intrusive, overwhelming, and disruptive to daily life. The condition is highly treatable with the right support.
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Symptoms of Perinatal OCD:
Obsessions (Intrusive, Unwanted Thoughts):
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Intense fears of harming the baby (e.g., dropping the baby, accidental suffocation)
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Graphic or disturbing images related to the baby’s safety
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Extreme worry about germs, illness, or contamination
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Fear of making a mistake that could harm the baby (e.g., feeding incorrectly, forgetting safety measures)
Compulsions (Repetitive Actions or Mental Rituals to Reduce Anxiety):
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Excessive cleaning, washing, or sterilizing
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Constantly checking on the baby (e.g., repeatedly ensuring the baby is breathing)
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Avoiding certain activities (e.g., not changing diapers or holding the baby out of fear of harm)
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Repeating phrases, prayers, or counting rituals to “neutralize” bad thoughts
âš It is important to note that parents with perinatal OCD are highly distressed by their thoughts and DO NOT act on them. These thoughts do not reflect intent or desire.
How is OCD Diagnosed?
A healthcare provider, such as a psychiatrist, psychologist, or nurse practitioner, will assess symptoms through:
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Clinical Interview – Discussing intrusive thoughts, compulsive behaviors, and their impact on daily functioning.
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Screening Tools – Questionnaires such as the Perinatal Obsessive-Compulsive Scale (POCS) or Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) may be used.
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Differentiation from Postpartum Psychosis – Unlike postpartum psychosis, individuals with perinatal OCD recognize their thoughts as irrational and feel extreme distress over them.
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Therapy – Cognitive Behavioral Therapy (CBT) and interpersonal therapy (IPT) can be highly effective.
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Medication – Some antidepressants and mood stabilizers are safe during pregnancy and breastfeeding.
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Lifestyle & Support – Social support, proper nutrition, and sleep hygiene play critical roles in recovery.
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Risks of Treatment vs. Non-Treatment
Risks of Treatment vs. Non-Treatment
Risks of Treatment vs. Non-Treatment
Treatment Options May Include:
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Cognitive Behavioral Therapy (CBT) – Exposure and Response Prevention (ERP) therapy is the gold standard for OCD treatment.
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Medication – Selective serotonin reuptake inhibitors (SSRIs) are commonly used and considered safe in pregnancy and breastfeeding.
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Mindfulness & Support – Stress management and peer support can help reduce symptom severity.
Risks of Treatment
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Medication Side Effects – Some medications may cause mild side effects, but many are well-tolerated and safe for perinatal use.
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Initial Discomfort in Therapy – ERP therapy can be challenging but is highly effective.
Risks of
Non-Treatment
For the Mother
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Increased stress and emotional distress
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Difficulty bonding with the baby due to overwhelming fears
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Sleep disruption due to obsessive thoughts and compulsions
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Higher risk of developing chronic OCD or depression
Risks of
Non-Treatment
For the Infant
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Disrupted bonding and attachment due to parental avoidance or excessive checking behaviors
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Increased stress in the household, which can affect infant emotional regulation
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Potential feeding or sleep disturbances due to maternal distress
The Bottom Line:
Untreated mental health conditions pose significant risks to both the client and their family. Seeking professional care leads to better long-term outcomes for the entire family. You are not alone, and help is available.
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​If you’re scared, unsure, or worried about yourself or someone you love, let's chat. It costs nothing to ask for help but that one conversation could change everything​