Mother holding her baby near a window.

SPECIALIZED THERAPY FOR OCD INTRUSIVE THOUGHTS

Perinatal OCD Obsessions and Compulsions

You're not alone and it's not your fault. With help, you can take your life back from obsessions and compulsions robbing you from the parenting experience you hoped for.

Intrusive thoughts about your baby are a nearly universal experience in new parents. Half the population of postpartum women have unwanted thoughts about baby being harmed. If your thoughts or behavior upset you or consume your mental presence, reach out for help.

HELP FOR PERINATAL MOOD AND ANXIETY DISORDERS

How Postpartum OCD Differs From Postpartum Anxiety and Postpartum Depression

There is significant overlap between perinatal diagnoses and many new moms have co-occurring challenges with anxiety and low mood. Mothers with postpartum depression may have ruminative thinking, loss of interest in previously enjoyed activities, feelings of hopelessness, changes in appetite and sleep, and may experience preoccupation with death. Postpartum depression is often present with anxiety and OCD.

Postpartum anxiety shares many features with postpartum OCD and can be conceptualized as existing on a spectrum. The content of postpartum anxiety themes tends to be more generalized and sufferers don't engage in repetitive rituals to the extent seen in OCD. OCD's obsessional content tends to be more specific and sometimes bizarre in nature with compulsive rituals and avoidance more distinctive. OCD symptoms are present more than an hour per day and cause psychological distress with functional impairment in important roles (eg. parenting, work, social relationships).

Mother holding her baby.

THERAPY FOR PERINATAL OCD IN VENTURA, CA

Help for Intrusive Thoughts, Anxiety Spirals, and Compulsive Rituals in the Postpartum Period

Although you may feel isolated or ashamed, many postpartum women suffer from intrusive thoughts or images that are scary and confusing. In an attempt to reduce the fear or anxiety caused by the unwanted thoughts, some pregnant or postpartum moms engage in mental rumination, checking rituals, compulsive research, and avoidance. These mental loops steal your presence, heighten your anxiety, and can increase the risk of postpartum depression.

In general, people with OCD have a tendency to obsess and perform compulsions over things they deeply value. The fact that for many perinatal mothers, the themes center around baby's safety or your role as a mother, makes sense. OCD hijacks what we care about.

Although it's normal to have concerns about sharing the content of your thoughts with healthcare professionals, it is best for your recovery to be forthcoming about what's troubling you. A therapist with training in both OCD and perinatal mental health will handle your concerns with careful consideration and full transparency about safety and privacy.

Mother holding her baby while breastfeeding.

EVIDENCE-BASED ERP THERAPY FOR POSTPARTUM OCD

Postpartum OCD, Treated by an OCD Specialist Using ERP

Treatment for perinatal or postpartum OCD involves a specific type of cognitive-behavioral therapy called Exposure and Response Prevention or ERP.

ERP is adapted to target the obsessional themes and compulsive behavior of the new mother at the pace that is right for her needs. A holistic and strengths-based approach that addresses co-occurring depression is often warranted.

Perinatal mothers receiving ERP will be gently supported as they confront triggers and areas of avoidance without the use of compulsions, rumination, or avoidance.

With repeated ERP practice, a new and empowered relationship with thoughts and emotions unfolds. Mothers can break free from the constant dread that makes new parenting so much harder.

Parent holding a baby.

SPECIALIZED TRAINING FOR PERINATAL OCD

Training in Perinatal Mental Health and Pregnancy & Postpartum OCD

Teva has completed specialized training in Perinatal Mood and Anxiety Disorders: Components of Care through Postpartum Support International and Pregnancy and Postpartum OCD through the International OCD Foundation Training Institute.

This focused training supports accurate assessment and evidence-based treatment for OCD and perinatal mood and anxiety disorders during pregnancy and postpartum.

Mother and baby resting together.

SCHEDULE A DIAGNOSTIC EVALUATION

Importance of Accurate Diagnosis

While unwanted thoughts are a nearly universal experience in the postpartum period (the IOCDF reports 70% to 100% of postpartum mothers have unwanted thoughts of infant harm), not all intrusive thoughts or rituals indicate the presence of obsessive-compulsive disorder. It's important to receive a professional diagnostic evaluation to learn more and get the appropriate treatment.

Perinatal or postpartum OCD is often misdiagnosed as "just anxiety," which can lead to inappropriate treatment. Strange or aggressive thoughts can be misdiagnosed as postpartum psychosis, which is a rare but serious psychiatric medical emergency. Misidentified harm obsessions can lead to contraindicated interventions such as involvement with Child Protective Services, law enforcement, or inpatient hospitalization.

Each diagnosis requires different treatment decisions and intervention, which is why it's critical to have a high quality assessment and specialized treatment.

Perinatal OCD Prevalence

It's common for OCD to show up during times of significant hormonal changes in women, with pregnancy and postpartum posing a uniquely high risk. In fact, the birth of a child is the most common life event that can trigger the onset or worsening of obsessive-compulsive symptoms. Estimates report the prevalence of postpartum OCD from 2% to 17%. Women with a history of OCD are estimated to experience recurrence at 25% to 75% during the perinatal period.

Resilience and Your Support Team

Mothers with social support will have greater rates of recovery from perinatal mood and anxiety disorders. Although it can be challenging with OCD symptoms and a new baby, maintaining a social community that allows you to shift your attention away from anxious rumination is important. Some ideas include attending regular new parent support groups, "Breastfeeding Sisterhood" type lactation support groups, Mommy-and-Me play groups, and infant care educational groups. To best support your recovery, it's also important to connect your treatment team so your psychotherapist can coordinate your care with any other clinical providers (eg. lactation consultant, psychiatrist, nurse practitioner). If you have a spouse or partner, they are welcome and encouraged to participate in your therapy.

Safety Information for Postpartum Mothers and Partners

OCD vs. Psychosis: When to Seek Urgent Help

Postpartum OCD's harm obsessions are experienced as unwanted and outside the value system of the mother. Unwanted thoughts or images of baby being harmed are distressing and misaligned with a mother's true values, beliefs, and sense of who she is (therapists call this "not me" feeling "ego-dystonic").

Most people with OCD have fair to good insight with understanding the content of their thoughts and behavior is irrational. Although they may be afraid to change, they seek help because they are bothered by their thoughts, sense they are bizarre or untrue, and suspect their compulsions and avoidance are not helpful.

In contrast, psychotic illness has very little or absent insight. Thoughts feel real and aligned with the sufferers beliefs during the course of the illness or episode (this is called "ego-syntonic"). Postpartum psychosis is a medical emergency with signifiant risk of harm to mother, baby, and other children. Postpartum OCD does not carry the same risks as postpartum psychosis. If you have questions about your own or your loved one's mental health, contact a healthcare provider for an evaluation.

Licensed Therapist

Hi, I'm Teva Johnstone, LCSW

I'm a Licensed Clinical Social Worker and psychotherapist specializing in obsessive-compulsive conditions. I provide individual therapy for OCD, anxiety, and perinatal mental health. In-person therapy in Ventura County and online throughout California.

  • Individual therapy for OCD, anxiety, and perinatal mental health
  • In-person in Ventura County or telehealth across California
  • Collaborative, values-aligned treatment planning

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