Postpartum OCD/PoCD: What to look for, how to get help.
Not only is postpartum depression one of the most understudied epidemics we face socially, but we now know that there are sub diagnoses as well, stacked diagnoses and layered symptoms are also getting more awareness and attention, slowly, but surely.
When we think of PPD we think of sadness, not showering, crying all day and being unmotivated or too numb to enjoy your experience — this is a very restrictive symptom box.
Instead of searching for the obvious signs, we need to be aware of more subtle ones that could indicate we are predisposed to or currently experiencing postpartum OCD. Science is just now getting around to including these topics and theories into their fold, which will hopefully turn into a policy change for the medical complexes currently in power of the birthing system.
Taking studies from the book “Biomarkers of Postpartum Psychiatric Disorders” By Lauren M. Osborne MD, Jennifer L. Payne MD, I found some remarkable information about how genetics play a part in our perinatal experiences.
“She realized early in her training that there are vast bodies of
research on how pregnancy affects many bodily systems, from research on
preeclampsia and gestational diabetes to that on the behavior of autoim-
mune disease in pregnancy, and more. We have at least diagnostic (if not
predictive) biomarkers for some of those entities (as in elevated glucose for
diabetes and protein in the urine for preeclampsia), but very little under-
standing of how the biological and psychosocial changes of pregnancy and
postpartum create changes in the brain, hence a search for biomarkers
that came from the idea of treating perinatal mental illness as an obstetrical
morbidity.”
“One hallmark of that understanding is the search for biomarkers, “quantifiable biological parameters” (Selleck, Senthil, & Wall, 2017) that can indicate the presence of disease or response to treatment. Some of the earliest biomarkers in medicine were noticed nearly 200 years ago, though with little understanding of their actual function, and the NIH now defines many types of biomarkers across most fields of medicine (FDA-NIH Biomarker Working Group, 2016). Biomarkers can serve many functions—they can help to diagnose a condition (as with hemoglobin A1c for type 2 diabetes), or to monitor a known condition (as with prostate-specific antigen [PSA] for those with prostate cancer). They can measure the response to treatment (for example, blood pressure for patients with hypertension given an antihypertensive treatment) or predict the likelihood of response to an exposure (for example, BRCA1 and 2 to evaluate which women will respond to certain ovarian cancer treatments). They can also be prognostic—identifying the likelihood of a clinical event or recurrence (BRCA1 and 2 to predict who will develop a second breast cancer) or the likelihood of disease developing among those currently without disease (again, BRCA1 and 2).” Preface of Biomarkers of Psych. Disorders in Postpartum
So not only do we have this which is in depth foundation for studying how postpartum sub symptoms present themselves before and after birth, but we also have our lived experience. I was diagnosed with Postnatal OCD after my son, Logan was born in 2014, mine manifested in a stressed hyper focus the first few days and weeks, which felt normal. Making sure his chest was always rising and falling as he slept, and if it was not I would tickle his feet or hands to wake him in a 7 second panic. This to me, was a marker. I had to check his breathing. It became cyclical, I could not focus on much else when he was near me and at night. That shifted though with time, once he got past the “SIDS” high risk window I could breathe easier, but how it shifted was in my vigilance and irrational rituals around that.
It was mostly in the car, and I would have a image that I had left him outside of the car or did not put him in his carseat. Anxiety would rise slowly, telling myself “no he is in there”, then to saying “Logan?”, then to a sort of panic, to where I would have to either reach back and feel him, check his breathing, or pull over and do it. Needless to say I noticed this was extreme since he had never been left out of the car or behind.
My cognitive behavioral therapist at the time was treating me for other things like C-Ptsd and ADHD, but she noticed this as well. I cannot give guidance on how to work through this because I do believe it will be different for most people, but mine did go away after I was aware, and started affirming rational things more often than not. It took time - but it was real, and nobody knew it was happening except me and my therapist. Not my doctor, or family, because it was just too “weird” to share I felt.
I am not sure how to find the right therapy for you, without us first consulting, but I will leave some things to be aware of if you think you may have it, or could get it someday, and bring it up with your provider or mental health professional. Ask your mothers if they had any of these symptoms, or your aunts, grandma. The more research we do into this the more we can apply our findings to helping families.
cyclical rituals, (have to do certain things to calm your anxiety with baby)
fixated on organizing, labeling, and having things “perfect”
can’t rest, or settle, without making yourself stressed or guilty
hyper attachment to baby, or children that becomes disabling to the point of not sleeping, not showering or leaving the house etc
controlling every thing about the baby because you can’t trust others will do it right
These are just some of the things I have learned to watch for in my work as Posrtpartum Doula, and if they are noticed, the best path is to step into whatever form of therapy or counseling feels nourishing for you.
Some of these are genetic, inherited, the more we can learn about them in advance the better shot we have at decreasing the number of parents affected by it.