Written by Psychologist Nikolina Miljus.
One in 100 pregnant women will experience obsessive-compulsive disorder (OCD) symptoms for the first time in pregnancy. For women who have dealt with OCD in the past, pregnancy may result in resurfacing of OCD symptoms. They are frequently linked.
If you’re a first-time mum it might be more difficult for you to distinguish between usual pregnancy worries and obsessive thoughts.
Paying more attention to cleanliness or your changing body makes perfect sense when you are pregnant. However, when behaviors aimed at relieving the obsessive thoughts start interfering with your daily life or take up a significant portion of your waking hours, it is time to seek professional help.
Common OCD Thoughts & Compulsions in Pregnancy
- Fears around becoming infected from germs and bacteria from both objects and people. This can lead to behaviors such as constantly cleaning, excessive hand washing, avoiding social contact and avoiding going out.
- Fears that your baby is not developing properly or that the normal everyday things you do may be harming your baby. You may start compulsively Googling, seeking information about every minor cramp or pain. You may avoid doing certain activities like using bleach to clean the toilet in case it splashes on you and hurts baby. These fears can be expressed in a million different ways.
- Interpreting many normal bodily sensations as a sign of miscarriage. You may find yourself constantly and repeatedly checking yourself in the bathroom for blood or other signs of miscarriage.
- Fears around your partner’s commitment to you. You may feel anxious about your partner going out without you. Obsessively check his phone for signs of infidelity. Accuse him or her of cheating on you. Try to control his behavior when you’re out. Constantly seek reassurance from him or her.
- Fear of a lack of control over your own behavior. You may feel that you want to compulsively act out sexually with strangers or violently hurt people. This usually leads to avoidance of social situations and other people. Leaving you socially isolated.
What causes OCD in pregnancy?
Women who have experienced OCD or anxious episodes in the past are more likely to encounter similar symptoms emerging in their pregnancy. The increased production of female sex hormones related to pregnancy is consistently linked (2) with the rise of anxious and obsessive symptoms.
Additionally, psychological stress caused by pregnancy can place an extra strain on coping capacities. If you’re a first-time mum, you’re facing many changes within your body and the responsibility of looking after a new life. Financial stress, prior difficult pregnancies, or current pregnancy complications can drain your psychological capacity to cope, and OCD symptoms may emerge as a result.
In a way, compulsive behaviors serve the purpose of relieving some of the stress and anxiety by restoring a sense of control over your body and your environment. As this solution is far from perfect, there are effective ways to deal with OCD when you are pregnant.
How to deal with OCD in pregnancy
Some obsessive thoughts or fears can be out-of-character and lead you to fear you are “going crazy.” Many women who experience obsessive thoughts in their pregnancy realize such ideas are not founded in reality. The core of OCD lies in the persistence of intrusive thoughts and compulsions to do specific actions, despite trying to use your willpower.
1.Start with self-care
Obsessive thoughts, irrational urges, and exhausting compulsive behaviors are challenging in any period of life, but when you encounter them during pregnancy, they can be especially overwhelming. This is why it is essential you take a more self-caring approach and learn how to calm the excessive anxiety.
Self-care starts by not blaming yourself for what you are thinking. Obsessive thoughts are not a sign you are a terrible person or an inadequate mum. Allow some time to de-stress and relax.
Even a simple breathing exercise like slowly inhaling while counting to 10, then slowly exhaling in the same rhythm minimizes physical aspects of anxiety such as hyperventilation.
2. Find social support
Sharing your OCD-fueled worries with someone you feel you can trust, such as your significant other or a close friend can have a powerful effect in breaking the compulsive cycle. Instead of battling with the anxiety alone, feeling understood and loved can help you restore a sense of security.
When you are faced with the fear of going crazy and are constantly haunted by obsessive thoughts, reaching out to a support group for women dealing with OCD can help you restore a sense of normalcy. Realizing you are not alone in what you are going through and learning from women who have had the same experience can ease this difficult period for you.
Cognitive-Behavioural Therapy (CBT)
Due to its effectiveness and safety, CBT is the treatment of choice for moderate to severe OCD in pregnancy. Depending on your OCD symptoms and your personal history, your medical professional might suggest one of two types of CBT explicitly tailored to treat OCD.
3. Cognitive therapy (CT)
The focus of cognitive therapy is on obsessive thoughts. CT can help you gain control over obsessive beliefs that fuel the compulsive behaviour by providing you with the tools to question the irrational side and empowering the reasonable side of your mind. Cognitive therapy is useful even when practiced in relatively brief weekly sessions.
4. Exposure and response prevention (ERP)
ERP focuses on weakening the link between obsessive thoughts and compulsive behaviour by slowly exposing you to situations that trigger the compulsive response. The goal of the treatment is to help you build the capacity to tolerate smaller levels of anxiety. When the repeated circumstances convince you nothing terrible happens when you don’t act on the compulsive urge, the driving urge behind the OCD symptoms starts to dissolve.
Even though there are some valid reasons to worry about taking medications in pregnancy, OCD can become too taxing on your health and that of your baby. In this situation, carefully chosen medication treatment can be the best option to manage the OCD symptoms and make sure your pregnancy progresses in a healthy way.
The most common medication choices for treating OCD in pregnancy are antidepressants due to their effectiveness and safety of use. When used in combination with psychotherapy, carefully chosen medication can be essential to ensure you are OCD-free after the delivery.
However OCD expresses itself you need to make sure you reach out for help during pregnancy. Leaving things in the mistaken belief that it will go away can lead to serious consequences for you and baby. There is plenty of help and support available during pregnancy and also for the postpartum period. Speak to your Doctor or midwife to see what help you can get.
(1) Female reproductive cycle and obsessive-compulsive disorder
Labad, Menchón, Alonso, Segalàs, Jiménez, and Vallejo
(2) New parenthood as a risk factor for the development of obsessional problems
Nichole Fairbrother and Jonathan S.Abramowitz