Perinatal Obsessive-Compulsive Disorder (OCD)

What if I harm my baby?

 

What is Perinatal Obsessive-Compulsive Disorder (OCD)?

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterised by obsessive thoughts, and behavioural compulsions.

Ψ Obsessions are intrusive, unwanted and persistent thoughts and mental images.

Ψ Compulsions are repetitive acts, including avoidant behaviours, that aim to reduce the distress associated with the obsessive thoughts. They could look like cleaning rituals, repeated checks, counting, saying a particular word or phrase, or avoiding certain places or activities.

Perinatal OCD occurs during pregnancy or a year after childbirth. It could be another manifestation of existing OCD or a sudden onset of a new condition.

Find out more about Obsessive-compulsive disorder

Symptoms of the condition often centre around the baby. They are associated with fears that the baby would be harmed, such as through contamination, inappropriate handling, etc. While individuals with perinatal OCD probably recognise that their obsessive thoughts and compulsive behaviours are irrational, they feel consumed by those thoughts and unable to break free from the rituals.

Often Undetected and Unspoken

Having a baby is stressful and overwhelming. As parents, it’s normal to feel anxious about caring for a young child, and worried that they will harm the child. This anxiety, at manageable level, could actually be helpful in ensuring that you avoid potential risks to your pregnancy and child. 

While many parents have that fear, people who suffer from perinatal OCD give undue importance to those thoughts, and believe that they are capable of causing harm.

These parents may be reluctant to disclose their anxious thoughts for fear that they may be regarded as the potentially dangerous and harmful parent.

Parents may also not be aware of the condition or recognise it as an illness. They may see themselves as an unreliable and unfit parent, or attribute their fears as “going crazy”. 

Failure to detect and address perinatal OCD can result in persistence of the distressing thoughts, and affect the relationship the parent has with the child and their family members. New fathers and mothers (or even those without children) with perinatal OCD may struggle to enjoy moments and bond with the child.

Depending on the severity of your condition, it can also impact your confidence in caregiving and overall quality of life as you spend the day worrying about your child being harmed.


How can I Cope with Perinatal OCD?

Ψ Learn more about OCD

Find out more about the condition. Understand that it is not your fault, and that you are not going mad.

It is often comforting to find an explanation for what you are going through. With better understanding of the condition, you could also make sense of the consuming thoughts and compulsions that you have.

Ψ Learn about your symptoms

Everyone’s triggers and symptoms would look different. It is always a good idea to note how your symptoms present and when they present. This give yourself and ideally your therapist a clearer idea of your presenting difficulties and how to manage them.

Ψ Talk to someone

Reach out to a loved one and share with them what you are going through. It can be relieving just to tell someone your feelings. It could be helpful to first write down your thoughts and feelings before you bring this up with someone.

It can be also reassuring to hear that similar anxious and distressing thoughts are experienced by other people too. Connect with support groups online or in your local community (e.g, OCDNetwork) to receive the emotional support much required in this journey.

Ψ Get practical support

Your anxiety may make you unavailable to care for your child for the time being. Reach out to your family and friends to help with the caregiving tasks.

Let them know how they can help (e.g., could you help to change the baby’s nappy)

Ψ Seek professional help

OCD can be managed with psychological therapy, and sometimes with the additional help of medication. Typically, Exposure and Response Prevention Therapy (ERP) and Acceptance and Commitment Therapy (ACT) are used to help individuals with OCD. They involve exposure to anxiety-provoking situations and accepting the intrusive thoughts while engaging in value-aligned behaviours respectively.

Your therapist will work with you to develop a management plan that best supports you. Things would get better, however overwhelming they seem now.

 

Supporting a Loved One Who is Struggling with Perinatal OCD

Many individuals who experience perinatal OCD worry that they get ostracized when others find out. Do not criticise their compulsions. Assure them that you are there to support them if they ever need it. 

Learn about the condition. With greater understanding of the condition, it may be easier for you to see why your loved one is acting the way they do. You would also realise that providing assurance (e.g., “I’ve sterilized the milk bottle”, “the baby is still breathing”) might not be the best form of support for them – counterintuitively it may sound. Instead consider staying by their side as they experience the discomfort rather than reinforce their rituals.

If you are concerned that you or someone you know is struggling with perinatal OCD, seek professional help. Feel free to reach out to us for support with coping with OCD.

12 Tips To Cope with a Cancer Diagnosis and Treatment

Learning that you have cancer is a difficult experience. After being diagnosed, it’s natural to feel anxious, numb or angry and wonder how you can live with the long and at times painful days ahead.

These are normal reactions to an abnormal, or otherwise, unexpected situation.

Furthermore, it can be hard to deal with the pain resulting from the symptoms or the side effects from cancer treatment, such as medication or chemotherapy.

Cancer treatments can bring about many changes in your body, altering the way you look and how you feel about yourself and your body. The demands of treatment could also influence your personal relationships, making it challenging to navigate your daily life and usual routines. Fortunately, remember that these are obstacles you do not have to face alone.

Here are some tips to help you cope with the diagnosis: 

Ψ Learn as much as you can about your cancer diagnosis

Try to obtain as much basic, useful information about your condition as you need to make informed decisions about your medical care. Information can help you to know what to expect. Taking in information can feel difficult and overwhelming, especially when you have just been diagnosed. Make a list of questions you’d like to ask before you visit the doctor. Consider bringing a family member or friend with you to your appointments to help remind you your questions or to remember what you hear.

Remember that you don’t have to sort everything out at once. It could take some time to deal with each aspect of your condition. Ask for help if you require it.

Ψ Anticipate possible physical changes that you may experience  

Plan for changes in advance. You can prepare yourself now so that you will be better equipped to cope later. Check with your doctor what changes you should anticipate. For instance, if the drugs can cause hair loss, you can seek advice and help from image experts about wigs, clothing, or hairpieces to make you feel more comfortable.

In addition, consider how treatment may impact your daily activities. Ask your doctor whether you can expect to continue with your normal routine in case you may need to spend more time in the hospital or have frequent medical appointments.

Ψ Try to maintain your normal lifestyle as much as possible

Maintain your usual routines but be open to modifying them as necessary. Take one day at a time. It’s easy to overlook this simple strategy when you are distressed. When the future is uncertain, organising and planning may suddenly seem overwhelming. 

Ψ Adopt a healthy lifestyle

This can improve your energy level. Choose a healthy diet consisting of a variety of foods and get enough rest to help you navigate the stress and fatigue of breast/ovarian cancer and its treatment. Engaging in physical exercise during treatment can also be helpful!

Ψ Review your goals, priorities and values 

Determine what is important to you in your life. Find some time to engage in the activities that are most meaningful and fulfilling to you.

Spend 3-5 minutes practicing the 60th Birthday Exercise to help you identify what is important to you and how you want to live your life.

Ψ Share your feelings.  

Talking about your emotions can be hard, but it can also bring comfort to you and the people who care about you. When you tell your loved ones what you are feeling, you give that person a chance to support you. You also give your relationship with that person a chance to grow. 

Cancer may affect your relationships. Communication can help reduce the anxiety and fear that cancer can cause.  

Ψ Be specific. 

When reaching out to others, be specific and clear about the kind of support you need. For example, saying something like, “Could you help me shop for groceries this week?” or “Could you help to drive me to my next doctor’s appointment?” gives a clear indication to your loved ones how to best support you.  

Being specific can also cut down frustration and reassure your family and friends that they are being helpful.  

Ψ Take steps to look and feel your best. 

Many women might feel uncomfortable with their appearance after having surgery or chemotherapy.  

If you had breast surgery or are experiencing hair loss, learn about some of the options available, such as breast prostheses and hair wigs. Give yourself time to adjust to changes and try different solutions until you find what makes you feel most comfortable! 

Ψ Let yourself feel loved and cared for. 

After a breast removal surgery or chemotherapy, you may find that regular activities such as dressing, undressing, bathing or being intimate with your partner or spouse, can give rise to complex emotions.  

You might feel so different that you stop taking care of your emotional and physical needs. This might cause you to even distance yourself emotionally from your partner. However, you can always make other choices, such as choosing to remain close to your partner or spouse. You deserve to feel loved and cared for.  

Ψ Talk to your spouse or partner about the physical closeness you need. 

Share how you feel about your body and talk about what you think or worry that your partner is feeling.  

Whatever your needs are – whether you have a need for physical affection, or if you are not yet interested in being physically intimate – let your partner know. He/she is most likely waiting for your signal to know what to do, how to act and what you need in order to best support you. 

Ψ Join support groups and talk to other people with cancer. 

Sometimes it will feel as though people who haven’t experienced a cancer diagnosis can’t fully understand how you are feeling. It might help to talk to others who have been in your situation. Other cancer survivors can share their personal experiences and shed some insight into what you can expect during treatment.

You may have a friend or family member who has had cancer. If not, you can also connect with other cancer survivors through local support groups in your area.

Ψ Develop your own coping strategies and practise self-compassion. 

Just as each person’s cancer treatment is likely individualised, so can your coping strategy!  

Here are some self-care ideas you can try out: 

  • Practise relaxation and mindfulness techniques (e.g., progressive muscle relaxation, breath focus, guided imagery, or loving-kindness meditation) 

  • These methods help cultivate a softer, more spacious and kinder mind, while fostering self-compassion and letting go of inner judgement and hostility towards oneself. 

  • Keep your own personal journal to help organise your thoughts 

  • Finding a source of spiritual support (e.g., from your religion) 

  • Set aside time to be alone each day 

  • Remain engaged with work and leisure activities as much as you can.

Seeking professional help

Even with various support groups and loved ones, the cancer journey may still feel incredibly lonely. You may wish to speak to a psychologist for support and to help you process complex emotions that may arise. Know that you are not alone, and that there is great strength in asking for help.

Make an appointment