Obsessive Compulsve Disorder and Pregnancy

OCD is more common in expecting mothers than you may think. If you are unfamiliar with OCD, it is characterized by repetitive thoughts that seem absurd but still fill you with fear. Then the compulsions are the results of the obsessions and those rituals like washing one’s hands, or checking the sleeping child, alleviate the anxiety short term.

According to current estimates, OCD affects about 2 to 3 percent of the population. There are no current estimates as to how many women it affects in or after pregnancy, but some experts guess that about 1 in 200 will suffer from it in the prenatal or postpartum period.

What makes OCD more difficult to diagnose in pregnancy and postpartum is the fact that both these states are characterized by heightened emotionality; how does one tell when feelings become pathological?

Crossing the Line

Here’s how. If, every once in a while, you need to check the oven before bed, or if you do it even every night, three times, and then sweetly drop off to sleep, you don’t have OCD.

If, in the postpartum period, you occasionally find yourself picturing some horrendous act of violence happening to your child, but can then shudder and shrug it off, and get on with your day, then you don’t have this condition. OCD is at the furthest end of the anxiety disorder spectrum and when you have it, you will certainly know it.

Prenatal or postpartum OCD differs from the everyday variety of OCD in that, often the obsessions and compulsions revolve around your child, not just everyday things and activities. You may worry that you’ll hurt him, or that someone else will.

Diagnosis

If you’re diagnosed with OCD during pregnancy, this is a complicated issue, although the data so far point to the relative safety of selective serotonin reuptake inhibitors (SSRIs), the class of drug usually used to treat the disorder. Because most OCD sufferers find relief using medication, it is often the treatment of choice.

But, if you are still in the middle of your pregnancy, it will be your choice whether or not to take such drugs when nobody really quite knows how or if it affects a developing baby. In less serious cases of the condition, some doctors and patients prefer to take a cognitive-behavioral therapy approach.

Survival Mechanism?

You may be wondering why a woman would be vulnerable to OCD during and directly after pregnancy. It has been suggested that gestational OCD is a kind of maternal survival mechanism gone haywire. Some experts hypothesize that OCD is really a manifestation of ancient grooming and guarding behaviors that have slipped their chemical loopholes and are acting in an over amplified fashion.

The irony of maternal OCD is that it might be tied to the very mechanisms of mothering but in an ineffective fashion.

There has been a lot of research into the biochemical basis of gestational psychiatric disorders. The fact is that women with a prior psychiatric history, or women who have mental illness in their families, are at a much higher risk for experiencing conditions like OCD or depression during pregnancy or postpartum. So that begs the question, is OCD something that is passed down generation to generation? That question is still up for debate.