***Attention anyone suffering from anxiety and or depression: In attempts to raise awareness of postpartum obsessive-compulsive disorder with true candor, I have included honest and uncensored descriptions of my terrifying experience with this condition. Sometimes such information can trigger intrusive thoughts for other people. For this reason, please read the following post when you feel secure and ready.***
Months before I ever heard the term intrusive thoughts or read Dropping the Baby and Other Scary Thoughts: Breaking the Cycle of Unwanted Thoughts in Motherhood written by Karen Kleiman and Amy Wenzel, I didn’t know what to make of the horrifying images that had crept into my mind shortly after the birth of my son in March 2011. In a way, the uninvited images of my son in distressing and fatal situations reminded me of the disturbing recollections I had had after seeing violent or graphic films. For example, even though I tried to shield my eyes during the bloodiest scenes in Saving Private Ryan, images from the film flashed and whirled about in my mind a few days after I had watched the movie.
To some extent, the scary thoughts I had regarding my son were similar to those nightmarish flashbacks of Saving Private Ryan. Similar in that they were fleeting yet quite disturbing and I wanted them to stop. However, the scary thoughts involving my son were unlike the scenes from the movie in that they seemingly popped up out of no where and they caused me much more distress. When I imagined gruesome war scenes after viewing Saving Private Ryan, I knew why such images were in my mind. But when I imagined my son atop a snow drift, submerged in the bathtub and trapped behind flames in our pellet stove, I couldn’t fathom from where these images were coming. I tried to fight the mental assault. I tried to force my mind to stop showing me such haunting images. I squeezed my eyelids shut as tightly as possible, I shook my head back and forth, and I even tried to expel the negative thoughts using deep cleansing breaths. But the harder I tried to push the unwelcomed visions away, the faster they fought back. I felt as if I had lost control of my mind because I knew I had no intention, desire or will to hurt my son, yet I couldn’t make the thoughts stop.
Fortunately, the thoughts did eventually go away. Unfortunately, things got worse before they got better, but the thoughts did stop and they happened to stop abruptly. I think sleep, medication and more sleep deserve most of the credit for that. However, even though these horrific thoughts left my mind as quickly as they had entered, I spent over a year not knowing there was a term for the experience I had had. I knew I had postpartum anxiety and depression, and I saw a number of mental health and medical professionals in my recovery, but no one could explain those thoughts to me. In fact, one professional informed me that I had had postpartum psychosis. She told me the images I saw of my son were hallucinations and delusions. She was wrong. And though I am not a doctor in this field, I know there is a big difference between intrusive thoughts and hallucinations. Likewise, there is a huge difference between an individual worrying that she is going crazy and a delusional individual who has lost touch with reality. In both situations, the individual is in need of help, but the type of help required is quite different.
I didn’t realize what I now know until October 2012 when I picked up Women’s Moods: What Every Woman Must Know About Hormones, the Brain, and Emotional Health, by Deborah Sichel and Jean Watson Driscoll. The book that had been on my shelf since March 2011 when I had read it cover to cover…except for one section. I had previously skipped the section about postpartum obsessive-compulsive disorder. I didn’t think I had postpartum OCD because I figured that would have involved excessive hand washing and other stereotypical rituals. I was wrong.
I read the section I had skipped and finally found some answers. After reading about postpartum OCD in Women’s Moods, I had a better understanding of what I experienced and I looked for more reading on the topic. This led me to read Wenzel and Kleiman’s book and numerous articles about intrusive thoughts. I learned a great deal. Even though the condition is called postpartum OCD, many women mostly or only experience the obsessive part of this illness. Women who are rattled with what ifs and plagued by excessive worry are often susceptible to intrusive thoughts. It is as if the vigilant mother’s mind goes into overdrive and she begins envisioning the worst and most horrifying things that could happen to her beloved child. The woman begins to obsess over these ghastly ideas. I misinterpreted my scary thoughts as signs that I had some latent malicious intent for my son and concluded that I was either insane or a monster. This conclusion escalated my anxiety and distress. However, Kleiman and Wenzel, who address mothers directly in their book, write “This distress, as disturbing as it feels to you, provides reassurance that these thoughts are anxiety driven and not psychotic. In fact, your anxiety is an indication that you are aware of the difference between right and wrong. We know that it can make you feel like you are going crazy, but you are not. Simply put, your worry about these thoughts is a very good sign.”
While this information is reassuring after the fact, it would have been wonderful if someone had explained this to me when I was having intrusive thoughts. It also would have been beneficial to know that many people have scary thoughts. They become problematic when the person having them perceives them as highly distressing. The images I recalled from Saving Private Ryan were scary thoughts, but they didn’t cause the same level of stress as the scary thoughts I had regarding my son. Therefore, they weren’t problematic. On the other hand, the thoughts I had regarding my son increased my anxiety, led me to believe I was going insane and sent me into a state of panic. Alarmed by my thoughts and high level of distress, I sought help at the local ER. They were just as alarmed as I was and sent me to a secluded room where an armed police officer watched over me. Kleiman and Wenzel write about this type of overreaction in their book. “Healthcare practitioners…may be equally equally agitated by the high degree of distress associated with scary thoughts. This can inadvertently lead to rapid escalation of anxiety if the response is an overreaction or action that reinforces the mother’s anxiety.” Hopefully, as we raise awareness about intrusive thoughts and postpartum OCD, fewer women will encounter the desperation and lack of understanding I felt after having intrusive thoughts.
For more information about scary thoughts or treatment for postpartum anxiety and postpartum OCD, read Dropping the Baby and Other Scary Thoughts: Breaking the Cycle of Unwanted Thoughts in Motherhood written by Karen Kleiman and Amy Wenzel. Or visit http://postpartumstress.com/about/karen-kleiman-msw-lcsw/