Swimming through a nightmare: OCD in pregnancy and postpartum

(This article was written by Kristin Burgard. A different version appeared on AnnArbor.com.)

Swimming is a big part of my life, but during my pregnancies and the time after the births of my two girls, it was more than just a great way to stay in shape. It was my lifeline.

I had always been a “worrier,” but my anxiety ran rampant when I was pregnant with my oldest daughter, Katie. For the first year of her life, I was constantly anxious: I worried about her coming in contact with even a speck of lead-based paint, cleaning products, or spoiled food. In an effort to cope with my fears, I constantly asked for reassurance from friends, family, doctors, and even, much to their chagrin, the Poison Control Center operators. Although dealing with my irrational fears was difficult, it was manageable until the third trimester of my second pregnancy when my fears turned to the unthinkable—that I might hurt my three-year old daughter.

Was I like Andrea Yates, the mother who killed her five young children in 2001? Was I losing my mind? The thoughts were terrifying. Giving Katie a cup of apple juice was as anxiety-provoking as handing her a loaded gun would have been. As soon as I’d pour the juice into the cup, I’d think, “What did I put in her cup? There is an open bottle of dishwasher detergent. Did I really just pour juice or did I pick up the detergent bottle, too?”

After smelling and examining it for five minutes, I would often dump the juice into the sink and refill the cup—over and over again. The relentless, intrusive thoughts were unbearable. Eventually I resorted to buying cases of drink boxes to avoid pouring juice, but my worries just found new ways to manifest themselves. A million times each day, I wanted to jump out of my skin and run away.

Too injured to run after being a distance runner for 20 years, I started to swim with the local Masters Swimming group. It is well know that strenuous physical activity is a good way to manage stress, and my OCD created a sustained level of stress above anything I could have imagined. For months, the only time I felt safe and somewhat calm was when I was in the water. Although I was falling apart mentally, I was in incredible physical shape. I joked with the coach that I was going to give birth on the pool deck.

Unbeknownst to me, I was suffering from postpartum obsessive-compulsive disorder (OCD), a postpartum anxiety disorder that can have its onset during the traditional “postpartum” period, but is also common during pregnancy. According to Postpartum Support International (www.postpartum.net), approximately 15% of all new mothers suffer from postpartum mood disorders including the more-publicized postpartum depression but also include postpartum anxiety disorders: OCD, posttraumatic stress disorder (PTSD), and panic disorder. Fathers and adoptive parents can also suffer with these conditions.

Symptoms of OCD – terrifying intrusive thoughts – are particularly confusing and scary due to the media hype that surrounds the rare but critically dangerous disorder known as postpartum psychosis. It is true that both OCD and postpartum psychosis bring on bizarre thoughts; however, the similarities between the two illnesses stop there. With postpartum psychosis, the strange thoughts are the woman’s reality. With postpartum OCD, a woman is severely distressed and recognizes her distressing thoughts as irrational, so there is little to no actual risk to the baby. However, the negative impact on the mother is incredible: OCD often severely limits her ability to care for herself, her baby, and her family. At the very least, OCD robs a new mother of the pleasures of parenthood.

People often associate OCD with obsessions about dirt and contamination, but this is just one presentation of the illness. The common thread for suffers of OCD is the experience of intense anxiety related to fears about something bad happening – even if the realistic risk is almost zero – and the performance of mental or physical repetitive behaviors, or “compulsions,” in an effort to alleviate this anxiety. Examples include asking repeatedly for reassurance, excessive hand-washing, or checking. Unfortunately, these actions may temporarily lessen the anxiety, but in the long run, it makes anxiety spiral out of control.

The most effective treatments for OCD are cognitive-behavioral therapy (CBT) (specifically one method known as “exposure and response prevention” (ERP), in which a person confronts their fears in a systematic way) and antidepressant medication. Unfortunately, many women, their partners, and even medical professionals have limited knowledge of disorders such as postpartum OCD. To make matters worse, most mothers are ashamed and afraid to ask for help, and don’t recognize the condition as something that is both common and treatable. If you are experiencing any of these symptoms, please know that you are not alone. Speak up and seek help. My experience shows that, with proper treatment, a mom can successfully overcome her OCD and regain control of her life.

I am thankful to have had Masters Swimming as part of the solution to overcoming my own postpartum OCD. I continue to enjoy the workouts and the friends that I have developed there. As for giving birth on the pool deck — my bag was packed for swimming on the morning my daughter, Allison, was born, but she was born in the hospital, not on the pool deck, at 6:20 a.m.— right in the middle of the morning masters workout. Allison is four now, and I marvel at how much that little girl loves to swim!

RESOURCES:
Postpartum Support International – (4PPD)

target=”_blank””>International OCD Foundation

Association for Behavioral and Cognitive Therapies

href=”http://www.abct.org target=”_blank””>Association for Behavioral and Cognitive Therapies
Click here to visit Kristin’s blog – Pampers, Pacifiers and Prozac