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Posted on Mon, Jun 14, 2010 : 6 a.m.

Swimming through a nightmare: Obsessive Compulsive Disorder in pregnancy and postpartum

By Kristin Burgard

 

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. And 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 Katie, then 3 years old.  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 Ann Arbor Master’s swimming group at Mack Pool. It is well known 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.

Resources

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 percent 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 the Ann Arbor Master’s swimming group and AAQUA 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 4 now, and I marvel at how much that little girl loves to swim! 

Comments

Cathy S

Fri, Oct 15, 2010 : 6:52 p.m.

Thanks for having the strength to share your story. Without brave women like you, so many issues would go unheard.

Barbara

Thu, Aug 19, 2010 : 10:33 p.m.

Kristin, what a beautifully written article. You just expertly conveyed your experience in a way that so many can relate to while sharing such important information and resources about OCD, postpartum issues, and mental health in general. I know that it will help a lot of people! Thank you for writing it!

Rachel Thompson

Wed, Jun 16, 2010 : 6:40 p.m.

Kristin -- This is an important (and well-done) article. Thank you!

skt33

Mon, Jun 14, 2010 : 5 p.m.

Thank you so much for sharing this story. I hope it reaches other parents who may experience similar symptoms.

Kristin Burgard

Mon, Jun 14, 2010 : 1:28 p.m.

Mousedeva, I'm sorry to hear that you suffer with OCD symptoms as well as trichotillamania. I did cognitive behavioral therapy (CBT) with Dr. Shelly Van Etten at the U of M Psychological Clinic. The treatment was life saving. I know that CBT is also offered at the Depression Center. Doing CBT with someone who is specifically trained makes a big difference. Check out www.abct.org for others in the area specializing in CBT. I also used antidepressants (Celexa with first bout of OCD, Prozac with second) and they both worked wonders.

Kristin Burgard

Mon, Jun 14, 2010 : 1:19 p.m.

Thank you for such positive comments. Wolverine3660, you asked about AAQUA. AAQUA is a swimming group for gay and gay friendly people. In the summer we meet at 9:30 am on Sundays at Fuller pool. New swimmers are also welcome. Kristin

Wolverine3660

Mon, Jun 14, 2010 : 1:01 p.m.

Kristin what is "AAQUA" that you reference? And I am glad that you are doing better.

Fran Loosen

Mon, Jun 14, 2010 : 10:17 a.m.

Thank you for this important insight!

Mousedeva

Mon, Jun 14, 2010 : 9:30 a.m.

Though I've never been pregnant, I have suffered from OCD since I was a child. I have trichotillamania in addition to several of the other OCD symptoms. It is common to have several though one main symptom. I understand what you are going through and wish there was a support group around here for it. UM apparently has a good OCD research dept. though. I'm glad you found a way to relax by swimming. An activity like that as well as support from family and friends is the best way to deal with it.

krc

Mon, Jun 14, 2010 : 8:40 a.m.

This is the first time I have heard of this awful disorder. Every OB, Midwife and Pediatrician should read this and keep it in mind at every checkup.

Elizabeth Nelson

Mon, Jun 14, 2010 : 8:28 a.m.

I want to congratulate you on your bravery, writing about this and educating people! I learned a lot from reading your article-- the more EVERYONE knows about mental health issues, the less likely that shame/stigma will prevent someone from seeking help. It's especially important to hear from people personally affected, so we understand that these things aren't merely definitions and symptoms written up in books. Kudos to you!