The term “OCD” is often misused, with people saying things like “I’m totally OCD” when referring to being meticulous, highly organized, or extremely clean.
The reality? OCD is so much more than that. It’s a mental health condition that can really affect a person’s quality of life. Like other mental health conditions such as depression and anxiety, OCD can be triggered or exaggerated by pregnancy. Being a new parent is already incredibly tough, and perinatal OCD can add a layer of challenge to a person’s experience.
That’s why it’s so critical that we address the issue of perinatal OCD, make people aware of what it is and how it manifests, so those who need professional help in managing the condition can take the first step.
We enlisted therapist Janet Bayramyan, LCSW, to share more about perinatal OCD, including what people who suspect they may be dealing with the condition can do.
First of all: Let’s clear up what OCD actually is
“Obsessive compulsive disorder is a mental health condition associated with having unwanted, intrusive and distressing thoughts, obsessions and repetitive behaviors that aim to relieve anxiety caused by the obsessions,” says Bayramyan. “The obsessions are persistent and unwanted, while the intrusive thoughts, images, or urges can cause significant anxiety or distress. Compulsions are repetitive behaviors or mental acts that the person feels driven to actually perform in response to the obsessions.”
According to the expert, there are many myths about OCD, which include the idea that OCD is just a personality quirk or preference.
“OCD is not simply a personality trait or preference for cleanliness or orderliness,” she says. “It's a mental health disorder characterized by intrusive, distressing thoughts (obsessions) and repetitive behaviors or compulsions aimed at reducing anxiety or preventing perceived harm. These symptoms can significantly impact one’s daily life and functioning.”
It’s much more than just a desire for cleanliness
There’s this myth that “everyone has a tiny bit of OCD”, says Bayramyan. That’s not true.
“While it's common for people to have preferences for things like a clean home or organized shelves, having preferences is not the same as having OCD,” she says. “The intrusive thoughts and compulsive behaviors in OCD cause significant distress and interfere with everyday life. It's not as simple as liking things a certain way or having particular habits.”
It’s also a myth that you can undo OCD with mere willpower. Managing the condition typically requires professional help.
What role can pregnancy play in cases of OCD?
“Pregnancy can trigger or intensify obsessions, which will most of the time be related to fears about the health and safety of the baby or oneself,” says Bayramyan. “Compulsive behaviors may also change or increase during pregnancy. Some people may feel compelled to engage in excessive cleaning, washing, or sanitizing to protect the baby from perceived threats (e.g. bacteria in the bottle). They may also feel the need to repeatedly check on the baby's well-being or perform rituals related to prenatal care.”
As with many perinatal mental health conditions, hormones can play a major role here. “The hormonal changes and stress of pregnancy can contribute to heightened emotions, which may exacerbate OCD symptoms,” says Bayramyan. “Feelings of guilt, shame, or inadequacy related to OCD may also be more intense during pregnancy, especially if the individual feels they should be focusing solely on the well-being of their baby.”
Perinatal OCD can make your mind go to terrifying places
“Postpartum OCD can involve intrusive thoughts or fears about accidentally harming the baby. Despite having no intention of causing harm, individuals with OCD may experience intense anxiety and guilt about these intrusive thoughts, leading to compulsive behaviors to prevent any perceived harm,” says Bayramyan.
“The transition to parenthood can bring about doubts and uncertainties for anyone, but for individuals with postpartum OCD, these worries may feel incredibly intense. They may constantly worry about whether they are capable of caring for their baby properly or whether they are making mistakes,” she adds.
Hormones play a role
People may be more vulnerable to OCD during or after pregnancy due to the massive hormonal shift your body undergoes.
“There is evidence to suggest that hormonal fluctuations during pregnancy and the postpartum period may influence the onset and severity of perinatal OCD. During pregnancy, estrogen and progesterone levels rise significantly, and reach their highest levels in the third trimester. These hormonal changes can affect neurotransmitter activity in the brain, particularly in terms of serotonin,” says Bayramyan.
As for post-pregnancy? “During the postpartum period, there is a rapid decline in estrogen and progesterone levels, along with other hormonal fluctuations. This hormonal shift, combined with sleep deprivation, stress, and other factors related to caring for a newborn, may contribute to the development or worsening of OCD symptoms in susceptible individuals,” she adds.
Some people will see their OCD symptoms reduce after they give birth, while others will continue to struggle.
Who is at risk?
People with a personal or family history of OCD are at increased risk for developing perinatal OCD.
“Women who experience significant anxiety or depression during pregnancy or after childbirth may be more vulnerable to developing OCD symptoms,” adds Bayramyan. “A traumatic birth experience, such as complications during labor and delivery or a difficult recovery, can increase the risk of developing perinatal OCD [as well]. People with perfectionistic tendencies or personality traits may be at higher risk of developing perinatal OCD and/or more prone to intrusive thoughts and worries about perceived imperfections or potential harm related to their pregnancy or baby.”
Let’s talk about treatments
While some lifestyle modifications, like physical activity, limiting caffeine and alcohol, and practicing self-compassion may be helpful, professional help may be required to treat perinatal OCD.
Treatments can include cognitive behavioral therapy, or CBT.
“Specifically, a type of CBT called Exposure and Response Prevention (ERP) is considered the gold standard treatment for OCD,” says Bayramyan. “This involves gradually exposing individuals to situations or objects that trigger their obsessions while preventing them from engaging in compulsive behaviors. Over time, exposure to these triggers without performing the compulsions helps reduce anxiety and break the cycle of OCD symptoms.
Medication may also be helpful, and a qualified psychiatrist can facilitate this.
If you’re struggling, you’re not alone
Perinatal mental health conditions can lead to feelings of guilt and shame, and they can feel very isolating. But they’re not your fault, and you’re not alone.
If you’re experiencing any concerning symptoms dealing with your mental health during or after pregnancy, help is out there and seeking it out is the first step towards healing.
Zara Hanawalt is a freelance journalist and mom of twins. She's written for outlets like Parents, MarieClaire, Elle, Cosmopolitan, Motherly, and many others. In her (admittedly limited!) free time, she enjoys cooking, reading, trying new restaurants, and traveling with her family.