In the two and a half years since I began this organization, I have spoken with hundreds and hundreds of women about perinatal mood disorders; at support groups, over the phone, over email, on our facebook page, over skype and in person. In this time what I have observed to be the most common, underlying thread is the prevalence of intrusive thoughts brought on by perinatal obsessive compulsive disorder (OCD). Not only is it apparent to me that the majority of women suffering from a perinatal mood disorder are dealing with perinatal OCD, but that this is the part of the illness that has the least amount of understanding and awareness.
The statistic quoted in Canada for postpartum depression is the same as the statistic quoted for general depression, 1 in 5 or approximately 20%, which tells us that there is no real statistic for postpartum depression. Worse, we have very limited data on perinatal mood disorders as a whole and in particular perinatal OCD. My estimate is that close to half of Canadian women who have at least one child suffer from some type of perinatal mood disorder, and that something like 80% of those women are dealing with perinatal OCD.
So what is Obsessive Compulsive Disorder (OCD)? The text book definition goes something like this:
Obsessive–compulsive disorder (OCD) is an anxiety disorder characterized by intrusive thoughts that produce uneasiness, apprehension, fear, or worry; by repetitive behaviors aimed at reducing the associated anxiety; or by a combination of such obsessions and compulsions. Symptoms of the disorder include excessive washing or cleaning; repeated checking; extreme hoarding; preoccupation with sexual, violent or religious thoughts;relationship-related obsessions; aversion to particular numbers; and nervous rituals, such as opening and closing a door a certain number of times before entering or leaving a room. These symptoms can be alienating and time-consuming, and often cause severe emotional and financial distress. The acts of those who have OCD may appear paranoid and potentially psychotic. However, OCD sufferers generally recognize their obsessions and compulsions as irrational, and may become further distressed by this realization. -Wikipedia-
Now that we know a little bit about what it is, let's discuss how it affects women during pregnancy and postpartum. Women are natural worriers, and when a pregnancy, baby or child is involved that worry can be heightened. If a women is suffering from perinatal OCD, this general worry about herself and her child is greatly amplified. I don't think anyone can truly understand intrusive thoughts unless they have experienced them. Flashes of horrific scenes of traumatic events involving themselves, their baby or other children on a regular basis can leave a women feeling very scared, very quickly. More over, if a woman is not informed as to what OCD is and how it manifests, she may very well feel like she is going crazy. The topping on the cake is the stigma attached to mental illness, which leaves women suffering from perinatal OCD scared to share how they are truly feeling with anyone, not even their partner, never mind their doctor. Time and time again I have heard women say they were afraid to tell their doctors what was going on for fear of being viewed as crazy and having their baby taken away. This leaves them in the position of not getting the help and support they need which only amplifies the situation and worsens the illness, like a vicious circle.
The reality of this situation is that most don't even realize these intrusive thoughts are an illness and one that can be dealt with at least to some degree. Everyone's situation is unique, but there are options. Things like Cognitive Behavioral Therapy, Talk therapy, Anti-depressants, Certain supplements, A healthy diet rich in the kinds of healthy fats the brain needs and Exercise are all things that will help OCD!
Another major peice to this equation is Awareness and Education. Canadians know so little about Obsessive Compulsive Disorder, never mind the fact that it is quite prevalent in the postpartum period. This lack of education or ignorance is the biggest factor that contributes to it's stigma. To truly help the many many women dealing with perinatal OCD, Awareness and Education has to occur on a national level across Canada, and certainly internationally to other parts of the world dealing with similar issues. With broad Awareness and Understanding, the stigma will lessen greatly, women will feel more comfortable coming forward to discuss their symptoms with their partners and doctors, and they will get the help they need sooner. This is key!
I personally experienced perinatal OCD with all three of my children. In fact, from it's onset after my first child 15 years ago, the illness has never completely gone away. Despite all of my research and knowledge on the topic, I still battle it everyday, and it can be quite scary at times. It has only been in the last couple of years that I have been able to fully talk about it, before like so many women, I was too scared to discuss what was happening in my mind. I found lack of support and understanding to be everywhere. However, support and understanding can be found here! It is PPDA's goal to increase Awareness and to Educate on the subject of all perinatal mood disorders, and in particular perinatal OCD.
Tascheleia Marangoni is the Founding Executive Director of PPDA and can be reached at firstname.lastname@example.org.
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