Holistic Living

Perinatal Mental Health; Zooming in on OCD

Dr Rachel Taylor-East, also known as Sasha, is a Maltese Psychiatrist and mother of two young children, Michael 5 and Luisa 2. She completed her post-graduate specialization in Psychiatry with distinction and is on the specialist register of the Malta Medical Council. She is also a member of the Royal College of Psychiatrists. Sasha completed her MSc in the Clinical and Public Health Aspects of Addiction at Kings College London, UK and her undergraduate Medicine and Surgery degree at the University of Malta, where she is currently a visiting assistant lecturer on the Psychiatry module.

Sasha’s main interests are in the areas of acute general adult Psychiatry, Neuropsychiatry and Psychological trauma. She is actively involved in clinical audit and medical education: teaching both in undergraduate medical, and post-graduate psychiatry specialization. She is a trained medical assessor in the Malta Foundation Programme and recently completed a course on coaching and mentoring organized by Mater Dei Hospital. Her contributions to academia through teaching, presentations and publications, and to various voluntary projects she has worked on, reflect this. She recently completed a befriending project with UNHCR. Understanding the specific mental health needs of asylum seekers has also been a specific interest of hers. As such she has been actively involved with liaising with various agencies, attending conferences, and hopes to motivate and encourage developments within this field.

We reached out to Sasha, to understand more about Perinatal Mental Health, in particular Perinatal OCD, in an attempt to create a general awareness of issues that effect so many new mothers ….

Perinatal Mental Health; Exploring OCD

We all know how stressful having a baby can be. It is so normal and common to worry about your child, and for a new mum to want to protect her baby. Many mums find that they start being more careful, and avoid certain risks. I became much more anxious when I have to travel for example, and I also haven’t been diving (something I occasionally did for fun) since I had my children. Many mums have a rise in obsessive or compulsive-like symptoms, which can be normal, and also helpful (for example being more meticulous with hygiene in the kitchen). Many women also have unexpected thoughts about their baby being harmed. For most women these thoughts are not a problem and are normal.

Some women, however, have symptoms that can interfere with life, and cause significant distress. This could be a condition called Perinatal OCD. Like anything else, OCD varies in severity. Most women can care for their baby and other children well, despite their symptoms. However, for some, perinatal OCD can be very disabling. Fortunately it is a very treatable condition, and women with OCD realize that their symptoms are excessive. Unfortunately, many are ashamed or shy to talk about them.

Perinatal OCD doesn’t get much media coverage either, and it is not uncommon. In fact, anxiety disorders are the most common mental illnesses.

OCD – an anxiety disorder – is a relatively common mental illness, affecting 2 out of every 100 people at some time in their lives. If someone has OCD during pregnancy or after birth it is called perinatal OCD, and it is thought that three out of 100 women have it in the year after giving birth. It is more common in first time mums, and in mums who have had OCD in the past.

OCD has three main parts:

  1. Obsessions – these are thoughts, images, urges or doubts that keep coming to your mind. You try to remove them, but they are repetitive, and they cause you to feel distressed. A mum might feel afraid that something is contaminated by germs or that her baby will be harmed due to contamination. Sometimes, a mum might have mental images of hurting her baby, but know that people with OCD don’t become violent or act on their thoughts.
  1. Anxiety – as a result of the thoughts. Often anxiety is related to other feelings such as fear, guilt, and disgust. This can affect your mood too, causing you to become depressed.
  1. Compulsions – thoughts or actions you keep repeating to try to reduce the anxiety. They do work initially but not for long! For example a mum might wash her hands excessively and in a certain way, or check things repeatedly, constantly asking for reassurance.

So, if you feel that you may have some of the symptoms above, do talk to your GP about it. They can give you advice, about what kind of help you may need, or may refer you to a psychologist or psychiatrist for an assessment. They would be able to distinguish OCD from other perinatal disorders and then you would be able to receive the right treatment.

If you ever feel that you cannot look after yourself and/or your baby; or you have plans to harm yourself; you should be seen urgently by your GP or a doctor at the A&E department.

If your symptoms are mild there are some things you can do to help yourself:

–       Talk about how you feel to your partner or a friend, your GP or the midwife who visits you after giving birth.

–       Know more about OCD so you can recognize the symptoms, and challenge your thoughts when you feel anxious.

–       Take care of yourself in general. Keep those energy levels up, by getting rest when you can, eating healthily and exercising gently. Think about what needs to be done now, and what can wait. Accept help from friends and family, so you can focus on feeling better.

Don’t blame yourself.

And don’t use drugs or alcohol to help you feel better. They wont.

There are loads of people out there willing to help – you are definitely not alone. All you need to do is ask.

To find out more about other perinatal mental health problems such as; perinatal depression, perinatal anxiety, postpartum psychosis or postpartum PTSD you can visit Mind – the Mental Health Charity

This is an example of Perinatal OCD:

Anne is a 30 year old mum of a 3 week baby boy called Joe. She is in a stable, supportive relationship, but her partner works long hours. Her pregnancy was complicated with bad morning sickness, which caused her to feel stressed. Also, during Anne’s pregnancy, she suffered a fall while out walking. She worried about that too, initially wondering if she had inadvertently harmed the baby.

After birth Anne started to have intrusive thoughts that she might drop her baby while bathing him. This gradually got worse, and Anne couldn’t help thinking that she might drop Baby Joe. She knew that her fears were exaggerated, but couldn’t help thinking that she might harm Joe. This made her feel very anxious and distressed. Anne was exhausted. She started to avoid picking Joe up while standing, and at 6 weeks afterbirth stopped going out of the house completely

The midwife that visited Anne (a service offered locally), asked her about her stress levels, and Anne broke down. Anne had been afraid to talk about how she was feeling. She subsequently also spoke to her obstetrician, who suggested she saw a psychiatrist.

Anne found out that she had lots of options available, both in the private sector and with the government mental health services including a perinatal mental health clinic at the obstetrics and gynecology department. All she needed was a letter from either her family doctor (GP) or obstetrician.

She saw a psychiatrist who encouraged her and explained what OCD was. She learnt about this condition, and began treatment with a psychologist – Cognitive Behavioural Therapy. Anne also learnt that had the symptoms got worse, the psychiatrist could have prescribed an antidepressant to help control the negative thoughts, and anxiety. She felt reassured and felt motivated to work towards getting better.

She managed to get on top of things, and was soon well again.

 

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