Anxiety UK

• What is postnatal anxiety?
• Postnatal anxiety and OCD
• How we can help
• Want to know more
• Personal experiences

What is postnatal anxiety?

Anxiety UK is contacted by many new mums who are experiencing anxiety symptoms following pregnancy and birth of their child. Having a child not only causes huge changes to a womans body in terms of the physical shock and hormonal fluctuations (which in tern have an impact on mood), but can also have a big impact on family life, sleep levels and stress. All of these things can lead a person to become more anxious than usual.

The anxieties experienced by new mums can take many forms:

• Postnatal generalised anxiety disorder (GAD): This can present as a constant state of high anxiety, with worries about everything from your child’s health, feeding, your ability to parent or that something bad might happen. This should be distinguished from the normal worries that new mums have, the difference being it will be having a negative impact on your life. For more info about GAD, click here.
• Postnatal obsessive compulisive disorder (OCD): This can be one of the most distressing types of post natal anxiety. This is because it is often accompanied by distressing thoughts and images, about harm coming to your baby either on behalf of the mum or others (there is never any intention to do this on the mum’s behalf). Mums can often feel very isolated with these feelings and worried about discussing them with family or their health visitor. You can read more about post natal OCD below.
• Postnatal health anxiety: We have had contact from a number of people who are experiencing a form of health anxiety, with an excessive preoccupation that there may be something wrong with their baby, this leads to repeated medical investigations, but as with traditional health anxiety, results rarely reassure the new mum in the long term and the best approach is to obtain support through CBT or a specialist who can help mums to challenge their own worries. For more information about health anxiety, click here.

Having a baby and Obsessive Compulsive Disorder (OCD)

OCD is a common problem, affecting one or two in a hundred people at any time.  Given that OCD can emerge or get worse during times of stress and major life transitions, it is not surprising that pregnancy and the postnatal period is a time of increased risk for developing OCD, for mothers and in some cases for fathers.  As parents will know well, the first months of a child’s life are hugely demanding, both physically and mentally, and the responsibility of looking after a baby for twenty four hours a day can feel immense.  These factors can all contribute to OCD getting a foothold and in some cases taking over.

It is possible for OCD to be about almost anything, but for many people with postnatal OCD the fears often revolve around accidentally or deliberately harming the baby. It is important to note that the occasional experience of these worries is absolutely normal and indeed very common in mums and mums to be. However, some people find themselves so distressed by their thoughts that they take measures to manage their anxiety or prevent their fears coming true. In this way the thoughts and behaviours can interfere significantly with their wellbeing and their experiences of pregnancy and parenting. It is the extent of and response to the worries, rather than just having them that becomes the problem.

During pregnancy all women are encouraged to be aware of certain risks related to what they eat, drink or do.  Pregnancy is hard as for anyone it is a long wait until that responsibility is over.  For a woman who has OCD or a tendency to be obsessional, this situation may cause her to avoid and restrict foods, places and situations well beyond the guidelines in order to keep as safe as possible, or at least feel that she has done everything in her power to do so.  She may spend large amounts of time cleaning and washing and ask those around her to do the same.  This often continues postnatally. For mums worried about contamination, babies crawling around and putting everything in their mouth as they do can be a real nightmare!

Another common theme of postnatal OCD is thoughts of deliberately harming your child.  After the birth, many parents experience occasional fleeting thoughts of this type, but are able to dismiss them as meaningless. Some people interpret the very fact that they have these thoughts as meaning that they may act on them and become frightened about their potential to harm their child in a ‘moment of madness’.  They may then take special measures to stay ‘safe’ around them such as hiding knives and sharp objects in the home or even avoid contact with the baby.

Whatever the type of OCD, it gets in the way of life, family life and enjoying being a parent at a time that really is hard enough anyway, so the best thing to do is to get treatment.  Two main things can get in the way of getting help: firstly, particularly if they have never had the problem before, it may be difficult for mums to recognize their experiences as being part of OCD.  Secondly, people may be reluctant to seek help due to the shame and secrecy associated with the disorder. Telling people that something is wrong can be especially hard at a time when parents and those around them expect them to feel happy. Although they are common, people don’t tend to talk about thoughts of harm in their postnatal groups so sufferers can really feel like they are the only ones.  Unfortunately, as there is often a lack of awareness about OCD during pregnancy and postnatally by professionals, people are rarely asked about these experiences. Sometimes postnatal depression is diagnosed even though depression is not the main issue.  This is important as the treatment is different.  If you think that you might have symptoms of OCD it may be up to you to suggest that you have OCD to your GP and ask for an assessment by someone who knows about this problem.

Research shows that Cognitive Behaviour Therapy (CBT) is very effective for OCD at any time, even if the problem is longstanding.  It may be a particularly useful option for people who are pregnant, breastfeeding or just prefer not to take any medication.  (You can of course have CBT if you are on medication as well.)  CBT works by helping you understand your problem and challenge it.  Although it may be hard to arrange treatment sessions with a new baby, it is also a really good time to make changes and overcome OCD so that you can really enjoy your life as a parent.

Anxiety UK would like to thank Fiona Challacome for the information on postnatal OCD.

Fiona Challacombe is a Clinical psychologist and Research Fellow at the Maudsley Centre for Anxiety Disorders and Trauma and the Institite of Psychiatry. She is specialising in understanding and treating postnatal OCD

How can we help?

Anxiety UK is a user-led charity with more than forty years experience in supporting those living with anxiety. By becoming a member of Anxiety UK, you will have access to a range of benefits, including:

• Access to reduced cost therapy within two weeks of submitting your therapy request
• Access to our helpline (available Monday-Friday, 9:30 am – 5:30 pm) staffed by volunteers with personal experience of anxiety
• Receipt of four issues of Anxious Times, our quarterly members” magazine
• Access to the members only section of our website, featuring regular support surgeries facilitated by anxiety experts
• Access to specialist helplines, including the psychiatric pharmacy helpline and the psychology information helpline

And many, many other benefits that will help you manage your anxiety long term. To become a member of Anxiety UK click here or ring 08444 775 774 today.

Want to know more?

Anxiety UK recently carried out a live webchat with Dr Fiona Challacombe, a leading researcher in post natal anxiety. Following the chat we have produced a summary sheet with the key points that were discussed and this is available in the paid members area of the site which can be accessed by clicking here.

Fiona also has information on her website at www.postnatalocd.org

Personal Experience

Do you suffer from post natal anxiety and want to share your experience with other people? Post your personal experience in the comments box below where it will be sent to our moderator for approval. Many people find this part of the site very useful when trying to understand their disorder so your comments really do make a difference. Please note, all comments submitted to the Anxiety UK website may be used by Anxiety UK for (but not limited to) publicity and promotional material.