I THOUGHT I’D BECOME A MONSTER

Nicky with Paul and baby Evie

For Nicky, the joy of a healthy baby girl was replaced by distressing intrusive thoughts about harm coming to her daughter. MC Magazine explores maternal obsessive compulsive disorder (OCD), a common and debilitating anxiety disorder.

Almost all of us have had unwanted thoughts or even sudden violent or offensive mental images. It could be ‘what if I drive into the central reservation’? When people with OCD experience these intrusive thoughts or obsessions, they feel compelled to respond by performing repetitive actions, either physical or in their head, as a way of alleviating the anxiety and to prevent danger.

Recent studies suggest women are most at risk when they’re pregnant or after they’ve given birth. Their intrusive thoughts can often relate to the child. The mother may worry about her baby coming to accidental or deliberate harm, for instance dropping the baby down the stairs, or baby suffocating. OCD can also affect fathers.

Libby Chamberlain is a psychologist with Mersey Care’s perinatal mental health team which works with mums (and dads) with this type of OCD.

“Having a new baby is a massive responsibility and the outside world can appear a dangerous place. The maternal brain is already programmed to the potential hazards to the newborn. There’s also lots of new advice to absorb. All this can lead to a pattern of increasingly anxious intrusive thoughts.

People may respond to the distress of these thoughts by developing compulsive mental or physical actions to try to alleviate their fear. They can spend so much time performing these actions that they don’t have time to enjoy the baby.”

WHY MIGHT OCD DEVELOP OR WORSEN DURING PREGNANCY AND AFTER GIVING BIRTH?

Experts say there could be several reasons; hormonal or biological influences, the impact of transitioning to a new role and an increased awareness of potential threat and responsibility as a parent to prevent danger to the child.

Getting early help is important. Parents can be referred by a health professional, or self refer, to talking therapies close to where they live. The perinatal mental health team works directly with people with moderate to severe complex perinatal mental health issues.

Says Libby: “The shame of having these thoughts can prevent people coming forward for help; it’s important they know it’s not them, it’s the condition. With help they can regain control of their thoughts so they can go back to enjoying their baby.”

GET HELP

If you think a friend or family member may have OCD, try talking to them about your concerns and suggest they get help

Talking therapy services in Sefton are provided by Access Sefton: insighthealthcare.org (searchAccess Sefton) and in Liverpool by Talk Liverpool: talkliverpool.nhs.uk

Referrals to the perinatal mental health team are via a health professional e.g. GP, health visitor or midwife.

It’s important they know it’s not them it’s the condition…with help they can regain control and go back to enjoying their baby.

NICKY’S STORY

“After a very long labour I was elated when Evie was born. The first few days were amazing, Paul my partner is great, we have a good home life, and everything was perfect.

I was so excited to have her that even when she slept I’d stay awake. Looking back I didn’t give myself enough time to recover from the birth. I was breastfeeding and she was constantly hungry. After three days without sleep, exhaustion set in.

I started having thoughts about something bad happening to her. What if we had a car crash? What if I fell downstairs holding her?

Psychiatrist Libby Chamberlan supported Nicky

As I became increasingly sleep deprived, the thoughts became more intrusive and distressing. What if someone sexually assaulted her?

I was having awful thoughts about my own baby. I couldn’t change her nappy or bathe her, I was in fear. What if sexual thoughts came into my head? I thought I had become a monster.

I’d stopped eating, I couldn’t talk. After 12 days I begged Paul to take me to A&E. I thought it would be better to kill myself – I didn’t want to die but I wanted the baby to be safe.

They were amazing; they assured me she wasn’t in danger. The mental health crisis team came out over the weekend and then the perinatal team quickly took over and diagnosed Perinatal OCD. Within a day I’d been assessed, prescribed medication, allocated a care coordinator, and referred for psychology. They took me seriously, explaining that it’s the condition and that they’d help me.

Paul cared for Evie and I stayed with my mum – I had never experienced anything like this, the thoughts were overwhelming. Gradually I moved back home and I was able to slowly do more and more with my baby girl.

I’m so far on now – I wanted reassurance that I wasn’t bad, and I got it. There isn’t a quick fix, it’s gradual. You go through a period of having the thoughts, but the team helped me to recognise that my thoughts were part of the OCD and we worked together to manage it.

I’d say to someone in my situation “don’t wait, get help – talk to someone before making any decisions. It’s not you it’s the condition and you will get better”.

FIND OUT MORE

• Maternal OCD, a charity founded by two mothers who experienced and recovered from extreme perinatal obsessive compulsive disorder: www.maternalocd.org

• Stories of recovery, including an account of his own OCD by dad Ashley Curry on the Maternal OCD website

• Fiona Challacombe’s Breaking Free from OCD

• Dropping the Baby and Other Scary Thoughts by Karen Kleinman

• Postnatal Depression by Michelle Cree, a supportive book to help new mums on their journey into motherhood.

SIGNS AND SYMPTOMS OCD

symptoms include:

• obsessions – where an unwanted, intrusive and often distressing thought, image or urge repeatedly enters your mind

• emotions – the obsession causes a feeling of intense anxiety or distress

• compulsions – repetitive behaviours or mental acts that a person with OCD feels driven to perform as a result of the anxiety and distress caused by the obsession.

Maternal OCD usually (but not always) revolves around significant fear of harm coming to the infant, with worries frequently focused on accidentally or deliberately harming the child or the child becoming ill.

Depending on the worries, this could involve compulsive behaviours such as cleaning, praying, rumination or avoidance of activities or even of spending time with the baby. 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.