Everything You Need To Know About Postpartum OCD, Psychosis, & Panic Disorders


 




Postpartum period is demanding period characterized by overwhelming biological, physical, social, and emotional changes. It requires significant personal and interpersonal adaptation. Pregnant women and their families have lots of aspirations from the postpartum period, which is colored by the joyful arrival of a new baby. Unfortunately, women in the postpartum period can be vulnerable to a range of psychiatric disorders like postpartum blues, depression, and psychosis. Perinatal mental illness is largely under-diagnosed and can have far reaching ramifications for both the mother and the infant. Early screening, diagnosis, and management are very important and must be considered as mandatory part of postpartum care. ~From the Abstract of the Indian Journal Psychiatry. 2015 Jul; 57(Suppl 2): S216–S221.doi: 10.4103/0019-5545.161481 PMCID: PMC4539865, Postpartum psychiatric disorders: Early diagnosis and management


Postpartum OCD


Criteria for OCD (Obsessive Compulsive Disorder)

People with OCD have either obsession, compulsions, or both. You can have either one.

Obsessions are repeated thoughts,urges, or mental images that cause anxiety.

  • Fear of germs or contamination,
  • Unwanted/forbidden/taboo thoughts involving sex, religion, and harm
  • aggressive thoughts toward others or self
  • having things symmetrical or in perfect order.

Compulsion is a repetitive behavior that a person with OCD has the urge to do in response to an obsessive thought. It’s usually in response to a thought, but it sometimes it isn’t related to the thought.

  • Excessive cleaning or hand washing
  • Ordering and arranging things in a particular way
  • Repeatedly checking on things such as repeatedly checking to see if the door is locked, the oven is off, or the flat iron is off.
  • Compulsive counting

Not all rituals and habits are compulsions because everyone double checks things, but a person with OCD generally can’t control their thoughts or behaviors even when those thoughts and behaviors are recognized as excessive.

A person with OCD spends at least 1 hour a day in these thoughts and behaviors. They also don’t get pleasure with these behaviors or rituals, but may feel brief relief from the anxiety the thoughts cause. And  they experience significant problems in their daily life due to these thoughts and behaviors.


Things That Can Develop With OCD

  • Motor ticks
  • Eye ticks
  • Blinking

Types of OCD

  • Germ contamination
  • Food contamination: People with this type may only be willing to go to certain restaurants, they may throw food out on the date of the package or even before.  They may not eat at other people’s homes.
  • Compulsive cleaning
  • Hoarding
  • Counting
  • Organizing/Ordering Things

How much stress is this causing and how much time is this taking up.

OCD seems to peak at postpartum.  So you may have had tendencies and be able to control your thoughts and beliefs, but after baby, it gets worse.


Is Social Media Doing More Harm Than Good?

Pinterest and Instagram are highly visual platforms and most photos are highly curated.  Think about the last photo you shared on social media? Nobody talks about how the picture was taken.  Most of the time it’s total chaos. Nothing goes the way you planned, but we don’t share this aspect of it. Yet we get the good shot anyway and post it on social media to show the Pinterest worthy photo. Real life doesn’t look like Pinterest!

Event planning is another thing. There’s so many ideas for parties and it’s easy to get caught up in party planning, and themes, and decorations. If party planning is an outlet for you, then by all means, go for it.  But I think with a lot of moms, we create this event to impress people and it causes distress and doesn’t work.  The 3 questions you should ask yourself when it comes to planning is:

  1. Who are you doing this for?
  2. What is the purpose?
  3. What is going to make your little immediate family happiest.

Triggers For OCD

  • Sleep
  • Feeling Out Of Control

Could There Be a Connection with Strep & OCD?

This is only a theory but we think this because of the connection between PANS (Pediatric Acute Onset Neuropsychiatric Syndrome) which is a strep infection that causes OCD symptoms in children. It’s very pervasive and very hard to heal with out a very big set of antibiotics.

There is an increase of OCD in the postpartum period, it’s just a wonder if this will ever be a connection.  Again their are no studies on this but some psychologists do see a trend.  Not to mention, many moms are given antibiotics due to c-section and high rate of Strep B.  Antibiotics affect the gut brain and the microbiome.


Root Causes of OCD

  1. Emotional Trauma
  2. Heavy Metals & Toxins

Healing Foods For OCD

The 5 foods that are powerful with getting rid of heavy metals are wild blueberries, spirulina, barley grass juice powder, cilantro, and atlantic dulse.

You can get all of these in at once which has the most impact in a smoothie.  Try the Heavy Metal Detox Smoothie from Medical Medium.

If you don’t get them in all at once, that’s okay, as long as you get all 5 in within 24 hours.

Other foods you can try are blackberries,  raspberries, strawberries, papaya, leafy greens (spinach, arugula, butter leaf lettuce) sweet potatoes and squashes.

Techniques for Overcoming OCD

  • Anxiety and Phobia Workbook
  • Working with a confident therapist
  • Treat your anxiety in general (calming techniques)
  • Be gentle with yourself.
  • Get professional thoughts if you have suicidal thoughts.
  • Challenge your obsessive thoughts and compulsive  behaviors with CBT techniques.

Postpartum Psychosis


This is super rare (about .5%) but it is very dangerous. So it’s vital you can help right away.

Criteria

  • Extreme confusion
  • Seeing or hearing things that aren’t actually there.
  • Thoughts of hurting one’s self one’s baby or others

It has a very acute and abrupt onset and usually begins 2 weeks following delivery or at most within the first 3 months postpartum

This is a psychiatric and obstetric emergency.


Risk Factors

  • Past history of psychosis with previous pregnancies in postpartum period.
  • A history of bipolar disorder
  • Family history of psychiatry illness such as schizophrenia and bipolar disorder

These are the major ones, but it could still happen without any of these factors.  Please don’t discount it.


Common Symptoms

  • Extreme elation or high mood
  • Mood lability
  • Rambling speech
  • Disorganized behavior or delusions
  • Excessive delusions of guilt
  • Alternating episodes of delusions of persecution, auditory hallucinations, delirium-like symptoms, confusion, excessive activity
  • At times, delusions can revolve around the infant, especially thinking the infant is possessed. had super powers, is divine, or is dead.
  • Infanticide and suicide are common with women suffering from postpartum psychosis. This is why you NEED to seek professional help.

The Good News? It’s Treatable! You are strong or getting the help you need.


Who Do You Go To For Help?

Go to the ER, the pediatrician, your OBGYN, or call 911.  Either way, you NEED help!


Could There Be a Relationship between Psychosis and Thyroid Dysfunction?

Izabella Wentz, Pharm D. shared in her Thyroid Secrets Video Series that 1 out of 6 women who were diagnosed with postpartum psychosis were tested and had in thyroid dysfunction.  So the big takeaway here is to have your doctor test your thyroid in addition to their protocol. 


Panic Disorder


Criteria

Right now, a diagnosis of panic disorder is based on the experience of recurring unexpected panic attacks in a person’s lifetime with at least one of these attacks being followed by a one month period in which the individual worries about having additional attacks or worries about having a heart attack or something like that.

Also, the individual has changed his/her behavior in a maladaptive way. This may include avoiding situations that provoke the panic. The person may even go onto experience varying frequencies and intensities of expected or unexpected panic attacks.

Panic attacks are characterized by experiencing at least 4 or more of these symptoms:

  • Palpitations
  • Pounding heart
  • Tachycardia
  • Sweating
  • Muscle trembling and shaking
  • Shortness of breath 
  • Choking sensation
  • Chest pain or discomfort (tightness)
  • Nauseau
  • Abdominal distress
  • Dizziness
  • Lightheadness
  • Instability or feeling faint
  • De-realization or De-personalization (it feels like you’re looking at yourself from the outside.
  • Fear of losing control or going crazy
  • Fear of dying
  • Numbness or tingling sensation
  • Chills & Hot Flashes

Most people experience the peak of a panic attack within a few minutes. The symptoms don’t continue on all day. So having a racing heart all day is more general anxiety.

Panic attacks can also be tacked onto another diagnosis with panic attacks.  You can have OCD with panic attacks but it’s not necessarily panic disorder.  Panic disorder is more fear of panic attacks and worry that you’re going to have panic.


Root Causes & Healing Foods For Panic Disorders

You can refer back to Everything You Need To Know About Postpartum Anxiety.

The Center For Clinical Interventions shares a whole protocol for panic and you can check it out here: cci.health.wa.gov.au/resources

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