Thursday, March 31, 2011

The Vines in My Mind - My Struggle With Postpartum OCD

So many people have emailed me and sent me messages encouraging me to please write about my Postpartum Obsessive Compulsive Disorder, that I've decided to share my experience. I don't know what I can say, and I've mulled it over a lot trying to come up with an angle or a thesis on the topic and I've decided to just write and let the words come in hopes that something I say can help someone who is going through the same thing or someone whose loved one is suffering from it. At least maybe I can help someone out there feel like they're not alone.

OCD isn't something new for me. I've had it since I was a little girl, only I had no idea that's what it was. Bad habits. She just has bad habits, everyone would say. First I found that I could make a sort of snuffing noise in the back of my nose and that if I did it over and over, the action satisfied something in me. It was like scratching an itch, but not a physical itch. It was more of an unsettled feeling I'd get and if I snuffed my nose that unsettled feeling would go away for a little while. It never stayed gone for long though, and I'd have to snuff and snuff, which drove everyone around me crazy.

My parents and grandparents went to great lengths to get me to stop snuffing. My grandmother took me to an ear nose and throat specialist thinking there was something physical causing me to do it. There was talk of getting my tonsils and adenoids taken out as if that might stop the snuffing. I was tested for allergies but no one ever found anything wrong. Finally, the doctors said I had a bad habit. That was enough to get me punished. They grounded me for snuffing, took away privileges and things I liked, even threatened to spank me and finally, although I was wracked with anxiety by this point, I stopped snuffing and the only reason I did was because I found that I could twitch my nose to relieve the unsettled feeling.

I became a rabbit. Twitch, twitch, twitch. My teachers complained about my constant nose twitching and pretty soon my family noticed that this was my latest bad habit and the punishments started again and again I replaced the nose twitching with a new habit until my childhood became a sequence of habits, replacing one for the next as each one was discovered.

And then it got worse.

When I was ten I became seized by the terrifying thought that I was going to choke to death. The thought began from something I saw on TV and then one morning at breakfast I choked on a gnarl of chewy bacon and had to reach down my throat to pull it out. After that, I became obsessed with the fear of choking. I could think of little else. I began to dread mealtimes. I would chew and chew my food but no matter how much I chewed, it wasn't good enough. It felt like my teeth weren't working. They weren't chewing good enough and I was going to choke to death, so I'd end up holding the food in my mouth and trying to spit it into a napkin when no one was looking. Of course, my family caught on pretty quickly. I was living with my strict father and stepmother at the time and visiting my mother every other weekend.  My father tried punishing me and my mother, on her weekends, tried to cajole me and convince me to please just eat and swallow my food. Every meal, no matter which parent I was with, became a struggle of threats or begging, but I held out in spite of some very harsh punishments (physical beatings every night from my father and stepmother) because my fear of choking was so great that I would rather be hit than face what I believed was certain death.

Interestingly, this fear faded gradually and I began to eat again once I went to live with my mother the following year, but by then I had wasted away so much that she had to feed me vanilla milkshakes with heavy cream every day to get some weight back on me.

I didn't fear choking anymore. Instead, it became dissecting animals in Life Science class, changing in gym class and a whole array of other phobias which grew with such intensity in my pre-teen mind that I could think of nothing else besides whichever fear happened to be eating away at me at the time. I was so petrified of having my period that I believe I actually willed it not to come until I was nearly fourteen and then that began a new round of severe anxieties all based on bleeding or of people finding out that I had my period. I didn't even tell my mother I had gotten it.

I won't list each and every fear and bad habit because the succession is long and tiring, but there was a clear pattern of my having some awful fear stuck in my head, then the fear taking over and causing me such great anxiety that I had to find some kind of "habit" to calm me down when I had the fear, even though the habits didn't always work.

I'm what people call high strung. I'm wound tight. You'll notice me fidgeting almost immediately upon meeting me. My mannerisms might remind you of a squirrel in your yard, jerking nervously, looking around, constantly aware of its surroundings and assessing each and every situation for potential danger. I see myself that way, like a small animal and in my mind there is always a cat about to strike, only the way I experience it, there is not the possibility of the cat. There is no maybe the cat's not out today, or maybe the cat isn't interested in killing and eating me this afternoon. No. The cat is always there and it will always pounce, so I must always protect myself. I am ever vigilant.

This is a hard way to live.

In 1999 I went to a therapist who referred me to a psychiatrist and together they diagnosed me with OCD. By that point, living in Atlanta in a deteriorating and abusive relationship, I had begun checking things. My fear of food poisoning and stomach viruses had become debilitating. I was wasting large amounts of money throwing out food that was perfectly good because I was afraid it might be spoiled and I had begun to clean and wash my hands in order to kill viruses and bacteria that I believed were going to make me sick. My fear was so great that I arranged my life around it. There were only certain places I would go or eat and I would panic about having to eat food at other people's houses because you just don't know about how long other people keep food and you can't be sure about their sanitation.

I had no idea this was OCD and was shocked by my diagnosis.

I had seen OCD on TV and those people were crazy. They had elaborate rituals that seemed more arbitrary than the little things I did. I wasn't counting ceiling tiles, lining up my belongings or refusing to step on sidewalk cracks on alternating weekdays. Media portrayals of OCD are always the most dramatic and severe cases, usually the quirkiest too because that makes for the most sordid viewing, but OCD has many other manifestations. It's different for every person who has it.

Some people tend to be heavier on the O - the obsession, which is the terrifying thoughts and in others, the compulsions are more obvious. Those are the cases you see where people check their door locks or devise elaborate rituals that can often seem comic in their absurdity. I don't do things like that so much. Instead, I get more caught up in the obsession part of OCD, though I am not wholly immune to compulsion either. My thoughts are often crippling when I'm in the throes of the disorder, which in me, can wax and wane situationally. Obsessive thought paralyzes me. You'd call me a worry wort, say I was neurotic and ask me why I was so anxious. Stop worrying all the time, you'd probably tell me, meaning well of course. Often I can play it down on the outside so that to outsiders I just look a little uneasy, while inside my mind is an F5 tornado of fear and panic about whatever idea has taken hold. Other times I can't control it, as much as I try and the thoughts become too great for me to contain and I have an all out meltdown, panic attack. These incidents make the people around me mad because to them it looks like I am freaking out over nothing and causing a scene for no reason.

Maybe the reality is that there is no reason. Usually whatever I am fearing doesn't ever happen, but my mind can't perceive an obsessive thought as an unlikely possibility. My brain isn't satisfied with "might not" and instead it just hears "will happen" and "is happening." Probability and statistics are wasted on me. If I hear that there is a 95% chance that I won't get attacked by a shark if I go into the ocean, all I can think about is the 5% chance that I will, except the more I think about it, the more I leave out the word chance and I forget that 5% until I quickly convince myself that I am absolutely going to get attacked by a shark if I go in the ocean and it becomes so real to me that I see nothing but sharp, bloody teeth and the sea red with me as if it has already happened.

I'll also think in chains of binding "what ifs." I'm almost proud of my ability to take any situation, no matter how innocuous, and through a series of what ifs, drag it out to its inevitable conclusion, which is always me dead and alone somewhere. Let me show you an example. Here's a simple one. What if I decided to go to Jamaica on vacation? Well the plane will probably crash. What if the plane doesn't crash? What if when I get there I get malaria or a parasite? What if someone plants drugs on me and what if I get arrested and thrown in a Jamaican prison? What if I don't get medical treatment for the malaria or parasite in the Jamaican prison? What if I die in a Jamaican prison? Oh my God, I am dead in a Jamaican prison for something I didn't do. Screw that dream vacation in paradise. I'm staying here where it's safe.  Go ahead. You have my permission to laugh. I know it sounds ridiculous. It is ridiculous.

I had it fairly controlled for a long time. I was aware and understood finally that I had OCD. For a couple years I took medication, which worked beautifully because on the meds, I just kind of forgot to obsess and since I wasn't wigging myself out obsessing over imagined fears and possible disasters, I didn't need any weird habits to calm me down.

I went off the Zoloft and some of the anxiety returned, but I knew what it was. I admit that I may have been a little rigid and ordered about the way I did things, but I was trying to stay in control in order to avoid situations that would flare my terror. I knew when I was being a little compulsive and I knew when I was getting scared and most of the time I could talk myself down from the proverbial ledge. I think I was managing my OCD quite well. Sometimes I didn't even show symptoms for so long I forgot I had it.

But then I had a baby.

Babies change everything. Having a baby is one of the most stressful life events that there is, especially for a woman who must bear both the physical strains of pregnancy, childbirth and often nursing, as well as the psychological pressure associated with caring for an infant. It's really, really hard. Women who have never once showed signs of OCD can suddenly find themselves overwhelmed with the disorder after having a baby.

Our society puts so much pressure on mothers and for new mothers the stress of this pressure is often unbearable. Everywhere you look there's some new study about something that's going to harm your baby. There are recalls, you hear horrific tales of accidents unavoided on the news. Family members and even total strangers weigh in with their advice on how you should be raising and caring for your child. Someone always seems to know someone to whom something dreadful happened and if only they'd known x, then y would never have happened and all would be well. Mothers with OCD can't tune out these messages very well.

Mothers have an instinct to protect their babies, but in mothers with OCD it's like the natural need to nurture and keep safe blows up like an H bomb. The need is all consuming. There is nothing else except keeping that baby safe.

This is what happened to me and this is what Postpartum OCD is like. At first I thought I was just being a good mother or really, trying very very hard to be a good mother or at least to figure out what the hell a good mother even is so I could aspire to be one.

I became obsessed with SIDS. I added obsessions about toxins, pesticides, bacterial infections, pertussis, influenza and piled on fears of other people dropping the baby, head injuries, shaken baby syndrome. I felt sick when other people held her because I wasn't in control and they might not know how to hold her and she could hit her head on something, or fall. What if they had a virus? What if they didn't realize and played too rough with her and she got brain injuries? Why are the neighbor's spraying their yard for bugs? What if that causes her to be autistic? What if she chokes? What if the formula is contaminated? What if the crib collapses?

Look, I could go on and on about my specific fears, but they all came down to one core belief - the world is dangerous and everything is going to kill my baby and it will be all my fault unless I act immediately to protect her and I will protect her at any expense even if that expense is my own health.

It is so frightening when you're tangled up in it. Often the littlest thing I read or hear about can plant a seed in my brain and the seed with germinate and the thought will take off like kudzu, constricting around me, tying me down in its knotty vines until I can't move and pretty soon the thoughts overtake me until I don't feel like I even exist anymore. Maybe you've seen the way kudzu can swallow a car or a building. The obsessive thoughts, the images of my sweet baby's head smashed on a tile floor, they swallow me the same way.

I hate the way my brain torments me. It feels like I have two minds - the one torturing and the one tortured. I can see where it might even feel as if you're being haunted by an entity outside of yourself because when these horrible images and thoughts pop into your head, it can feel like they aren't coming from you and you wonder then, where are they coming from? Why won't they go away? Why can't I put my baby down for a nap without seeing her blue and suffocated and feeling like I need to start planning her funeral? Why can't I just make it stop?

That's where the guilt comes in. Why can't I make it stop? Am I weak? Have I gone crazy? And worse yet, worst of all, how is this affecting my baby. What a tragic irony. You fear harm coming to your baby and somehow your fear of harm becomes the very thing that might be the most harmful to her. Surely she must feel your tension and then, is she just as scared as you are?

That's what everyone will tell you when you have Postpartum OCD. You had better cut it out or you'll make your baby crazy. The baby feels everything you feel, they say. She'll pick up on your fear. You don't want to make your baby scared, do you? 

These are hard words to hear when an illness you can't control is clawing at your psyche. You may think you're only trying to get someone to see logic and begin to behave rationally, but telling a woman with any postpartum disturbance (depression, anxiety, OCD etc.) that she is going to hurt her baby if she doesn't stop acting this way isn't helpful. It's harmful because it piles up even more anxiety, shame and guilt. In my case the guilt is the worst, but having someone tell me I should just stop behaving the way I am also makes me mad. Adding anger to an already frothing stew of anxiety and guilt will only make the pot boil over.

I guess what people don't understand about my OCD is that I already see the logic that it seems I don't. I already know I'm being absurd. There's this strange detachment that comes along with it for me. I can see myself getting more and more out of control. I can tell myself it's just the disorder. I know I have it, yet sometimes I am powerless to stop it. Someone'll want to hold the baby. I'll start seeing images of the baby gasping in the ICU with pertussis. I'll try to talk myself out of it. It's ok. The baby's going to be fine. But the images won't go away, or I'll be bombarded with more and more images of the baby coming to harm and these are detailed images worse than anything you've seen in a horror movie. I'll know it's just the OCD and then I'll start to heap guilt on myself. Stop feeling this way. You're being crazy. You're a mess. It doesn't always work and then I'll have a panic attack.

No one wants to be this way. I don't choose it. I don't get pleasure from worrying and being afraid. Don't you think if I could stop that I would? I don't get anything out of being this way except pain and psychological imprisonment.

When the baby was born my OCD grew intolerable. It was as though I put on a pair of glasses. Imagine that those glasses were the wrong prescription. In fact, they were the glasses of someone who is practically blind, so the lenses are thick as bottle bottoms. When I look through them the world I see is distorted, ugly, scary, confusing. I can't make sense of what I see with these glasses stuck on my head and I can't get them off, so I'm only viewing the world through a messed up lens and staggering around, knowing I'm wearing the wrong glasses, but desperately trying to walk upright, to function normally and to find my way around in spite of them. 

I can't see clearly yet. I wish I were writing this having healed, but I'm not. I want to heal and I'm working on it. I sought help and getting better isn't easy. It's hard when other people don't understand and when they can't feel how you feel or see things the way you do. It's especially hard to ignore the criticism and judgment from people who think they're only trying to help you.

What I hope for myself is that soon I can pull the glasses off and play outside with my beautiful baby and see a world that welcomes both of us. A world of peace and calm, where the vines will flower and everything feels safe again. 

If you are struggling with any Postpartum condition or have a loved on who is, I find this site, Postpartum Progress ,very helpful. It has lists of resources where you can get help and every day there are articles and stories by women who have gone through similar experiences.


Green said...

It was very brave of you to write this. I'm really proud of you for sharing something so painful and personal.

Amber@Beyond Postpartu said...

I wish you continued healing! Thanks for sharing so openly.

Anonymous said...

I could have written this myself. I also have OCD and like you it's more obsessive though I have compulsions as well.

Anonymous said...

I think you are very gifted.

BTW - have you ever seen this food site:

(click on the Foods section)


JDogg said...

You are a good mom, and you should know that you are on the right path if you are working on getting better. I can't imagine having any OCD with my girl. Too bad I can't make it there from Tampa this weekend.

Natalie said...

Wow. I just thought I was neurotic, but I am now seeing a lot of myself in what you have written.

I am terrified of holding them too close to the edge of a balcony or place where they could fall. Even if I am holding them tightly I think "what if they lunged out of my hands and over the balcony?" and then, I see their little bodies, on the ground, under me...I'm paralyzed.

My oldest is 4.5 and I still have those thoughts. They get easier, but I think I've always had them, just tried to ignore them. Interestingly enough, my therapist always said "I wouldn't want to live in your brain, it never stops" but didn't diagnose me, so what does that mean? I know you aren't a therapist, but by writing this, you have helped me, and for that, I thank you.

I hope you find your way out of the fog soon. I know what you mean about "knowing it is absurd, but not being able to stop the thoughts" because that's exactly what it is like for me.

They say knowing is half the battle. I really hope 'they' aren't just lying to us all.

EricaM said...

This post is amazing and honest. Super awesome. I don't ever talk about my OCD but it's rampant at times. Including taking 45 minute showers to scrub my body over and over, etc. That kinda stuff. But I try super hard to overcome this junk. Thank you for being so honest.

Anonymous said...

I'm sorry you are dealing with this. I have OCD too; I had it before I had my baby, but mine also got WORSE after I had the baby. It's so hard. I don't want to talk to anyone (medical) about it because I keep trying to "will" it away, and I already have enough health problems to deal with. I'm just tired of it though. I get very anxious and obsessive, and I also have a couple of compulsions. Nothing that anyone outside my family would notice, my my immediate family knows.

Paige said...

so much of that sounds so familiar, especially about getting hung up on things. The first obsessive kind of thing I remember was in grade school where I would get a word in my head and have to keep spelling it. I specifically remember having to spell synopsis repeatedly in my head, while playing a basketball game--the letters had to correspond with the dribbling.

I cannot imagine the added stress of a baby. Good luck!

anne said...

A beautifully written portrait of an OCD sufferer (and I know, because I am one [and was a psychiatric NP in a former life so there's that]). I'm so sorry you're having such a flare up after the birth of Baby Lawns. It makes things so much harder doesn't it?

I read that you are working on this but wanted to throw out something that worked incredibly well for me in case it might help you: acceptance commitment therapy. It was a godsend and took care of several longstanding obsessions and a couple of major debilitating compulsions. Part of my therapy was reading Stop Obsessing by Edna B. Foa - good stuff.

Thanks for drawing some attention to this.

Arwen said...

I've been diagnosed as mild OCD in the past and I always thought that the Psychiatrist was the one who was crazy because obviously I have anxiety disorder... I've been wrong. I lucky in that my obsessive thoughts only bother me about certain things but I've definitely been there.

My biggest obsession is proper seatbelt placement especially now that my kids are both in boosters rather than car seats. Ugh. That particular obsession was borne out of a horrific story I read on the internet years and years ago when my eldest was an infant. And now, years later, I still envision the things that happened in that story *every *single *time my kids buckle up. My eldest (she's 9) hasn't legally required a booster for 2 years now but until she grows to the point where it's obvious that the seatbelt fits her shoulders and hips the way that they are designed to, she'll stay in it even though none of the other kids in her class have used boosters for quite some time. It's horrible of me, I know, but when she asks why she has to use a booster when the other kids don't I tell her that maybe their parents don't love them as much as I do her... which I know is horrible of me...

Anonymous said...

I'm another one with some OCD issues as well as anxiety and depression, which makes it hard for me to let my kids go off without my eagle eye and superhuman ability to keep them from danger. It's definitely a crappy deal and I resonate with your story and I hope you're feeling more psychologically healthy soon.

Gina said...

You could have described me as a child - the "bad habits" - I used to go through a ton of them. And even now, if I do one, I find myself feeling like I could just do it over and over and over, so I have to immediately distract myself before I fall into that trap.

And the obsessive worrying and fears - I have them. I never once considered that it might be OCD, because like you, I thought that OCD was the tapping the door frame, counting things, etc. You have educated me.

JoeinVegas said...

Things rolling around inside your mind seem the worst to me, not being able to control what you supposedly should.
Hope it gets better.

Rich said...

I wish I knew what to say to make things better. Hopefully your husband is supportive and understanding, given the recent stresses. All the best.

Suffer Kate said...

What impresses me the most about you, Madame Lawns, is that you understand what's going on and you realize that what you think about won't happen. I am stunned by the depth of this entry, by the way. I wish there was some way I could assuage your fears, but I went through the same thing. I'm still OCD when it comes to the pets, now that the kids are teenagers.

Heather said...

Babe. I am so sorry to hear how much you are hurting right now. Every new mom goes through some postpartum; how can you not with hormones rocketing through your body and major sleep deprivation, but what you are experiencing is even worse. I am glad you are getting help and I hope you continue to feel better. I think seeking out quiet places to meditate is such a wonderful way to find alternative coping mechanisms. All of us with stress in our childhoods found ways of coping with the uncontrollable fear whether food, drugs, sex, drinking, OCD behavior. How brave of you to stand up and fight, and seek help. You are doing the hardest thing ever to protect your daughter and I know you're going to win cause you're a winner.

Tracey said...

Being a new mom is hard under the best of circumstances. You are very brave to deal with this "rationally" in that you know it is irrational. And you are very brave to share your story. Good luck to you.

James said...

I originally read this when there were no comments, and couldn't possibly think of how to reply.

It was was amazingly powerful and i respect you even more so for putting it publically and i wish i had your fortitude.

I can completly understand what you mean about the thoughts - I've had this for a long time, however i was diagnosed as bipolar, given the massive swings that i have.

I agree with JoeinVegas. Its just how the particular thought gets stuck with you and its almostlike it's in spin cycle on a dryer as a friend put it...

I wish you well with everything that happens

Shannon Culver said...

I have a nephew that this really helped me understand. He's 9, and has 'bad habits'. Insight into what might be happening in his little mind was a gift that will help immensely. His mom also found it so valuable. Putting yourself in public for all of us to know about your secrets was incredibly brave. Know that your bravery will make an important impact on another young person.

Dayna said...

After watching that series last year on OCD people, I realized that some of the things were me. People's hands, I always notice them and they bother me. The girl on tv referred to them as "soft hands" and I knew axactly what she was talking about.

Sinclair said...

You are not alone WL

Hope this post helps.

Anonymous said...

I just want to let you know that one of the first things that I thought about you when I met you this week was how calm you seemed with your baby. I was even going to mention something to you about it. To me it seems like young mothers today are so much more at ease than I was when I was younger. So I was very surprised to read this passage. I know your struggles must be hard. Writing has always been a healer for me as I am sure you already know. Good Luck and keep up the good work. I can't wait to come back down South. Your new neighbor.

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