Living with Perinatal OCD

If you think you are living with perinatal OCD, or even if you’re just not sure you’re doing well with your mental health, it’s important to talk to your care team so they can work with you to get you feeling better! The tips below can help you in starting and having these conversations.

How to Talk to Your Care Team

Decide who in your care team you feel most comfortable talking to. It doesn’t matter who it is, whether it’s your OB care provider, doula, lactation consultant, and/or your child’s pediatrician.

Let them know that you think your concerns are excessive and going beyond what might typically be expected for this time period. For example, “baby blues” are very common, but usually don’t get in the way of living your life or last for a long time — if your provider tries to dismiss your concerns as “typical,” reinforce that they are going above and beyond what is typical. You can also suggest that your care team give you one of the following screening scales, if they have not already, as they might help provide clinical evidence of what you are saying:

  • Perinatal Anxiety Screening Scale (PASS): The PASS screens for a broad range of anxiety symptoms during pregnancy and the postpartum period, though not necessarily specifically OCD. Score of 0-20=minimal anxiety. Score of 21-41= mild-moderate anxiety, score of 42-93 = severe anxiety. Learn more about the PASS.
  • The 4-item version of the Obsessive Compulsive Inventory - Revised (OCI-4): This is a new, ultra-brief measure which can be used as a routine screener for identifying likely OCD. Learn more about the OCI-4.

Request a referral to an OCD specialist if your provider does not feel comfortable treating psychiatric specialties.

Give information about your experience and symptoms. You might find it helpful to write things down beforehand so you can come prepared with a list to share, instead of stressing about remembering everything in the moment.

Make sure to ask questions! Some good ones include:

  • What are their thoughts on what you’ve described? Do they agree with your conclusions/diagnosis?
  • What are the treatment options available to you?
  • How experienced are they with OCD?
  • Who would they refer you to in their clinic/health system/community/etc., if they are not comfortable continuing on their own?

Once you are with an OCD specialist, ask more specific questions. Some good ones include:

  • What is their training with OCD?
  • What is their approach to treating OCD?
  • What should you expect from treatment with them?
    • How often will you be meeting?
    • Are there any side effects or other things you should be aware of?
    • How long before you might see results, based on their usual work?

Learn more about finding a therapist for OCD.

How to Talk to Your Family

It can sometimes be difficult for other family members to understand what you are going through with your perinatal OCD, especially if they’ve never lived with or known anyone who lived with OCD themselves. We created a section of this resource center for family members that they might find helpful, and read on for more tips.

Bring them into your therapy and/or medication management sessions. Your care team can be a resource in helping you explain what you are going through to your loved ones and the rationale for your treatment.

Practice appropriate communication — don’t be a mind reader or expect others to be a mindreader for you! Some other communication tips include:

  • Using “I feel…” statements.
  • Not assuming they understand you if you haven’t actually told them anything or explained things to them.
  • Giving explicit instructions, e.g. when it comes to baby care or housework.

Tell them when you need help or more support, and vice versa — when you need some time to yourself. Don’t assume that your support people don’t want to help you, or that asking them for help is a burden or inconvenience.

A Note on Suicidal Thoughts

The time before and after giving birth can be stressful for birthing and non-birthing parents alike. It is increasingly common for parents suffering from perinatal mental health concerns, including perinatal OCD, to have thoughts about suicide or hurting themselves, something referred to as “suicidal ideation.” These thoughts are very distressing to experience and even more distressing to think about telling someone else, for fear of what might happen to you and/or your child if you tell.

If you are living with these distressing thoughts, know that it is not your fault and you are not to blame. Suicidal ideation is treatable with professional help. Talk to your current care team about what you are going through, or find help today.