What if... The horror of perinatal OCD

I remember the exact moment the first intrusive thought unexpectedly landed. I just knew that something had happened that couldn’t be undone. You can’t unthink a thought. You can’t go back to the blissful time before your mind threw up the worst thought imaginable. I was rubbing my huge pregnant belly - 29 weeks pregnant with twins - and then ‘what if you ever abused your babies?’ Such a silly thought. It should have been so easy to dismiss. But I couldn’t. It stuck. I started drowning in excruciating fear and doubt as unwanted intrusive thoughts consumed every moment. So began a seemingly endless marathon, one that I hadn’t signed up for and hadn’t even known existed! But as a Christian I believe that the Lord is using even this for good. I pray that my story will resonate with and encourage someone else who finds themselves struggling with the nightmare of OCD. [a,b]

 

From the moment the first niggling seed of doubt popped into my mind, I tried to solve it. Why I had thought it? Where had it come from? What did it mean? What if I thought it again? What if I couldn’t stop thinking it? How could I stop it? It had to stop before the babies arrived.

For the next 6 weeks, until the twins were born, I became totally focused on the urgency of getting back to my blissful pre-first-thought self. I felt as though I had Tourette’s of the mind. Disturbing, dark, violent thoughts of me hurting my babies repeatedly flashed into my mind, each bringing a jolt of searing pain and shock. I just wanted to be free of these thoughts and enjoy this special time. The possibility of having these thoughts when the babies were born terrified me. I’ve never felt terror like that before. I was afraid that somehow then the thoughts would be more real and dangerous. I felt like I had failed as a mother before I had even begun. My husband was supportive, calm and reassuring, but he couldn’t pull me out of this spiral.

 

Our twin boys were born early, at 35 weeks. They were so tiny, precious, perfect and fragile. After a brief respite of about a day, the thoughts flooded back, worse than during my pregnancy. I felt as though I was living in a dark horror movie, with me as the monster. After a few days of trying to stay calm and keep going as normal, I could feel the panic start to swell. How can you escape from your own mind? I rang the hospital bedside button in the middle of the night and asked one of the midwives for help. A lovely psychiatrist visited the next day. I told her everything. I was diagnosed with OCD, which had manifested during this perinatal period. She prescribed medication which, over time, helped take the edge off my panic and brought me down from the ledge so to speak.

 

Like many people, I had seen OCD as a quirky set of habits and rituals, often focused on cleanliness. I didn’t know that it could involve the torment of intrusive, unwanted thoughts of hurting those you love. It is an anxiety disorder that is characterised by unwanted thoughts and doubts, and the actions or compulsions taken to neutralise them. For me, the compulsions were mostly internal. I was stuck in my head arguing with, trying to solve or cowering from my thoughts.

 

The boys spent a few weeks in hospital feeding through nasogastric tubes, during which time they beefed up a bit and were discharged. Bringing them home was such a bitter sweet time. It reminded me of that line from A Tale of Two Cities, ‘It was the best of times, it was the worst of times’. My husband and I worked around the clock looking after our precious boys. At the same time I was drowning in the thoughts. I remember thinking that I must just keep going. I mustn’t give up. I clung to Jesus. I found the Psalms very encouraging. He got me through each day.

 

I was particularly terrified of looking after the boys on my own, when my husband had gone back to work and my mom had gone back home to South Africa. I struggled with the enormity of facing each whole day, so I broke it down into jobs, the next feed, the next load of washing, etc. I am so grateful that by God’s amazing grace I was able to look after my boys.

 

I found it very difficult to accept that the thoughts wouldn’t go away. My therapist asked what it meant to me if the thoughts continued. I just couldn’t face that reality. I felt that a life with these thoughts would be worse than death. It sounds so dramatic writing that down, but I really couldn’t see a future for myself if these thoughts didn’t stop.

 

Over the months, with the help of Cognitive Behavioural Therapy (CBT), I gained the confidence to face the thoughts head-on. My therapist encouraged me to be courageous. Before my OCD episode, I associated courage with climbing mountains or sailing solo across the ocean. I’ve come to understand that being courageous is about facing what you fear, whatever that might be. I faced the intrusive thoughts and my fear of hurting my boys through exposure therapy, and they slowly lost their impact.[c]

 

I was able to gain distance from the thoughts. I saw them as a reflection of my fear of hurting my boys, not an indication of intent. I stopped entertaining the possibility that I could somehow want to hurt them. I always knew that logically, but the thoughts and images were so consuming, frightening and vivid.

 

In confronting my OCD fears, it was important that I didn’t avoid my babies, even in subtle ways. I used to brace myself and wince every time I went to pick them up, kiss them or have any contact with them at all. I was afraid of what I might think, what new horror my mind would throw at me. I’ve learned not to try to block the thoughts when I feel that wave of fear. I think them on purpose, often to a tune like ‘happy birthday’ or whatever song I have in my head. The thoughts are still there, but this approach changes my emotional response to them. I used to feel extreme shame, disappointment, confusion and fear. All the time. Now I’m better at mocking the thoughts, dismissing them. If the fear of ‘what if I did that?’ starts to rise, I agree with the OCD thoughts. I say ‘yip, I’ll probably do that’. It’s a way for me to diffuse the anxiety by not engaging with the questions.

 

I remember saying to my therapist that I felt that my OCD was a pit that I couldn’t get out of. She challenged me to see it instead as something to learn from. I have learned so much. I have grown and matured. I have so much more empathy for those struggling with the pain of hidden mental anguish. I have a deeper love for and trust in the Lord. He gives me the strength for each moment and His love is my reason for being.

 

I also stopped believing that I had to be ‘cured’, that the thoughts had to stop, before I could be a good mum and spend time with my babies. I started to enjoy special moments and live my life with the thoughts still clanging in the background. I learned to accept that they will be there. I wasn’t just going to forget to think them! They weren’t going to stop just because I wanted them to. Ironically, the fact that I wanted them to stop so desperately is what made them stick harder.

 

It’s been nearly a year since my first core-shaking thought. Recovery wasn’t like a switch being pulled. It was and is a long process, with steps forwards and backwards. I slowly moved from the deepest blackness to a faint glow of light, and then I realised that I was getting better and I would be ok. I believe that this experience is shaping me into a stronger, more attentive and loving mother. I’m thankful for that.

 

I know that there is hope and light for other mums and dads walking this long, difficult road. Asking for help was an essential step towards recovery. I would suggest that you speak to your midwife, GP or Health Visitor if you’re struggling with distressing intrusive thoughts. It really isn’t easy admitting you’re ‘not ok’, but it will get the ball rolling with accessing help. Sharing with family and friends allows them to support and stand by you. In my experience, OCD doesn’t go away on its own. It just grows in secrecy and silence. Shining a spotlight on it disempowers it and allows you to live your life.

 

a] 2 Corinthians 1:3-4

b] Romans 8:28

c] Psalm 27:1