Do you ever feel like you get stuck? Maybe this feels like getting stuck in a thought, or replaying a scenario (real or imaginary) in your mind over and over again. Maybe you get stuck until something feels just right and you can’t move on until it does. Perhaps you feel stuck because you have set limits and boundaries with yourself in an effort to keep yourself safe from imagined danger, like you can’t walk up or down the stairs with your baby because you’re afraid of the baby getting hurt. You might feel stuck in rules, like needing to wait three seconds after the light turns green before you can safely drive across the intersection. This “stuckness” might be highlighting some OCD-tendencies in your life and could be good information for treatment. 

Just because you have some OCD-like behaviors does not necessarily mean you meet the diagnostic criteria for Obsessive Compulsive Disorder, but it does mean that you deserve effective treatment and support so you can feel “unstuck.” OCD thoughts and behaviors can become more noticeable, especially in life-altering moments, such as trying to conceive and having a child. It can be our nervous system’s way of making sense of a world that feels so unorganized and chaotic. 

OCD often gets caught up in  safety, rules, and control. It is not about having an organized home or lining things up perfectly. Sometimes it is obsessive thoughts that replay over and over again, sometimes including graphic or violent images. These thoughts can be incredibly distressing. Why would you, a loving and caring person, be imagining a horrible car accident that you somehow caused in your imagination? Why would you, a peaceful and calm human, think terrible thoughts about someone else that you don’t even know? What do these thoughts mean or say about you? They don’t define you and they don’t mean you want them to happen. You are not your thoughts. Your thoughts might just mean you’re stuck in a cycle or loop. 

The OCD cycle looks like this:

1. Have a distressing thought (this could be triggered by something or just appear out of the blue)

2. Feel anxious or distressed by it

3. Do a compulsion or ritual to manage the anxiety

4. Feel temporary relief

5. Start the cycle over

An example I see frequently in the postpartum period is when parents have a distressing thought of their child getting hurt. Sometimes this is attached to bath time, the baby being in the car, or going up or down the stairs. This thought causes anxiety because it goes past being a silly intrusive thought and into a thought that is graphic and scary. The parent has this thought, can’t get it out of their mind, and starts feeling anxious about it. They might then have the compulsion to stop giving the baby a bath, drive only in the right-hand lane when the baby is in the car, or need to scoot up and down the stairs instead of walking. Avoiding these situations provides temporary relief, but the next time they are faced with the situation, they will feel stuck again. 

Something of note is that postpartum OCD and postpartum psychosis often sound very similar, but they are quite opposite of each other. In OCD, the distressing thoughts are thought of as intrusive thoughts. They feel strange, distressing, and even scary. They can be shocking to us. In postpartum psychosis, one might have the same thoughts, but their relationship to the thoughts is very different. In psychosis, a person may believe certain thoughts are true or actually happening, rather than recognizing them as intrusive or disconnected from reality. There might be hallucinations, confusion, delusions, or significant changes in mood and behavior. Postpartum psychosis is a medical emergency and you should seek immediate evaluation and care if you believe you are experiencing psychosis. 

If you're not sure whether what you're experiencing is postpartum OCD, postpartum psychosis, or something else, you don't have to figure that out on your own. Reach out for help and let a mental health or medical professional help you sort through what's happening. You are not alone in this, no matter how scary the thoughts are or how stuck you may feel.