Scary Thoughts

Adele Morgan, with son Ryan, 8, recalls having obsessive thoughts after his birth. Experts say postpartum OCD is under-recognized.
Adele Morgan, with son Ryan, 8, recalls having obsessive thoughts after his birth. Experts say postpartum OCD is under-recognized. (By Brian Branch-price For The Washington Post)
By Stacey Colino
Special to The Washington Post
Tuesday, March 7, 2006

When each of her three kids was an infant, Nichole Ahern of Chevy Chase had recurring visions of tumbling down the stairs with the baby in her arms.

Last fall, Mindy Walker of Westchester, N.Y., had fleeting thoughts of letting her infant daughter drop out of her arms.

Adele Morgan of Hillsborough, N.J., says that the challenges of caring for her first baby made her think about putting him in the microwave or throwing him off the deck when he wouldn't stop crying.

None of these women ever harmed their babies, and all are successful, loving mothers. And these kinds of intrusive, unwanted thoughts -- mild versions of those associated with obsessive-compulsive disorder (OCD) -- are extremely common among new parents.

In a study of 85 new mothers and fathers conducted at the Mayo Clinic in Rochester, Minn., researchers found that 89 percent experienced distressing, intrusive thoughts related to their infants: images of the baby suffocating or being contaminated with germs, or worries about the baby having an accident, being harmed or kidnapped.

Most new parents take these unwanted thoughts in stride, and try to neutralize them by reassuring themselves, checking on the baby or enlisting support from others, the study found. "For most parents, this is just mental noise," says Jonathan Abramowitz, a psychologist and director of the OCD/Anxiety Disorders Program at the Mayo Clinic. "They dismiss it and move on."

Abramowitz admits to having had these thoughts as a new parent himself: While burping his daughters when they were infants, he sometimes considered what would happen if he whacked them too hard. While giving them baths, he occasionally wondered how hard it would be to drown a child.

But some new parents get very troubled about these thoughts. "People tend to become more distressed by these bad thoughts if they interpret them as meaningful or if they believe they should be able to control their thoughts," Abramowitz says. "They're the ones that develop problems."

Indeed, some women -- like Morgan-- develop clinically significant symptoms of OCD during pregnancy or the postpartum period -- a phenomenon that is vastly under-recognized, experts say.

While reliable statistics on postpartum OCD are lacking, the lifetime incidence of OCD in the general population is believed to be 2 to 3 percent. What distinguishes OCD symptoms from normal intrusive thoughts is partly the extent to which these ideas are anxiety provoking, irrepressible and persistent.

"To have a real obsession, it's an intrusive, unbidden thought, idea, or image that comes to your mind that you do not want and actively try to resist," explains Gerald Nestadt, a professor of psychiatry at the Johns Hopkins Medical Institutions in Baltimore. "You can't get rid of the thought."

Shortly after Vicky Valentine Henry, of Glen Allen, Va., gave birth to her son in March 2001, she began having distressing thoughts: While driving, she'd envision stopping short and her son flying through the windshield. She had fleeting visions of drowning him in the bath.

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