I remember being about 6 months postpartum with my son and suddenly having a thought (more like a vision) of doing something horrible to him. The thoughts become more frequent and occurred at completely random times. Unfortunately, I was a therapist for severely traumatized children prior to his birth, so I heard the worst stories ever. And, these stories spilled into my postpartum brain (I’m not going to divulge the nature of these thoughts because I don’t want to trigger anyone). I would stop and think, “Oh my God, what if I did this to my child?” “WHY in the HELL am I thinking this?” And, the worst, “WHAT is wrong with ME??” I didn’t tell anyone. I didn’t tell my husband or my homeopath (whom I tell EVERYTHING). I thought about telling a therapist, but I was afraid that if I told a therapist I would be reported to Social Services and I would lose him. So, I stayed quiet…for months.   Fortunately, what I did do is complete a wonderful and comprehensive 200-hour yoga teacher training. During the training, the importance of meditation was stressed. I learned that “I” am not my thoughts and a host of other ways of understanding and dealing with these scary and completely nonsensical thoughts.   And then, a dear friend had a baby. A few months postpartum, she came to me and said, “I am having terrifying intrusive thoughts.” I was so relieved because I was not alone. We shared our stories. She handled it better than I did, she told her OB and got support. Fast-forward a few years, after having my daughter and once again having dealt with postpartum anxiety and a new set of intrusive thoughts; I am finally on the other side of my postpartum emotional turbulence and determined to support other women in the postpartum period. So, I completed a training in Maternal Mental Health through Postpartum Support International and the 20/20 Mom’s Project.   Of course, the topic of intrusive thoughts was recurrent throughout the training. Once again, I felt the relief that I was not alone. Here are some facts on scary thoughts (borrowed from the Postpartum Stress Center Blog):
  • Scary thoughts are a very common symptom of postpartum depression.
  • Scary thoughts are negative, repetitive, unwanted, intrusive thoughts that can bombard you at any time. They can come out of nowhere.
  • Scary thoughts can come in the form of thoughts (“what if I burn the baby in the bathtub?”) or images (picture the baby falling off the changing table)
  • Scary thoughts can be indirect or passive (something might happen to the baby) or they can imply intention (thoughts or images of you throwing the baby against the wall)
  • Scary thoughts are NOT indication of psychosis. They may make you feel like you are going crazy but you are not.
  • Scary thoughts can be part of a postpartum OCD diagnosis (postpartum Obsessive-compulsive disorder) or they may occur in the absence of a full blown diagnosis.
  • If you have a history of OCD or tend to be a worrier or describe yourself as overly analytical or perfectionist, you may be at increased risk to experience this symptom. Then again, you may have NO history of any anxiety symptoms.
  • Scary thoughts will make you feel like you’re a bad mother. They will make you feel guilty and ashamed. Try not to beat yourself up about this. Remind yourself it is a symptom. It is not about who you are.
Research shows that 85% of mothers’ experience “baby blues” and 15% percent of those mothers develop postpartum depression (or other variations of Perinatal Mood and Anxiety Disorders), which include depressive symptoms, and intrusive thoughts that can become more frequent and distressing. James Leckman[i] of Yale found that 30% of healthy parents reported having thoughts of harming their newborns! Luckily, Yale University researchers are beginning to understand why healthy parents have these thoughts[ii]: They (Yale researchers) used functional magnetic resonance imaging (fMRI)—a technique that tracks blood flow and related patterns of activity in the brain—to see which neural circuits became active when healthy parents saw and heard their babies. Prior studies had examined parents’ brains as they looked at photos of their babies, finding activity in brain areas associated with pleasure and positive mood. But when parents in the Yale study heard their babies cry, the researchers observed activity in neural networks closely associated with obsessive-compulsive disorder (OCD), as well as in brain areas associated with social emotions such as empathy. Strikingly, it seemed that listening to their babies cry triggered a deeply anxious neural response even in parents who hadn’t been diagnosed with a psychological problem. The researchers offer an evolutionary hypothesis for the neural signs of anxiety they saw in these parents. They believe that, after the birth of a child, a period of high alert may have helped parents protect their babies from environmental harm in times when this was a treacherous and all-consuming task. “Those mothers who were more careful with the baby were more likely to have a baby live,” and thus pass on this obsessive-compulsive tendency. Dr. Leckman found that 95% of healthy mothers and 80% of healthy fathers began to exhibit OCD (a psychiatric condition characterized by highly distressing thoughts (obsessions) and ritualistic behaviors (compulsions)) type thoughts prior to the birth of the baby. The hypothesis is that “the healthy maternal brain is hardwired for a period of transient OCD.” A little bit of OCD might be helpful to a new mother, but too much (excessive worry/anxiety) or too little (detatchment/apathy) could play a part in Perinatal Mood and Anxiety Disorders.  When the thoughts move beyond what is needed for survival and become irrational, then the thoughts are no longer useful. What Can I Do?? If you are worried about the thoughts you are having, that’s a good sign!  Karen Kleiman rights in her book, Dropping the Baby and Other Scary Thoughts: “When scary thoughts feel inconsistent with your belief in who you essentially are, your character, and your personality, they are referred to as ego-dystonic thoughts. When a thought is ego-dystonic, it is in conflict with whom you fundamentally believe yourself to be. This inconsistency creates piercing anxiety. However, this distress, as disturbing as it feels to you, provides reassurance that these thoughts are anxiety driven and not psychotic. In fact, your anxiety is an indication that you are aware of the difference between right and wrong.” Good moms do have bad thoughts, especially when they are struggling with anxiety and depression. The thoughts do not mean anything, they are just thoughts!! However, thoughts have an energetic component, so they have an impact on our emotions and bodies that create more anxiety, depression, and tension. If you have an intrusive thought, remind yourself that is your brain playing a trick on you, it is a symptom of anxiety, and the more attention to pay to the thoughts, the more power they have. When the intrusive thoughts occur:
  • Distract yourself: Get your body moving, go for a walk, get outside, listen to music, find something that makes you concentrate (puzzles or some other task….preferably enjoyable!) or do anything that gets the brain into doing something else!
  • Tell yourself it is ok to think these thoughts, there is nothing wrong with you, everything is ok, everyone is safe, and you are a good mother for feeling that these thoughts are so scary and out of character for you!
  • Tell someone. Tell your partner, a friend, a therapist, your doctor, or anyone else you trust. Postpartum Support International has a number of programs to serve women who are struggling with PMAD’s. They can connect you with a therapist in your area, an online support group, and offer other support.
Lastly, reach out immediately to your healthcare provider, call 911, or go to the Emergency Room (also borrowed from the Postpartum Stress Center Blog):
  • If you feel that your thoughts are out of your control or that you cannot manage the intrusion call your healthcare provider
  • If at any time you feel you or your baby are not safe, call 911 or go to the Emergency Room.
  • If you have been told that your thoughts are worrisome to others but they seem real to you, or you feel that your thoughts make sense and everyone around you must be the crazy ones, let someone close to you know how you are feeling and tell them it’s an emergency.
If you are suffering from intrusive thoughts, please reach out. Talk with your doctor or partner. There are a number of groups at the Family Garden to connect you with other mothers and professionals or call Postpartum International to find a therapist or a support group. Taking care of yourself is taking care of your baby.
[i] [i] Abramson, Anna J. “The Postpartum Brain.” The Greater Good, Spring 2008: 36-39. [ii] Abramson, Anna J. “The Postpartum Brain.” The Greater Good, Spring 2008: 36-39.