'When I came home after giving birth, I was unable to leave the toilet. I was thinking that I would transmit the germs from the toilet to my baby. I was washing my hands over and over again, up to my elbow. I could hear my baby crying outside, but I still couldn't stop washing. I was in a panic that I would infect my baby. Normally I am a meticulous and clean person, but I have never experienced anything like this before. I blamed it on being a mother for the first time, but it did not go away and increased over time. My mother came, took care of the baby and tried to comfort me, but I could not leave the toilet for 2 hours. I started to cry. I felt very bad because I couldn't take care of my baby.'
'I started to be afraid that I would do something to my baby. Actually, I got pregnant very willingly, I didn't understand why it happened. I was especially afraid that I would throw my baby out the window, and sometimes I thought I would stab him, but I knew I wouldn't do it, but this time I thought I would do it in case I lost my mind. I am so afraid. How can I think about such things? I never wanted to be alone with my baby. I always wanted a few people at home to block me if I did it. I collected the knives from the house.'
There are sample OCD stories above. The most common examples of obsessions that occur with various symptoms, especially after the first days of birth, are as follows:
She will infect her baby with germs and diseases.
She will stab her baby.
She will strangle her baby.
She will strangle her baby.
She will infect her baby with germs and diseases. p>
Those thoughts and images that suggest that she will throw her baby out of the window
She will poison her baby
She will harm her baby in any way
She will sexually abuse her baby.
Since these and similar thoughts will increase the mother's distress, she may resort to some compulsions or avoidance to eliminate them.
These are often:
Not being alone at home with the baby
Intensive repetitive cleaning, thinking that it will transmit germs to the baby
Knifes, scissors etc. removing cutting tools from the house
Repeatedly asking people at home whether they have harmed the baby
Staying away from your baby for fear of harming your baby, taking care of your baby Don't leave it to others
Avoid feeding your baby
Checking the baby to see if it harms the baby
Not changing your baby's diaper with the thought that he will sexually abuse your baby
It is in the form of avoiding news about child abuse and murders.
All types of obsessions and compulsions can be seen during pregnancy and the postpartum period. The most common obsessions are infecting the baby with germs etc. and being aggressive towards the baby in various ways. obsessions. The most common compulsions are cleaning and checking. The mother experiences distress, thinking that she will harm the baby or spread germs to the baby, and to avoid this, she begins to avoid the baby to be safe.
Pregnancy and the postpartum period are periods that carry risks for the emergence or exacerbation of many psychiatric diseases. It was observed that the symptoms started during pregnancy in approximately 18% of female patients diagnosed with OCD, and the symptoms worsened during pregnancy in 55%. The risk of OCD is slightly increased in post-pregnancy patients compared to pregnant patients. The reported prevalence rate in the post-pregnancy period is between 2-4%. It has been reported that in most cases of OCD that begins in the post-pregnancy period, it is observed more at the first birth, occurs within the first four weeks after birth, and has a sudden onset. The risk of postpartum OCD increases in people with a past history of major depressive disorder, obsessive and avoidant personality disorder or personality disorder, dysfunctional obsessive beliefs, and people who have had their first birth. Postpartum OCD has also been reported in men, but there are not many studies on it. The emergence of OCD in this period is due to increased responsibility in parents and being overprotective against threats, and this situation causes significant anxiety through misinterpretation. A number of obsessive-compulsive symptoms emerge in order to prevent these negative thoughts, the anxiety they create, and the potentially dangerous consequences that may occur.
& nbsp; It is suggested that fluctuations in oxytocin, estrogen and progesterone levels in OCD that begin during pregnancy and the postpartum period trigger obsessive-compulsive symptoms by causing irregularities in serotonin and dopaminergic functions, which play a role in the pathogenesis of the disease.
Cognitive behavioral therapy is the first choice for mild and moderate symptoms in OCD patients during pregnancy and postpartum; For severe symptoms, pharmacotherapy may be deemed appropriate by evaluating the cost-benefit balance. The first 3 months of pregnancy is the period in which the baby's organs are formed, which we call organogenesis. In this process, if there is a chance to carry out the treatment with only cognitive behavioral therapy without using medication as much as possible, this path should be followed; if not, the possibilities of serotonergic antidepressant or magnetic stimulation treatment, which are the most innocent group in terms of drug use and have an anti-obsessing effect, should be considered and decided according to the patient. During breastfeeding, all psychiatric drugs pass into milk.
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