perinatal depression, pregnancy, depression, pregnant, OCDPhoto: 123rf.com

At some point early on in her pregnancy, every woman learns that she should avoid unpasteurised dairy products, raw or undercooked meat, soil, cat litter and unwashed food products.

Each can carry a parasite that could cause toxoplasmosis. And although the numbers are very low (about three in every 100,000 babies are born with congenital toxoplasmosis), it’s a serious infection that can deform or even kill.

When artist Elizabeth van der Beugel read about toxoplasmosis for the first time, she instantly recalled buying sausages a few days earlier from her local butcher and noticing he hadn’t washed his hands. Not being able to remember whether she had washed her own hands on coming home that day, she panicked.

She wondered whether other items in the fridge next to the sausages were contaminated. She realised that the entire contents of the fridge, as well as surfaces in her kitchen and the rest of the house, could be affected.

In addition to triggering a major cleaning frenzy, her fear of infecting her unborn child made her adopt an excessive handwashing routine. It became more extreme by the day.

Abnormal Fears

Soon, Elizabeth was meticulously and repetitively cleaning all her food, as well as every piece of cutlery and crockery. A meal could take up to four hours to prepare. She also spent hours on the Internet researching toxoplasmosis.

Elizabeth mentioned her seemingly disproportionate concern to her midwife and dropped hints about the changes in her behaviour. But she was told not to worry too much, as most women bring up similar issues at some point during their pregnancy. And, by Elizabeth’s own admission, her attempts to ask for help were thwarted by her tendency to play down the issue, not wanting to make a fuss or be perceived as an attention-seeker.

“I simply struggled on and my husband could do nothing but watch my conduct and confidence deteriorate,” she says. “As the months went by I stopped working, going out and accepting visitors to our house – all out of fear of contamination.”

Medical Help

When she was eight months pregnant, Elizabeth’s husband decided to take matters into his own hands after reading an article about depression during pregnancy.

“He phoned our midwife and made an appointment,” explains Elizabeth. “We told her everything that had happened. She was really concerned about my level of anxiety.”

The midwife referred Elizabeth to a counsellor who finally diagnosed her with perinatal Obsessive-Compulsive Disorder (OCD), a temporary – but much misunderstood – maternal mood disorder that aff ects new mothers in the period before and after giving birth.

She was put on a Cognitive- Behavioural Therapy (CBT) programme which focuses on helping patients find practical strategies to change the way they think, feel and behave. By the time she gave birth to a healthy son a few weeks later, she seemed to be back to normal.

Another Episode

Then, five weeks after the birth, Elizabeth spotted a report about atoddler who had been abused and subsequently died of his injuries. Like any other parent, she was aff ected by it. But she tried to put it at the back of her mind. And even though related thoughts and images kept popping into her head, she managed to ignore them with reasonable success.

That is, until one morning when her son was eight weeks old.

Elizabeth woke up with her head full of horrific thoughts of babies being abused and injured. No matter how hard she tried to get rid of them, the images haunted her day and night and grew more disturbing.

“I started thinking that I must want them to be in my head,” she explains. “What did that say about me?” Soon, the visions in Elizabeth’s mind started to feature her own baby as the victim and herself as the perpetrator.

“Weeks went by and I didn’t tell anyone. I was so scared, embarrassed and confused. The few times I did try to confide, I made no sense. I couldn’t go into details about what I was seeing.”

The situation was so distressing that Elizabeth could only see one way out. But just as she was planning to end her own life, what she calls “a last shred of self-preservation” made her tell her husband everything.

“He was amazing. He didn’t question me, he simply phoned my doctor who referred me back to my counsellor immediately. He knew straight away that I was suff ering from another episode of perinatal OCD.”

In retrospect, Elizabeth feels that her own lack of awareness of perinatal OCD and, more crucially, the lack of knowledge among health professionals was among the most terrifying aspects of her experience.

“I was so afraid I was going mad and that they would take the baby away from me,” she says. “It was all so shameful and so against how one is supposed to think and behave as a new mother.”

Indeed, Elizabeth is now convinced that perinatal OCD, though not caused by it, is certainly aggravated by the cultural expectation of mothers.

“The reason I didn’t seek help is that I was ashamed of myself,” she says. “I felt that I had failed at being a good mother at the first hurdle. No one wants to admit that they can’t handle something as normal as being pregnant.”

Extreme Lengths

As stated on the website of the charity OCD-UK, there’s no danger of mothers with the condition harming their children. Quite the opposite is true: OCD is typified by the extreme lengths that mothers go through to protect their children from the perceived threat of harm.

Two years later after giving birth to her first child, Elizabeth became pregnant for a second time. In addition to being able to use some very powerful CBT techniques on herself and placing a self-imposed ban on using the Internet, she had more support and regular visits from her midwife who, like her GP, was well prepared and knowledgeable about her condition.

“Midwives and health visitors are more educated about the condition now,” she says. “But considering perinatal OCD is common and easy to treat in most cases, it’s crucial that not only health professionals pick up on it early but also that public awareness is raised.”

 

This story was originally published in the March 2014 issue of Simply Her.