Postpartum OCD vs. Postpartum Anxiety: How To Spot The Difference

Written by Cynthia Radnitz, Ph.D.

Becoming a parent can bring a new level of worry into your life. Of course, some degree of worry is understandable when you are responsible for a new baby. But sometimes the worry can become persistent, overwhelming, or difficult to control.

Postpartum anxiety and postpartum obsessive-compulsive disorder are both conditions that can emerge or worsen after childbirth. Approximately 10% of new parents experience postpartum anxiety and roughly 3 - 5% experience postpartum OCD. 

So how can you tell whether you have one or both of these conditions? Although the two conditions can overlap, understanding how they differ can help you recognize when it may be time to seek support. Let’s talk about it.

What Is Postpartum Anxiety?

Postpartum anxiety generally involves excessive or persistent worry during the period after childbirth.

The concerns may focus heavily on the baby, but they can also involve many other concerns, like your own health, your relationship, finances, or returning to work.

Many experiencing postpartum anxiety find themselves thinking:

• What if my baby gets sick?

• What if I am not producing enough milk?

• What if something happens while they are sleeping?

• What if I can’t handle going back to work?

• What if I am doing something wrong?

Postpartum anxiety may also include physical symptoms such as tension, difficulty relaxing, racing thoughts, trouble sleeping even when the baby is asleep, or feeling constantly on alert.

Anxiety disorders can first appear during pregnancy or after delivery, even in people who have never experienced significant anxiety before. Many have found relief from this anxiety through treatments like CBT.

What Does Postpartum OCD Look Like?

Postpartum OCD also involves anxiety, but is marked by the presence of obsessions and compulsions.

Obsessions are unwanted thoughts, images, or urges that repeatedly enter your mind and cause distress. During the postpartum period, these can center around topics such as the baby's safety, contamination, and germs.

These thoughts can be particularly frightening because they often involve the things the parent cares about most. They are also intrusive, unwanted thoughts inconsistent with the person’s values and behavior.

Compulsions are a strong, hard-to-control urge to do something. Someone with OCD may feel compelled to do something to make sure the feared outcome does not occur. With postpartum OCD, this can look like repeatedly checking if the baby is breathing, excessively washing and sterilizing bottles, or avoiding being alone with the baby.

Postpartum Anxiety vs. Postpartum OCD

There is not always a perfectly clean dividing line between the two, so it’s always important to get an accurate evaluation from a clinician experienced in both OCD and perinatal mental health.

In general, however, we look for the pattern. With postpartum anxiety, worry may move from one realistic concern to another and feel difficult to turn off. With postpartum OCD, fears are more likely to become repetitive and intrusive and lead to rituals or avoidance.

One of the clearest differences between postpartum anxiety and postpartum OCD is often what happens after the worry or intrusive thought appears. Does the parent feel the need to do something to alleviate their anxiety? Does this need feel impossible to stop? Does the parent feel the need to do the same behaviors again and again?

How Is Postpartum OCD Treated?

Postpartum OCD is treatable. One of the primary evidence-based treatments for OCD is Exposure and Response Prevention (ERP), a specialized form of Cognitive Behavioral Therapy. ERP helps you learn that you can experience uncertainty or an intrusive thought without needing to respond to it with a ritual.

At CBT Specialists, our clinicians have advanced training in treating OCD using approaches including ERP and I-CBT. We also have expertise in treating perinatal mood and anxiety disorders using evidence-based approaches such as CBT and Interpersonal Therapy.

Advanced Treatment For Postpartum Anxiety & OCD In Rochelle Park, NJ

New parenthood already comes with enormous change. If you’re experiencing postpartum anxiety or postpartum OCD, don’t face it all alone.

CBT Specialists provides evidence-based treatment for OCD, anxiety disorders, and perinatal mood and anxiety concerns. Our doctoral-level clinicians, Dr. Julie DiMatteo and Dr. Cynthia Radnitz, offer in-person and online.

During a free 15-minute consultation, we can discuss what brings you to therapy, answer your initial questions, and determine whether our approach may be a good fit.