• Erin Apple

My Perinatal OCD Diagnosis

When I was 18 weeks pregnant, I tearfully broke down in my therapist’s office. I had been seeing this same therapist for over a year, dealing very successfully with my previously diagnosed agoraphobia, an anxiety disorder marked by avoidance of feared situations. I had made great progress, but lately, I felt as if I had come unraveled.



The Warning Signs

It all started when I first learned I was pregnant. The minute I got my first faintly positive pregnancy test, my tendency to over-Google everything came on full-force. My husband and I had dealt with some fertility struggles so I refused to believe that this pregnancy was real and here to stay, and I researched everything I could that day. I read in some online forums that if my early pregnancy was progressing properly, my faint pregnancy line test should roughly double in darkness every two days, so I went out to the store and bought several more boxes of tests. I obsessively checked those tests nearly every morning, feeling sick fear in my stomach that the ever-darkening line would start to fade away, indicating I was losing the pregnancy. It took 11 tests over 16 days for me to finally feel satisfied with the darkness of the test line, and even then I still took another test or two a couple of weeks later, just to be sure.


That sick, fearful feeling persisted though, and I became obsessed with the idea of miscarrying. I spent hours every day reading about miscarriage statistics, signs and symptoms, delving deep into online forums to read about others’ heartbreaking experiences. On top of that, I began to fear using the bathroom, waiting for the dreaded moment that I would see blood. Every time I went to the bathroom, I started obsessively checking my underwear and toilet paper for blood throughout the day, all the while focused on that magical 12-week “safety” mark when I would no longer have to worry. I felt so scared, sad and incredibly anxious during this time, but I mostly blamed it on my terrible morning sickness which was making me feel miserable all day and night and preventing me from doing my favorite anxiety management activity – running.

Seeking Relief

By the time 14 weeks rolled around, the morning sickness let up and my miscarriage fear subsided, but I felt no better. My obsessive thoughts changed at this point – I no longer feared losing the baby, but instead felt obsessively worried about how becoming a parent would change my life, and how pregnancy would change my body. Having lived through an abusive relationship in the past, I had spent a long time and a lot of hard work in therapy rebuilding my body confidence. To see my body changing and to not know how my life would soon change in other ways was overwhelming. I turned to my familiar source of temporary reassurance – Google.


All day, every day, nearly every free moment was spent worrying and researching to try to reassure myself that my life and self-image would not be ruined by parenthood. I cried over blogs where women shared the hardships of life with children. When I read studies on difficulties working mothers faced and looked at in-depth feminist perspectives on the culture of modern motherhood I would cry some more. I read about and became terrified of postpartum depression and other mood disorders, convinced that I would absolutely fall apart once the baby was born. All of this made me feel like I wasn’t strong enough to handle these fears of the future and I felt desperately guilty for having them.

The Downhill Turn

Deep down, I remembered that this pregnancy was something we had wanted so badly and had struggled for, so to lose my feelings of joy and excitement made me feel like something was terribly wrong with me, that maybe I wasn’t cut out to be a mother after all. I tried to stop Googling, but I just couldn’t – the compulsion to search for reassurance was like an itch that desperately needed to be scratched. I wasn’t enjoying my pregnancy and daily life became a struggle where I could just barely manage work, sleep and obsessive reading, and no more.


On top of this, I began to have regular intrusive thoughts of harm coming to loved ones and pets. It wasn’t just the baby and myself that I was worried about – I began having vivid mental images of my husband falling down the stairs or having a heart attack, my parents drowning in their new pool, or leaving my front door open accidentally and my cat getting outside and being hit by a car. Often I had to physically shake my head to make the thoughts stop or get up to repeatedly check that I had actually shut the front door, but the relief was only temporary. Driving on the highway (already an agoraphobic trigger for me) became unbearable, as I was terrified I would panic and lose control of the car. Being a passenger was no better, as every car that passed us on the road triggered visions of fiery, fatal collisions. Often, I lashed out at my husband for driving too fast or simply sat in the passenger seat and cried.


My brain often felt as if it was on a constant loop of uncontrollable anxious thoughts, and my biggest wish was just to crawl out of my body and brain for just a few minutes to take a desperately needed break from the inner turmoil. There were numerous days I felt as if I was losing control of myself. I no longer felt safe in my home or my body, because I lived each day on the verge of panic. On top of that, I irrationally feared I was losing all control and going completely mad.

Breaking Through the Shame

I kept all my fears and intrusive thoughts inside and put on my best happy face in public, scared that I was going crazy. I felt too much shame to bring this up with my friends or even my therapist until one day I finally broke down to my husband. Sobbing inconsolably, I talked about the impending birth of our child and kept repeating “please don’t let this ruin my life.” I talked about my guilt and how my brain felt broken. I wept into his shoulder, telling him that he deserved better than me, that he deserved someone who could be happy and enjoy life with him. I felt like such a failure. It was a dark moment for me, but he consoled me and encouraged me to share these feelings with my therapist, which I finally agreed to do. A week later I spilled all of my thoughts out to my counselor during what was supposed to be a routine check-in session, something that was not fun or easy for me to do.


But it got me help. We talked and my therapist told me that these symptoms sounded very much like OCD. I recall feeling relief that this terrible thing that I was dealing with actually had a name. We knew I had some obsessive tendencies already, but something about pregnancy (hormones, brain changes, loss of control or something else) had triggered the full-blown disorder. She gently suggested medication in addition to therapy, something I had been too scared to pursue for anxiety in the past. But I was desperate for help. I went to my doctor, who wrote me a prescription and a referral to a psychiatrist.


The day I filled my first antidepressant prescription, I stayed home from work and spent a total of 11 full hours Googling SSRI medications during pregnancy, reading every bit of information I could find and looking for reassurance that I was making the right decision. Despite having the support of my therapist and OBGYN, I desperately feared making the wrong decision and hurting my baby. It took another hour of crying in front of my pill bottle that evening for me to finally take my first pill. That action turned out to be a huge step in the right direction.

Hope for the Future

I am still in the early days of therapy and medication management for perinatal OCD. I have a long way to go, but I have something now that I didn’t have before – hope. Now I know what’s going on, and I have hope that with the aid of my medical team, I will get better. Hope is crucial.


Perinatal mood disorders (most commonly, anxiety and depression occurring during pregnancy or the postpartum period) are incredibly common. The only disorder I had heard of was postpartum depression, but I hope that by sharing my story, more attention will be brought to anxiety, OCD and other mental illness associated with pregnancy and birth and that women and our doctors should be on the lookout for symptoms not just in the postpartum period, but during pregnancy as well. Our culture must reject the stigma surrounding these common and debilitating illnesses. I had no idea that anxiety disorders such as OCD could develop during pregnancy itself, not just in the postpartum period. I had no way to recognize that what was going on was abnormal since worries and fears during pregnancy are common and profound struggles with new motherhood are normalized.


Until we have a better medical protocol in place for routine mental health screenings during pregnancy and after birth, women, unfortunately, need to be our own advocates. If you are struggling, please share your experiences with your doctor, and don’t hold back. Recognizing that you are struggling and deciding to take that first step to get help requires incredible personal strength, and for that strength, every one of us who struggle with mental illness should feel very proud.


The strength I have developed will absolutely get me through this – I believe that. And, dare I say, I believe that the strength and knowledge I’ve gained will help make me a darn good mother to my daughter when she makes her debut.

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