Postpartum OCD and Swimming

Swimming is a big part of my life, but during my pregnancies and the postpartum period after the births of my two girls, it was more than just a great way to stay in shape. It was my lifeline.

I had always been a “worrier,” but my anxiety got completely out of control when I was pregnant with my oldest daughter, Katie. I was terrified about riding in the car, crossing the street, eating un-pasteurized cheese—anything that could possibly harm my unborn baby. And for the first year of her life, I was constantly anxious: I worried about her coming in contact with even a speck of lead-based paint, cleaning products, medication, or spoiled food. To quell my anxiety about harm befalling her, I constantly asked for reassurance from friends, family members, doctors, and even, much to their chagrin, the poison control center operators. In the third trimester of my second pregnancy, my fears turned to the unthinkable—that I might hurt Katie, who at the time was three years old.

Was I like Andrea Yates, the mother who killed her five young children in 2001? Am I losing my mind? The thoughts were terrifying. Giving Katie a cup of apple juice was as anxiety-provoking as handing her a loaded gun would have been. As soon as I’d pour the juice into the cup, I’d think, “What did I put in her cup? There is an open bottle of dishwasher detergent. Did I really just pour juice or did I pick up the detergent bottle, too?” After smelling and examining it for five minutes, I would often dump the juice into the sink and refill the cup—over and over again. The relentless, intrusive thoughts were unbearable. Eventually I resorted to buying cases of drink boxes to avoid pouring juice, but my worries just found new ways to manifest themselves. A million times each day, I wanted to jump out of my skin and run away.

Too injured to run after being a distance runner for 20 years, I started to swim again after being away from the pool for over six years. For months, the only time I felt safe and somewhat calm was when I was in the water. I swam six days per week in the last two months of my pregnancy, taking one day off per week only because I was terrified of getting injured and not being able to swim. Although I was falling apart mentally, I was in incredible physical shape. I joked with the coach that I was going to give birth on the pool deck.

Unbeknownst to me, I was suffering from postpartum obsessive-compulsive disorder (OCD). According to Postpartum Support International, a non-profit organization committed to promoting awareness, prevention, and treatment of mental health issues related to childbearing, approximately 15% of all new mothers, approximately 600,000 U.S women per year, suffer from postpartum disorders. This includes the more-publicized postpartum depression, but also a number of postpartum anxiety disorders like OCD, posttraumatic stress disorder (PTSD), and panic disorder. These anxiety disorders can occur during the traditional postpartum period but are also common during pregnancy, as was true in my case.

People often associate OCD with obsessions about dirt and contamination, and this is one form of the illness. But the common thread is that suffers of OCD have an “intolerance for uncertainty,” according to Shelly Van Etten-Lee, a cognitive-behavioral therapist at the University of Michigan. If there is a zillion-to-one chance that something horrible could happen, it could, and that causes suffers of OCD extreme distress. Those with OCD perform mental or physical repetitive behaviors, or “compulsions,” in an effort to alleviate this intense anxiety. Examples of these behaviors include asking repeatedly for reassurance, excessive hand washing, ordering, or checking. Unfortunately, doing this may temporarily lessen the anxiety, but in the long run, it causes the anxiety to spiral even more out of control.

The two most beneficial treatments of OCD are cognitive-behavioral therapy (CBT) (specifically one method known as “exposure and response prevention” (ERP), in which a person confronts their fears in a systematic way) and antidepressant medication. Unfortunately, many women, their partners, and even medical professionals have limited knowledge of disorders such as postpartum OCD. To make matters worse, most mothers are ashamed and afraid to ask for help, and don’t recognize the condition as something that is both common and treatable. The symptoms of postpartum OCD are particularly confusing and scary to a new mom due to the media hype that surrounds the rare but critically dangerous disorder known as postpartum psychosis. It is true that both OCD and postpartum psychosis bring on bizarre thoughts; however, the similarities between the two illnesses stop there. With postpartum psychosis, the strange thoughts are the woman’s reality. With postpartum OCD, a woman is severely distressed and recognizes her distressing thoughts as irrational, so there is little to no actual risk to the baby.

However, the negative impact on the mother is incredible: OCD often severely limits her ability to care for herself, her baby, and her family. At the very least, OCD robs a new mother of the pleasures of parenthood. My experience is a testament to the fact that, with proper treatment, a mom can successfully overcome her OCD and regain control of her life.

I am very thankful to have had the Ann Arbor Masters swimming program as part the solution to overcoming my own postpartum OCD. I continue to enjoy the workouts and the friends that I have developed there, but, in the months before and after the births of my daughters, it truly was a lifeline. During my struggles, my Masters swimming friends were tremendously supportive—offering encouragement and often lending a compassionate ear. Swimming itself gave me a break from the terrifying thoughts floating around in my brain; keeping track of when the next 100 begins while I was physically tired was a welcome and refreshing distraction. It is well know that strenuous physical activity is a good way to manage stress, and my OCD created a sustained level of stress above anything I could have imagined. Masters swimming truly helped me through the darkest period of my life.

And, as for giving birth on the pool deck, my bag was packed for swimming on the morning my daughter Allison was born, but she was born in the hospital, not on the pool deck, at 6:20 a.m.—right in the middle of the morning Masters workout. Allison is four now, and I marvel at how much that little girl loves to swim! 

For more information, visit the Postpartum Support International website at postpartum.net and the OCD Foundation at ocfoundation.org.