by Alexandra Wykowski, LCPC
Reading Time: 10 minutes
Hi readers! I’m Alexandra. I’m Wellness & Co.’s newest therapist. I specialize in perinatal mental health, OCD, and anxiety related disorders. I love being able to support parents through the challenges they face during their parenthood journey. My experience in the mental health field has been varied, including providing intensive support services for children and their families, managing supportive housing for those with severe and persistent mental health struggles, and being a therapist for 7+ years. While I pull from a medley of therapeutic theories, Cognitive Behavioral Therapy (CBT), combined with Exposure and Response Prevention (ERP) grounds my work. I have a passion for working with moms and dads who find their journey into parenting…challenging.
In fact, it was the hardships I faced as a new mom that sparked my desire to become a perinatal mental health specialist.
Becoming a mother is a beautiful, life changing experience. But, for me, it was one that was complicated by Perinatal Obsessive Compulsive Disorder. As a therapist myself, I knew the signs, and I knew I should be seeking out help. But if I’m being honest, getting into therapy and possibly needing medication to work through my “sticky thoughts” was scary for me. It meant admitting I needed help when, for my entire life, I thought motherhood would just come naturally to me. I was worried about the judgment of others and felt some deep shame.
Even when I decided that I could no longer spend my days giving into my compulsions, I had a difficult time finding a therapist in my area that specialized in perinatal mental health. I made calls to therapy offices that went unanswered, and sent emails into the abyss. When I finally did get through to someone, there was a lengthy waitlist. It was an exhausting experience caring for two small children while spending hours a day checking and double checking things to ease my anxiety. At my wits end, I finally made an appointment with my primary care doctor. I remember walking in and telling him what medication I thought would work and what dose to start me on. I cannot imagine having to advocate for myself if I was outside of the mental health world.
I know there are other moms out there, like I was, who are afraid their mental health could affect their ability to be present for their family. In fact, 1 in 5 moms and 1 in 10 dads will experience a Perinatal Mood and Anxiety Disorder (PMAD). In addition, finding quality, effective treatment can be exhausting.
No parent should feel unheard or unseen. And they certainly should not be made to feel ashamed asking for help.
When the “Happiest Time” Becomes a Nightmare: Understanding Perinatal OCD
We are raised on a very specific narrative about parenthood: it is supposed to be a golden season of blissful bond-building, first giggles, and heart-melting milestones. But for millions of new and expecting parents, the reality can be a truly distressing and isolating experience.
Instead of warmth, they are met with frightening, unwanted intrusive thoughts–a harrowing reality known as Perinatal Obsessive-Compulsive Disorder (pOCD).
If your journey into parenthood feels agonizing rather than joyful, you are not failing, you are not a bad parent, and most importantly: you are not alone.
I remember sitting on my parent’s back porch where my husband, toddler, and newborn joined me for a visit with them. Mid conversation, I could feel the tears begin to well up in the corner of my eyes. I tried to shut the feeling down but it was too overwhelming. I had spent the morning agonizing over the fear that I had brought bed bugs into the home. I made and unmade each bed numerous times and spent more time than I care to admit looking intensely at each and every bug in our home. Had I been anywhere that was infested? No. Did I know anyone who’s home was infested? Again, no. But that didn’t matter to my brain. No amount of logic would suffice. Each time my brain responded with, “But what if you are wrong? What if the bugs can only be seen at night? What if you are not looking hard enough?” And so the cycle of thoughts, anxiety, compulsion and short-term relief continued.
The Hidden Numbers Behind the Silence
Unwanted intrusive thoughts are far more common during the perinatal period than most people realize. According to research from the National Institutes of Health (NIH):
- 7.8% of pregnant women experience unwanted intrusive thoughts linked to Perinatal OCD.
- 16.9% of postpartum mothers experience these symptoms—more than doubling after birth.
Despite how widespread pOCD is, Postpartum Support International reports that only a tiny fraction of affected parents ever seek professional treatment.
Why So Many Parents Suffer in Silence
One client I worked with had unwanted intrusive thoughts that were contributing to her depression. These thoughts led her to believe her baby didn’t love her. She found herself dissecting each reach her baby made to another person, each smile and how long it lasted, each moment the baby would cry when she held them. As she went for her check-in with her OB/GYN, she casually mentioned the anxiety and depression to the nurse. She filled a questionnaire with four questions all about depression, but they focused on suicidal ideation, which didn’t apply to her. The nurse did not ask any follow-up questions. She was embarrassed and felt like her anxiety made her a “bad mom.” So when the doctor came into the room and didn’t address her concerns, she didn’t bring it up again. In fact, she reported feeling a sense of relief at not having to face her fears and explain herself to her doctor. Unfortunately, this was a missed opportunity for the doctor and nurse to help her with her unwanted intrusive thoughts and refer her for treatment. It took another 6 months before she found herself in therapy.
If effective treatments exist, why aren’t parents getting help? The barriers to care are heavy:
- Shame and Guilt: Parents fear that voicing their intrusive thoughts means they are secret monsters.
- Fear of Intervention: Many terrorize themselves with the idea that opening up will lead to Child Protective Services taking their baby away.
- Misdiagnosis: pOCD frequently co-occurs with Postpartum Depression (PPD). Healthcare providers who aren’t specifically trained in Perinatal Mood and Anxiety Disorders (PMADs) often miss the OCD component entirely, treating only the depression.
What Does Perinatal OCD Look Like?
Most people experience fleeting, strange thoughts throughout the day and brush them off without a second thought. For someone with Perinatal OCD, however, these thoughts become “sticky.” They hook into the brain and refuse to leave.
Perinatal OCD is defined by a cycle of intrusive thoughts (obsessions) and the actions taken to relieve the resulting distress (compulsions).
1. Intrusive Thoughts (Obsessions)
These are vivid, distressing mental images or ideas that pop into a parent’s head. Common examples include:
- Fear or mental images of accidentally or intentionally harming the baby.
- Intense dread that the baby will contract a fatal illness or is unsafe outside the house.
- Highly specific “magical thinking” rules (e.g., “If I don’t take five deep breaths before changing this diaper, my baby won’t learn to speak”).
Crucially, these thoughts are ego-dystonic. This means the images are the exact opposite of who you are and what you truly want. Because they clash so violently with your love for your child, they trigger overwhelming anxiety, horror, and guilt.
I think it’s important to note here that Perinatal OCD does not have to have a theme revolving around your child specifically. For example, while pregnant, an expectant mom may have unwanted intrusive thoughts related to perfection and needing each report at work or each email they send to be “perfect.” While the concerns are not directly related to the baby or pregnancy, the fact that the symptoms arose during pregnancy or following childbirth could lead to a pOCD diagnosis.
2. Relieving the Panic (Compulsions)
To lower their intense anxiety or try to “undo” the scary thoughts, parents engage in compulsions, such as:
- Avoidance: Refusing to hold the baby, use knives while cooking, or stay home alone with the child.
- Reassurance Seeking: Constantly asking partners or doctors if the baby is okay.
- Hyper-Researching: Spending hours compulsively reading medical forums or articles.
- Mental Checks: Over-thinking every decision or repeating phrases internally.
While a compulsion offers brief relief, it accidentally reinforces the fear, starting the agonizing cycle all over again.
Another client of mine struggled with one sticky thought about accidentally dropping her newborn child while walking down the stairs. This is a pretty common worry of new parents. But for her, it stuck and it was painful. She even wondered to herself if having the thought over and over again meant she secretly wanted to drop the baby. She began to ask her husband to carry the baby up the stairs for bathtime. He did so thinking he was helping ease her anxiety. But the thoughts grew. Her brain suggested that maybe she shouldn’t just be afraid of stairs but anytime she is holding her baby. So to help alleviate her anxiety, she began to find reasons to not hold her own child unless she was sitting. As you can imagine this made it incredibly difficult to live a fulfilled life. She deserved to feel the joy of parenting… all parents do.
The Gold Standard of Healing: There Is Hope
The most vital thing to know about Perinatal OCD is that it is highly treatable. You do not have to live at the mercy of your mind.
According to the NIH, the gold standard of care for pOCD is a combination of Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP)1:
- Exposure and Response Prevention (ERP) gently helps parents sit with the presence of uncomfortable, intrusive thoughts without resorting to compulsions to “fix” them. Over time, the brain learns that these thoughts are just harmless noise, stripping them of their power.
With specialized care from a perinatal mental health professional, pOCD has a high treatment success rate. Parents can step out from under the shadow of fear, stop being bullied by “sticky” thoughts, and get back to living a life rooted in their true values… and loving their child in peace.
If you or someone you know is struggling with perinatal intrusive thoughts or anxiety, please don’t hesitate to reach out to me. From one parent to another, this is HARD. And for me, it has been such a beautiful experience to help moms and dads feel stronger, less afraid, and less lonely.
You don’t have to figure this out on your own. I’d love to connect for a consultation to learn more about what you’re experiencing, answer your questions, and talk about how I may be able to support you. My hope is to provide a space where you feel understood, supported, and empowered as you find your way through this season of parenthood.
Until next time,
Alex
Reference:
- Mulcahy M, Long C, Morrow T, Galbally M, Rees C, Anderson R. Consensus recommendations for the assessment and treatment of perinatal obsessive-compulsive disorder (OCD): A Delphi study. Arch Womens Ment Health. 2023 Jun;26(3):389-399. doi: 10.1007/s00737-023-01315-2. Epub 2023 May 3. PMID: 37138166; PMCID: PMC10155656.
Alex specializes in OCD, anxiety-related disorders, and perinatal mental health. She creates a compassionate space where clients can better understand their thoughts and behavior patterns, strengthen their sense of self, and build the confidence to live more authentically.
