What if I stabbed my baby with this knife?

One afternoon in January 2013, I gave birth to a beautiful daughter. She was five weeks early and small, but healthy. I was overjoyed to be her mother and instantly fell in love. My husband and I sang Oh, How Lovely Is the Evening to her within minutes of her birth, and we spent the next several hours in a state of bliss, marveling at her every move.

That night, as we tried to rest, I had a peculiar thought: what if I were to throw my daughter down the spiral staircase in our home? Ashamed, I confessed the thought to the nurse on duty. She kindly suggested that I was exhausted from my labor and should get some sleep. She would take care of our baby for the night. The next day, a social worker summoned by that nurse visited us and became the first of many professionals to help me understand my postpartum mind.

As the days, weeks, and months of my daughter’s first year went by, I bonded deeply with my daughter. At the same time, I intermittently had scary thoughts about harming her or myself. Terrified, I tried to counter the thoughts with certain repetitive behaviors, phrases, images, thoughts, and musical patterns. This condition, I learned, is called postpartum obsessive-compulsive disorder (PPOCD).

Unlike postpartum depression, PPOCD is not a widely known condition. It affects only about 3 to 5 per cent of postpartum women. Mothers who experience it often have no reference for their suffering, and believe that if they tell someone, social services will take their baby away. Thus many women do not seek treatment, resulting in an underreporting of the condition. I was lucky, in contrast, to receive excellent medical care from two psychologists and a neurologist who recognized the illness. I was also treated with strong medications and joined a support group in the Healthy Expectations Perinatal Mental Health Program at Children’s Hospital Colorado.

PPOCD arises out of a deep protective instinct gone awry. Because I was so determined to keep my daughter and myself safe, I looked every minute for danger. Everything in the room became a potential weapon in my mind. When I was in the kitchen, I imagined picking up a knife and stabbing my baby. In the bathroom, I pictured myself drowning her. In a parking lot, I imagined myself leaving her in her car seat on the ground and driving away. The scary thoughts were also about myself. I pictured killing myself by jumping over railings, taking whole bottles of medicine, or drowning in a lake. When my anxiety was at its highest, these thoughts would persist in periodic episodes lasting hours, even while I was lovingly caring for my daughter.

It’s estimated that about 90 per cent of people—men and women alike—experience violent or scary “intrusive thoughts”. These thoughts are not a sign of bad parenting or deficient morals. Rather, they emerge from the overzealous care that sometimes accompanies early parenthood, a product of a mind constantly scanning for danger. Sleep deprivation increases the likelihood of such thoughts. The difference for mothers with PPOCD, however, is the intensity and frequency of the scary thoughts, as well as the panic attacks that accompany them. For me, the intrusive thoughts created a physiological anxiety response—fear in the pit of my stomach, queasiness, inability to sleep (even when exhausted), weakness in my arms and legs—along with a cruel indictment of myself as a mother.

Because I pictured myself doing monstrous things to my daughter or myself so often, I began to wonder if I was a monster. I felt an almost unbearable shame from the thoughts. This is a sign, called ego dystonia, that my psychologists used to assure me that I was not psychotic or a danger to my daughter. I constantly told myself that I was not crazy and that I loved my baby. But the thoughts kept coming, leading to various coping behaviors. These included constant checking and rechecking of the temperature of my daughter’s room; an avoidance or rearrangement of knives and other dangerous objects in my house, in restaurants, and in other people’s houses; an avoidance of staircases in all buildings; an avoidance of crowds; asking my husband to hide my medication until it was time to refill my pill case; certain mantras I repeated to myself; certain imagery I required myself to imagine; and certain musical patterns I repeated in my mind ad nauseam.

In the midst of my sickness, I was lucky: I had a supportive husband, parents, in-laws, friends, church community, and medical providers. Similar to other mothers who experience PPOCD, I had many ups and downs. At times, the thoughts would go away, and I would become hopeful that I had recovered. Then, the thoughts would return.

Around my daughter’s first birthday in January 2014, I began my real recovery. My anxiety attacks became less frequent, finally fading to almost nothing. I felt as if I had experienced a second, extended, labor and delivery—much more difficult than the first. While I cared for my daughter with tenderness during her first year, and loved her deeply, it was only during her second year that I began to believe that I was, in fact, a good mother.

Editor’s note: In 2015, Loretta wrote a piece called String Quartet OCD to express her PPOCD journey in music. You can listen, download, and purchase the CD here. 10 per cent of profits will go to the Healthy Expectations Program for Perinatal Mental Health at Children’s Hospital Colorado.