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Other Postpartum Anxiety Disorders


According to the DSM IV, One must meet the following criteria in order to be diagnosed with Obsessive Compuslive Disorder:

A. Either obsessions or compulsions:

Obsessions as defined by (1), (2), (3) and (4):

  1. Recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress.
  2. The thoughts, impulses, or images are not simply excessive worries about real-life problems.
  3. The person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action.
  4. The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from without as in thought insertion).

Compulsions as defined by both (1) and (2):

  1. Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly.
  2. The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive.

B. At some point during the course of the disorder, the person has recognized that the obsessions or compulsions are excessive or unreasonable.

C. The obsessions or compulsions cause marked distress, are time consuming (take more than 1 hour a day), or significantly interfere with the persons normal routine, occupational (or academic) functioning, or usual social activities or relationships.

D. If another disorder is present, the content of the obsessions or compulsions is not restricted to it (e.g, preoccupation with food in the presence of an Eating Disorder; hair pulling in the presence of Trichotillomania; concern with appearance in the presence of Body Dysmorphic Disorder; preoccupation with drugs in the presence of a Substance Use Disorder; preoccupation with having a serious illness in the presence of Hypochondriasis; preoccupation with sexual urges or fantasies in the presence of a Paraphilia; or guilty ruminations in the presence of Major Depressive Disorder).

E. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Postpartum Obsessive Compulsive Disorder

Obsessive Compulsive Disorder affects about three to five percent of women after giving birth. (Bennett, S.S. et. al. 2003) Symptoms include:

  • Intrusive, repetitive and persistent thoughts, usually about something bad happening to the baby. You may also have thoughts about killing yourself, the baby or someone else. (Obsessing)
  • Tremendous sense of anxiety, horror and disgust about these thoughts. (You could never imagine carrying them out.)
  • Repetitive behavior in an attempt to reduce the anxiety resulting from these thoughts. (Compulsions) i.e. not letting anyone hold the baby, avoiding holding the baby yourself, hiding the knives, trying not to be alone with the baby, etc.

According to the DSM IV, One must meet the following criteria in order to be diagnosed with Panic Disorder:

A. Both (1) and (2):

  1. Recurrent unexpected Panic Attacks (see below)
  2. At least one of the attacks has been followed by 1 month (or more) of one (or more) of the following:
    • persistent concern about having additional attacks
    • worry about the implications of the attack or its consequences (e.g., losing control, having a heart attack, "going crazy")
    • a significant change in behavior related to the attacks

B. The Panic Attacks are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism).

C. The Panic Attacks are not better accounted for by another mental disorder, such as Social Phobia (e.g., occurring on exposure to feared social situations), Specific Phobia (e.g., on exposure to a specific phobic situation), Obsessive-Compulsive Disorder (e.g., on exposure to dirt in someone with an obsession about contamination), Post Traumatic Stress Disorder (e.g., in response to stimuli associated with a severe stressor), or Separation Anxiety Disorder (e.g., in response to being away from home or close relatives).

A panic attack is a discrete period of intense fear or discomfort, in which four (or more) of the following symptoms developed abruptly and reached a peak within 10 minutes:

  • palpitations, pounding heart, or accelerated heart rate
  • sweating
  • trembling or shaking
  • sensations of shortness of breath or smothering
  • feeling of choking
  • chest pain or discomfort
  • nausea or abdominal distress
  • feeling dizzy, unsteady, lightheaded, or faint
  • derealization (feelings of unreality) or depersonalization (being detached from oneself)
  • fear of losing control or going crazy
  • numbness or tingling sensations in your hands and/or feet
  • fear of dying
  • paresthesias (numbing or tingling sensations)
  • chills or hot flushes

Postpartum Panic Disorder

Panic Disorder occurs in about ten percent of women during and after childbirth. (Bennett, S.S. et. al. 2003) Symptoms can include fear of getting pregnant again. Also Read Fear of Childbirth

References

  • Bennett, S.S., Indman, P.: Beyond the Blues: A Guide to Understanding and Treating Prenatal and Postpartum Depression. San Hose, CA, Moodswing Press, 2003.
  • DSM IV

© Copyright 2006 Jodi Kluchar

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