Dark Thoughts in Postpartum
They come up at the most inopportune time.
At night. When you are driving. As you care for your baby.
They come up as thoughts and as images.
They're horrible and dark.
No, you are not "crazy" and despite what you may think, these thoughts don't "mean" anything. You are not a bad mom.
These are intrusive thoughts (and images), and can be common in postpartum.
What is an Intrusive Thought?
An intrusive thought is basically at thought that pops up into your head and "intrudes" upon you. It is typically dark and scary. In postpartum, these thoughts often are around harm to you, your baby, and loved ones. It can be thoughts of you causing the harm or others causing it. Intrusive thoughts can often includes images of these thoughts.
Common Intrusive Thoughts in Postpartum
Due to the dark nature of intrusive thoughts, they are typically not talked about openly with others.
For one, they are usually pretty awful, so it's understandable that there is a part of you that doesn't want to speak them out loud and give any "truth" to them. Second, there is already so much judgment around the motherhood space, that there is often a fear that you will be judged by having these thoughts. What kind of mother thinks these things?
As a therapist who specializes in working with moms (and who is also a mom and has had some of these thoughts myself during postpartum), I've heard "it all." Meaning- your dark thoughts aren't going to scare me nor am I going to think you are crazy or that you are actually putting your baby in harm.
Some common intrusive thoughts that mothers have are:
dropping their baby
drowning their baby
touching their baby inappropriately
suffocating their baby
their partners doing one of the above harm on their baby
getting into a car accident
baby getting hit by a car or they themselves hitting their baby with their car
How common are intrusive thoughts in the Postpartum Time?
Intrusive thoughts are actually very common, with 70 to 80% of mothers reporting having them during the postpartum time. Intrusive thoughts and images tend to be more prevalent in the first several weeks after baby is born, with many moms reporting that these types of thoughts start to decrease.
For some moms, these thoughts and images don't decrease and may unfortunately get worse. In these cases it is likely that they are experiencing postpartum depression and/or postpartum OCD (more that that below).
Intrusive Thoughts aren't Dangerous
Due to the disturbing nature of intrusive thoughts, they often feel really bad and can feel like they're dangerous and may lead you to cause harm to your baby.
It's important to note that intrusive thoughts are DIFFERENT than thoughts in a psychotic episode. When someone has dark thoughts during a psychotic episode (these thoughts can be in the form of delusions and/or hallucinations) they will believe them and may take action for them. With intrusive thoughts in depression and OCD, you are aware that these thoughts are "bad" and typically they scare you.
So while these thoughts feel really bad, they don't actually have any "truth" to them nor do they mean you are going to do them or that they will happen. Basically they are just another thought. A thought itself has no inherent danger to it.
Understanding the Range of Thoughts
You can think of your thoughts as on a spectrum. On one end you have very negative/dark thoughts and on the other end you have very positive/more magical thoughts. In the middle is our neutral thoughts.
Most of our thoughts are going to be in the middle range- slightly negative to neutral to slightly positive.
We all have these more "outlier" types of thoughts that occasionally pop up in both a very positive and very negative nature.
Perhaps you have a thought about winning a billion dollars in the lottery. As I'm sure you can imagine- that thought feels good. It can be fun to daydream about. So when a thought that is very positive (and even a bit magical) in degree comes up, we don't think much about it. We don't create meaning over it.
When a very negative thought pops up (like- what if I drive off the side of the road), it doesn't feel good and often feels scary. This feeling then leads us to try to make sense of why we are having it which can lead us to make a meaning out of it. This can look like- "something is wrong with me that I'm having this thought," and "I'm a bad mother for having these thoughts."
In reality, they are no different than that very positive thought of winning the lottery. It just felt bad so we created a meaning about it.
Why do we have intrusive thoughts?
Very negative thoughts are just part of being human. We all have the wide-range of thoughts, but typically these very negative thoughts don’t "pop in" often.
When we have an increase of these intrusive thoughts it can often be due to a reaction from stress, trauma, and/or as a symptom of a mental health diagnosis.
Postpartum Intrusive Thoughts
For most moms, they report more intrusive thoughts during the first couple weeks after baby is born. During this time estrogen and progesterone are dropping pretty rapidly, which is believed to be a factor in the increased intrusive thoughts during this time. You are also likely to be going on little sleep not to mention experiencing the stress of taking care of this new baby.
How to Stop Scary Intrusive Thoughts
The hard thing is you can't stop a thought from happening. Once it pops in, it's already done. However, you can learn ways to better cope with it happening and work to decrease them from "taking hold" and creating more distress for you.
Label It
One strategy is to label it appropriately. Say to yourself- "this is an intrusive thought." Then tell yourself that you don't need to go down that track and you can let it be as it is.
Try to then shift your focus onto something else- you can try to read something, do a puzzle, listen to a podcast or book, go for a walk, go outside, etc.
Take Care of Yourself
Prioritizing your sleep is really important. Sleep helps us regulate our emotions. Lack of sleep can contribute to higher levels of anxiety and depression. During postpartum, sleep can be hard to come by. Working with your partner or other loved ones, to make a plan for how you can get more sleep can be very important for your wellbeing.
Engage in Movement
When you are physically able to, engaging in daily movement can be another really important factor for your overall wellbeing. It's important to take it easy and do what feels good for you and what will work in your life. I typically recommend to start with walks. Walks can be a great way for baby to settle and sleep in the stroller, it can get you outside and get fresh air (which can be very regulating for your body), and it helps get you out of the house which often can feel isolating.
When Postpartum Intrusive Thoughts Don't Go Away
If you are past the first couple weeks of postpartum and you are finding yourself still experiencing intrusive thoughts that are causing you distress, you may be experiencing Postpartum Depression and/or Obsessive Compulsive Disorder (OCD), Postpartum-Onset.
It's important to know that you can treat Postpartum Depression and Postpartum OCD. Therapy and for some, medication, can help you recover.
About Postpartum Obsessive Compulsive Disorder
OCD in the postpartum time is different than Postpartum Depression. Depression often shows up as feeling sad/down, not finding pleasure in things that used to be fun, changes in sleeping, changes in eating/appetite, feeling tired (even while sleeping enough), and lack of energy.
With Postpartum OCD, you experience intrusive thoughts that will create anxiety/distress, then in order to cope with these thoughts, will engage in some sort of behavior to try to make it better. This behavior can become compulsive- in that you feel that you need to do it in order to appease the intrusive thought. The intrusive thought is also one that you "can't let go of."
Some common behaviors I see with Postpartum OCD include- seeking out reassurance from others that everything is okay, repeated checking on baby or the item of the thought, changing your behavior to not trigger the thought, go over and over in your head all the ways the thought is not true or will not happen.
For example, a common one I see with moms I work with is that they have an intrusive thought of drowning their baby in the bath. They may also have images that go along with this thought. So in order to deal with this, they have their partner bath the baby and they stay away from bath time.
Postpartum OCD can feel really bad and can really interfere with how you show up as a mom in that you start to change your behavior in order to deal with the obsessive thoughts. I also see a lot of shame that is experienced by moms with OCD, as they feel that there is something seriously wrong with them that they are having these thoughts.
For some moms this may be the first time they are experiencing OCD. However, for others, they often start to recognize that they have had other situations during their life with similar patterns of having a thought that gets "stuck" and then engaging in some sort of behavior to deal with that thought.
OCD is a mental health condition, just like Depression and Anxiety. It is also one that can be treated and it's really important to reach out for support. OCD typically does not "go away" on its own and does require specialized treatment as some common ways we treat depression can actually reinforce OCD. If you think you may have OCD, it's important to share this with your care provider and provide some examples on how you are getting stuck on a thought and the ways you are behaving to deal with it.
Getting Help for Intrusive Thoughts in Postpartum
Intrusive thoughts during the postpartum time can really make things difficult. Postpartum is already a lot and when you add in scary, dark thoughts and images, it can make this time unbearable. It's important to know that you can get help and start to feel better. Reach out to a trusted loved one, your doctor, and/or look for a therapist that specializes in postpartum.
If you're in California and interested in my services, you can schedule a consult or a therapy appointment here.
Key Takeaways for Intrusive Thoughts in Postpartum
Intrusive thoughts are unwanted thoughts that can "pop up" in you mind.
Intrusive thoughts often cause anxious, scary feelings.
70 to 80% of mothers report having intrusive thoughts in the postpartum time
Hormones and lack of sleep are likely contributors to increased intrusive thoughts after giving birth
Intrusive Thoughts do not mean you're a bad mom
Sometimes, intrusive thoughts can be sign of having Postpartum Depression and/or OCD with a postpartum onset
Therapy can help with your intrusive thoughts
Disclaimer: This is not a replacement for a therapeutic relationship or mental health services. This is for educational purposes only and should be in used only in conjunction in working with a licensed mental health professional. If you are in California and looking for a professional therapist feel free to use the contact me to request an appointment or search Psychology Today for local therapists in your area.
