For new mothers, having a baby is a time of emotional highs. But the postpartum period can also deliver a severe blow to the state of mind of some women.
"I was constantly shuddering at the thoughts that were going on in my mind," the Rev. Kristen Looney, a new mother, told ABCNEWS' Deborah Roberts in an interview for 20/20 Downtown.
Looney said she was tormented by fears that she might harm her baby girl, Caitlin. One of the most distressing thoughts, she said, was that of drowning her newborn. "It was horrible to give her a bath, and once I got her in the towel, there was huge relief, like, 'She's safe, she's out.'"
She also worried that she would suffocate the baby or throw Caitlin into the fireplace.
And while such horrific thoughts may seem inexcusable or even insane to many people, mental health professionals say they are — while potentially serious to the mother's mental health if left untreated — "more bark than bite" in terms of posing direct harm to the child.
OCD vs. Psychosis
Looney's symptoms are part of postpartum obsessive compulsive disorder, or postpartum OCD, a condition in which a new mother's hypervigilance about possible harm to her baby (posed by other people, situations or even herself) leads to intrusive thoughts, obsessive thoughts, avoidance behavior, anxiety, depression or fear.
Women with postpartum OCD will typically have thoughts that are out of character and very frightening. She may be consumed with recurrent thoughts of harm coming to her infant from other people or other situations, or even herself. She might be so preoccupied with harming her child that she avoids the baby all together.
But mental health professionals are clear in drawing the distinction between postpartum OCD and postpartum psychosis, an extremely serious and rare mental illness that is at issue in the trial of Andrea Yates, the Houston mother who drowned her five children last year.
The symptoms of postpartum OCD "may be uncomfortable and even tormenting to a woman, but in postpartum psychosis, a woman will act on those thoughts," says Dr. Lee Cohen, director of the Perinatal and Reproductive Psychiatry Clinical Research Program at Massachusetts General Hospital in Boston.
Women afflicted with postpartum psychosis tend to have difficulty sleeping, are prone to agitation or hyperactivity, and intermittently experience delusions, hallucinations and paranoia. In this delusional state, a mother loses touch with reality and may no longer be able to distinguish between right and wrong.
By contrast, experts say, women afflicted with postpartum OCD understand the thoughts are wrong.
Occurrence of OCD
Obsessive compulsive disorder is a mental disorder that has received a fair amount of media attention, including Jack Nicholson's depiction of a dry-witted neurotic in the movie As Good As It Gets.
The National Institute for Mental Health reports that about 3 percent of people in the United States have OCD, making it more common than either schizophrenia, bipolar disorder or panic disorder.
Still, experts aren't quite sure of the prevalence of OCD in new mothers, though they say their clinical experience suggests it's high.
Liz Torres, a psychologist at McLean Hospital in Belmont, Mass., and a psychology instructor at Harvard, says she has seen many patients with the condition in her own clinical practice.