Pregnancy And Mental Health Are Like Oil And Water

A new study shows that pregnancy may give rise to obsessive-compulsive disorder in some women, making the balance between pregnancy and mental health care even more complicated.

According to Reuters, the study found that of 78 women who had ever been pregnant and were treated at the Yale OCD Clinic, nearly a third began seeing symptoms during pregnancy or immediately postpartum. Of those who already had the disorder when they conceived, a third found their symptoms intensify during pregnancy (though 22%, interestingly, improved). Study author Dr. Ariadna Forray says that the women whose OCD worsened during pregnancy also tended to have worse symptoms during their premenstrual periods, suggesting that for some women, OCD can be linked to hormones. Says Forray, "These women may have a differential sensitivity to reproductive hormones, and, as such, normal reproductive events are triggers for the onset or exacerbation of OCD."

The study didn't examine social factors, but it's also possible that the many (sometimes conflicting) recommendations women are supposed to follow in order to ensure the health of their babies might trigger OCD in moms-to-be already predisposed to the disorder. Forray's team found that women whose OCD worsened in pregnancy were especially concerned with "contamination" — not necessarily surprising when pregnant women are told to avoid so many foods, substances, and activities (including worrying) because they may harm or damage their unborn children. Of course, one such substance is the antidepressant medication that can help with OCD — revealing yet another way pregnant women are caught between their own health and the health of their future offspring.

Further illustrating this bind are bipolar patients, whose medications can cause serious birth defects yet who also face serious problems if they go off them. According to CNN's Michele Hoos, bipolar moms face a 25-50% risk of postpartum psychosis (the sheer vagueness of this stat seems to highlight the need for further research in this area). But while their disorder presents unique challenges, some sufferers remain determined to have kids. 27-year-old Meredith tells Hoos,

I'm not going to not have a child because I'm afraid they're going to be bipolar. I've seen so many wonderful things and I've done so many wonderful things, and I plan to do a lot more. My kid will have a better life than a lot of kids out there. This isn't going to stop me.

As Hoos points out, doctors ten years ago advised bipolar patients not to procreate. Thankfully, we've moved past that, but we still don't really know how to care for both pregnant women and their fetuses when mental illness is involved, nor do we fully understand the ways in which pregnancy can influence said illness. For women like Meredith, we need to do better.

Image via anna1311/Shutterstock.com.

Pregnancy May Trigger Or Worsen OCD Symptoms [Reuters]
Do Pregnancy And Bipolar Disorder Mix? [CNN]

Earlier: Study: Antidepressants May Increase Miscarriage Risk