Help-seeking Among Mothers with Postpartum Obsessive Compulsive Disorder: A Phenomenological Exploration

Abstract Help-Seeking among Mothers with Postpartum Obsessive-Compulsive Disorder: A Phenomenological Exploration Clinically significant perinatal mental illness affects an estimated 15-20 percent of the global childbearing population. Compared with the most commonly diagnosed perinatal mental health conditions (e.g., depressive and anxiety disorders), postpartum Obsessive Compulsive Disorder (ppOCD) is less well understood and often under- or misdiagnosed. The purpose of this exploratory qualitative study was to gain a beginning understanding of mothers' lived experience of ppOCD, with special attention to their help-seeking experiences. Using interpretive phenomenological research methods, I conducted interviews with six mothers who had been diagnosed with OCD during the postpartum period. The Network Episode Model, which conceptualizes help-seeking as a dynamic, interactive process, was applied throughout the study as a sensitizing framework. Ricoeur's Interpretation Theory guided the analysis process. Following initial coding and thematic development, I conducted member checks with participants, shared the findings, elicited feedback, and modified the thematic structure accordingly. Four predominant experiential themes emerged from these analyses: Perceiving a problem: Early internal experiences with ppOCD; Secrets and Shame; Searching for Solutions; and Learning to Live with OCD: Acceptance and Resilience. Mothers experienced persistent intrusive thoughts of their child(ren) and/or themselves being seriously harmed or killed, either intentionally, accidentally, or due to illness. At symptom onset, mothers had no pre-existing knowledge of ppOCD. Feelings of shame about the content of intrusive thoughts, as well as perceived public- and self-stigma, impeded their help-seeking process. Alternatively, a self-directed process of knowledge and resource seeking via independent internet research and social networking promoted feelings of personal empowerment, facilitating professional help-seeking and treatment adherence. Obtaining an accurate diagnosis, working with a mental health practitioner who "understood" ppOCD, and having a strong social support system resulted in achieving a greater understanding of ppOCD as a treatable illness, decreased psychological distress, and promoted resilience. The findings emphasize the need to carefully screen for and identify ppOCD among women during the postpartum period, and to provide adequate training for medical and mental health providers caring for this population to better understand the clinical presentation, provide quality, non-stigmatizing treatment services, and to promote social network support.