Hannah Hakim
“As far as I know, I'll always live with OCD. I think the pandemic really magnifies these types of fears. But my hope is that I can tell the difference between my own voice and the voice of my OCD. And I practice a lot of mindfulness, just trying to enjoy the little moments of [my toddler] taking forever to tie his shoe. There's beauty in that.”
Hannah Hakim was raised in South Carolina. She moved to Boston for graduate school, where she met her husband and never left. She loves trying new hobbies and reading a good book on the beach. She has worked in public health policy, as a post- partum doula, and is currently a stay at home mom.
This blog is made possible by a sponsorship from Sage Therapeutics. All content on this page has been curated by the Mass. PPD Fund without input from Sage Therapeutics, Inc.
March 2022 | Interviewed and edited by Jessie Colbert, Executive Director, Mass PPD Fund
Did you have expectations about bringing home a new baby? What did you think it would be like? What were your hopes and fears?
I have a lot of experience with newborns. As a doula working with parents in their first couple of days at home, I just thought I would know what to do. I took all of the classes – the childbirth classes, the breastfeeding classes, the newborn care classes. I just felt, like, super prepared. I expected to have this amazing bond right away with my baby – because I often feel that with other people’s babies. And people will say, “You have such a calming presence. I can see that our baby was so close with you.” So, I expected that [connection] to be even more powerful with my own baby.
I definitely had fears about having an older child – especially teenagers still scare me! I felt much less prepared for that. But more immediately, I was afraid of the lack of sleep. And the lack of time for myself. I’m definitely [a person who likes to] come home from work and be by myself for a bit before I can talk to my husband. I felt like those things would be much scarcer, and I was afraid of that.
Oftentimes when a baby is born, parents have plenty of support for the baby, but not a lot of support for themselves. Did you feel like you had people looking out for you?
I just didn't have enough of what I really needed. And I really struggled to say what it was that I needed. My parents, my immediate family, they don't live close. And really none of our friends had had babies before, so I think there's just a different type of care and expectations that those people have when they come visit a new parent. What I mostly wanted, and that no one could provide for me, was to, like, duplicate myself – so that I could hold my baby, while I [also] slept, and while another one of me ate. That's what I most needed!
And it was a lot to have people over, even friends or family. I couldn't handle the overstimulation of people talking to me while the baby cried, so I would try to schedule visits during some of his calmer hours. But that was when I would have slept. Sometimes people offered with chores, like doing my laundry, but it was really hard to say yes. And some friends did bring over food, but that ended so quickly.
Tell me about your journey with mental health challenges around your new baby. When did you realize something was “not right”? What turned things around for you?
For me, it started in pregnancy. And by it, I mean the obsessive-compulsive disorder [OCD]. It was just really loud thoughts that I could not get out of my head. Like, needing to plan for every possible scenario that might happen in the birth or bringing home the baby. And the inability to make a decision. How do I pick the exact right baby mattress? Do I want the Dr. Brown's bottles or the Evenflo bottles? These decisions just compounded and it was impossible. It felt like nesting in overdrive for my entire second and third trimester.
After the baby came home, my fears around germs really amped up. I was, like, creating a safe space in the house that I knew was clean, that was okay for me or my baby to be in. It's another reason why having people over was so difficult. I felt like I had to clean everything that they touched after they left. That was very exhausting.
The other part of my mental health struggles was that I did have a traumatic birth, which made bonding with my baby very difficult. I was really deeply depressed. And I often felt dissociated, like I was watching myself on a video camera. That was really heartbreaking. Like I said, one of my expectations was that I would bond with my baby right away, and when that didn't happen, it was really distressing for me. That’s when the intrusive thoughts came into play – just the scariest, most horrible thoughts about harm to myself or my baby. I couldn’t put my baby down because of them. Even to eat dinner – I was often just, like, eating with a plate over his head.
I think there were a lot of clues that something wasn't right. But I also knew that there's such a wide range of normal, so it can be really hard to know. It wasn't until I joined a new mothers’ group that I realized I wasn't feeling the same as other moms. They might have even described a very similar situation, like not being able to put their baby down, but the function of our actions was different. Like, she can’t put her baby down because [he’s] colicky and won’t rest, but for me it was more about something bad happening to my baby. Or, you know, moms are sanitizing their bottles, but for me it was never enough, I had to do it again and again.
Hannah filled out multiple depression screens in her OB and pediatric offices but there was never any discussion or help with next steps. She said this made her feel “invalidated, like I wasn’t worthy of help.” At 18 months postpartum, she completed another positive screen in her PCP office and an in-house behavioral health provider followed up with her and recommended a partial hospitalization program. But that program did not address the OCD.
I did a second partial hospitalization at McLean specifically for OCD, and that was much more helpful. Before that, I just thought of OCD as my obsessions around cleaning and germs. But it was actually a lot more pervasive. I realized how many more of the intrusive thoughts, the thoughts about harm, the way that I rehearse disaster in my mind [are all OCD]. It’s hard to express your fears with someone who doesn’t have a knowledge of OCD, because it’s so illogical. Like, not driving my car because something bad might happen – the baby might have a blow out, I might have a panic attack, we might get in a car accident. I think specialized OCD care has made a huge difference in my ability to recognize the things in my own life that are driven by OCD, and be heard and validated. And learn ways to start to tackle those fears.
During this second hospitalization, Hannah and a few other moms in her program decided to start meeting regularly to support one another in their dual identities of moms living with OCD. This has since blossomed into her Moms with OCD virtual support group, attracting dozens of moms from around the country.
Hannah’s son turned one at the beginning of the COVID-19 pandemic in early 2019. Because of the impact of the pandemic on her mental wellbeing, she left her job to stay home with him, which made things more manageable for her.
Looking back, what do you wish you had known? What do you wish had gone differently? How can we do better to support moms with challenges like yours?
I wish I had known my signs and signals that I wasn't well. And I wish that my partner or my friends could have known those signs. With my partner, a lot of it comes out in bickering or arguments. Like, he might perceive me nagging him that he didn't put the spray bottle right back where he found it. But a lot of that is my need to have control over this specific environment, so that I can have more control over these scary outcomes that my brain is telling me are going to happen. It also shows up as avoidance, which is especially hard for me to recognize. Like, I'm not leaving the house or I'm not getting out of bed because the prospect of getting dressed – there’s just too many decisions. In a perfect world, I wish he would have said to me, You don't seem like yourself. Here's the name of a provider that I really like, who takes your insurance and has appointments available.
And I think that our maternity care system misses an opportunity to really empower birthing people in the strength of their bodies and in their intuition. I had a traumatic birth, and one of the pieces that was so traumatic for me was the way my midwife really didn’t listen to me in the birthing room. There were requests I made that she completely disregarded. She told me this is what she always does, so I had to submit. And I think that happens in traumatic ways and in commonplace ways across most births. In my Moms with OCD group, we talk a lot about trusting your gut. If something isn't feeling right, you can tell a friend, tell your doctor, tell anyone who will listen, and help you get the support you need. In the birthing room – a time that’s supposed to be so happy and intimate – you’re really, like, beaten down and just made to feel like you're completely incapable of doing this. What you already knew was an enormous job! That really hurts my heart. In OCD treatment they teach you to ignore your OCD, but that provider taught me that I can’t trust myself either. So I [didn’t] know what to listen to or how to make my next move.
Do you identify as a “survivor”?
No, I still think I am survive-ing. As far as I know, I'll always live with OCD. But my hope is that it remains more in the background, that I can tell the difference between my own voice and the voice of my OCD. As I understand it now – as more than just my cleaning obsessions – OCD has probably been prevalent in my life for as long as I can remember. But I’m learning to trust my own intuition more and more every day. And I practice a lot of mindfulness, just trying to enjoy the little moments of [my toddler] taking forever to tie his shoe. There's beauty in that.
I’ve heard from a lot of moms that they also felt like OCD was prevalent in their lives before, but they weren't diagnosed or didn't realize how much of a problem it was until they were pregnant or gave birth. I think the pandemic really magnifies these types of fears, especially around germs, as well as the social isolation that comes with motherhood and with mental illness. And it adds a new layer of difficulties for new parents, and in our ability to access care, because everyone is really suffering with their mental health right now. And there’s just not enough resources out there for professional mental health care. But I wonder what it would mean for us as a society to be more supportive of each other. Really coming back to, like, it takes a village to raise a baby, to be a person in this world. We have to have community and connectedness, and we could all be helping each other more.
More about Hannah’s Moms with OCD support group and her other offerings can be found on her website, Alma Birth Company.
More information and resources on OCD are available at the International OCD Foundation.