Composer Loretta Notareschi in her Denver home. Her score for "String Quartet OCD" sits on the piano behind her.

(Photo: CPR/Michael Hughes)

Denver composer Loretta Notareschi remembers the joy she felt the day her daughter was born in January 2013. The sun streamed in the windows of the hospital, and Notareschi and her husband sang a lullaby to their baby Ruby.

Notareschi also remembers how quickly life as a new mother became difficult. Within hours of giving birth, Notareschi began struggling with something called pospartum obsessive compulsive disorder.

She experienced frightening thoughts about everyday objects hurting her or her baby. She found herself whispering odd phrases to soothe herself.

Notareschi channeled the pain of her experience with postpartum OCD into a new string quartet. On Wednesday, she and Denver’s Playground Ensemble will present the music alongside a panel discussion about postpartum mental health in a unique recital at Regis University.

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She hopes sharing her story through music -- and talking about it with postpartum mental health experts on the panel -- will help listeners understand and empathize with women who endure postpartum OCD.

“It has given me the opportunity to not only express myself and put my most personal feelings into my music, but also to talk about it, to do this educational piece,” Notareschi said during an interview in her Denver home. “And also to hear about other people’s experiences and let them know they’re not alone.”

Overwhelming Thoughts

Notareschi remembers moments of bliss in her first year of motherhood as she bonded with and cared for her daughter Ruby. But she also grappled with frightening, intrusive thoughts and intense anxiety.

“It was just this juxtaposition of the very scary and the very motherly sorts of feelings,” Notareschi said. “It’s very crazymaking to have those at the same time.”

Like many women who suffer from postpartum OCD, Notareschi thought of repetitive phrases to soothe herself when she felt anxious or couldn’t sleep. She’d think of colorful chords or harmless objects, like a soft hairbrush for infants or a toy duck.

And objects in Notareschi’s home felt like threats. The spiral staircase -- a part of the house Notareschi had always loved --  suddenly seemed like a hazard. She had other terrifying thoughts about knives on kitchen countertops.

“It’s like a what-if thought that becomes overwhelming,” Notareschi says.

The CDC estimates between 8 percent and 19 percent of new mothers will experience postpartum depression. Symptoms can include intense sadness, trouble sleeping and difficulty connecting with the baby.

Postpartum OCD is less common. The OCD Center of Los Angeles says 3 percent to 5 percent of new mothers grapple with it.

Seeking Help

The symptoms of postpartum mental illness can be terrifying for a new mother, said Kym Spring Thompson, a clinical psychologist at Children’s Hospital Colorado. Some women fear their baby will be taken away if they speak honestly about their symptoms.

Kym Spring Thompson, a clinical psychologist with Children's Hospital Colorado, works with new mothers who struggle with postpartum mental illness and mood disorders. 

(Photo: Courtesy Children's Hospital Colorado)

Thompson, who will be on the discussion panel at Wednesday’s recital, says it’s important for a mother who experiences postpartum OCD symptoms to seek help quickly.

That’s what Notareschi did. She told a nurse in the hospital when she had an intrusive thought. And she got treatment and therapy for about a year.

She also joined a support group called Mothers and Moods, which Thompson oversees as part of the Healthy Expectations Perinatal Mental Health program at Children's Hospital.

“There are women that have really gone through the thick of it and can share their experience with other women in the group and say, 'It’s going to get better,’ ” Thompson said.

Throughout her treatment, Notareschi kept track of anxiety attacks she experienced over her first year as a mom. They became less common and less intense over time. That gave her hope.

"I put them on a graph and I saw this trajectory," she said, "And I thought, 'Great, I really am getting better.' "

Reclaiming The Tune

Notareschi sees her piece about postpartum OCD as her contribution to a tradition of composers writing deeply personal music for a string quartet.

She hesitated initially, worried that some listeners might dismiss a female composer’s music about such a personal experience.

“But then I thought, ‘You know what? There’s a lot of meaning in this for me and I want to explore it musically,’” she said.

She plowed forward and wrote an intense piece. “String Quartet OCD,” which the Playground Ensemble debuted earlier in February, opens with stabs of dissonance that represent the intrusive thoughts of postpartum OCD. Later, there’s mournful movement simply called “Shame.”

The Plaground Ensemble String Quartet plays "Shame" (third movement) from Loretta Notareschi's "String Quartet OCD." Recorded Jan. 27, 2016, in the CPR Performance Studio.

At times, the patterns in the music resemble the mantras and repetitive thoughts Notareschi used to soothe herself.

But there’s also a happy ending. In the final moments, Notareschi quotes the melody of a lullaby she and her husband sang to Ruby on the day their baby was born. It’s called “Oh How Lovely Is The Evening.”

“It’s a kind of reclaiming of that tune,” Notareschi said. “When I put it in the last movement it was like the evening has become lovely again. And I was able to move on and reclaim this for the positive thing that it always was, or was supposed to be.”

Today, Notareschi has recovered. She composes, teaches music at Regis University and takes care of her daughter.

Ruby is 3 years old now. Like her mother, she loves music and loves to sing. She plays violin and ukelele in the home studio where Notareschi composes.

Some day, when Ruby is older, she’ll listen to “String Quartet OCD.” ​

She’ll hear the sounds of the darker moments that came with being a new mother. But she’ll also hear the moments of joy her mother experienced.

They’re both part of understanding what Notareschi went through.