Dealing with OCD during COVID-19
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Dealing with OCD during COVID-19

We have already talked about how the Pandemic influenced Health Anxiety and offered some tips on how to manage Health Anxiety about COVID-19. In this post, we’ll focus on OCD, and particularly the version concerned with germs and contamination.
We look at how the Pandemic affected OCD sufferers and explain when worries and precautions may have become unhelpful. We also list a few tips to start managing common germ-OCD related issues and continue to protect ourselves and others while protecting our mental health!

The impact of COVID-19 on OCD

The Pandemic can be seen as a huge pandora’s box of anxieties. Of all the different types of anxiety, the most notable mentions go perhaps to OCD (especially in the form connected to excessive worry about germs and contamination) and Health Anxiety (an extreme concern about one’s own health).

Those with pre-existing OCD (i.e. OCD present before the Pandemic) have seen their symptoms increasing due to COVID. This is understandable if we consider that the Pandemic protagonist, the coronavirus, is indeed a germ and that contamination OCD is characterised by obsessive worry about germs.

It seems that COVID’s lethality and ease of diffusion may confirm to OCD sufferers that their fears of contamination and becoming ill are potentially valid. This keeps sufferers stuck in a cycle of obsessing about potentially catching the lethal germ, feeling increasingly anxious about it, and responding to it by excessive washing and avoiding crowds or people altogether.

It wouldn’t be unreasonable to argue that some people have developed OCD because of COVID. Particularly those who had a vulnerability to develop OCD (50 per cent of which is genetics, and the other 50 is a mix of personality traits, stressful life events and other psychosocial factors).

Common Signs of OCD Amplified by the Pandemic

Excessive Worry about Spreading COVID-19

In OCD, it is common for sufferers to worry excessively about spreading germs and causing ill health to others. OCD sufferers often have a high tendency to take responsibility for protecting others from this. As COVID spread quickly, even without symptoms, this has further increased fear around spreading germs/COVID to others. Ultimately COVID has further inflated the already present concerns of infecting others that typically OCD sufferers can experience. 

OCD habits may align with Official COVID-19 Guidelines

OCD signs and symptoms have been further amplified by how almost perfectly some of the official guidelines for dealing with covid align with the rituals and habits of someone suffering from OCD, such as washing the hands often and for a prolonged time, covering our mouth and nose with a mask and keeping our distance from others. Indeed, during the Pandemic, we have constantly received the message to wash our hands regularly to prevent the spread of germs and doing so for a specific amount of time (e.g., at least 20 seconds).

The Pandemic may Validate OCD fears and Worries

Overall, the Pandemic experience for sufferers of germs-related OCD is arguably one of the most challenging. This group of people may perceive the inherent risks of the coronavirus and the measures they’re advised to take, as validating their extreme concerns around contamination along with their excessive attempts to prevent germ spreading and ensure cleanliness. Thus, not only they may have seen their symptoms increase during Covid, but the reality of the risks of coronavirus may make OCD sufferers less inclined to try to work on their OCD and reduce such excessive behaviours. This is because it has become much harder to draw a line between ‘normal’ and ‘abnormal’ concern and worry.

How much is ‘too much’ worry and precaution during COVID-19?

Worries and Precaution are a Subjective Matter

How can we tell how much precaution is normal during a pandemic? If, during average times, this would already be a difficult question, in times of Pandemic, it becomes truly challenging to draw a line between normal and not.

There is no single indicator that could be applied universally to say that somebody is worrying too much or engaging in cleanliness behaviours and precautions excessively. Even in non-covid times, it was hard to say that someone is worrying excessively about something simply by looking at the number of times they engage with such worries and related behaviours. 

The most important and reliable indicator to understand whether our worries and anxiety might have crossed the ‘unhelpful’ line is when such fears and related behaviours start to negatively impact our lives. 

When are Worries and Precautions Healthy?

One might worry about COVID and catching the virus multiple times a day. They may think about it when they wake up; they feel a bit anxious when reading or watching the news, or perhaps they feel a rush of adrenaline when they hear one of their loved ones has covid-related symptoms. However, this does not mean that they’re necessarily worrying ‘too much’. 

If this person’s ability to function is left intact, that is, if they’re still able to work effectively, have some social contact (while following the rules), and engage in meaningful and pleasant activities, then we could say that they are not worrying too much.

When do Worries and Precautions become unhealthy and unhelpful?

If our worries about catching or spreading the virus make it challenging to show up and keep our attention at a work meeting. If they make it difficult to enjoy a meal with a partner or to step out of the house to buy some groceries, then these could be the telling signs that our worries and precautions have become unhelpful. In this situation, a mental health issue might have emerged.

In other words, worries can be seen as more problematic if they occupy people’s minds much of the time; they are extreme (i.e. catastrophic), causing high levels of anxiety and having a high impact on our lives. Behaving in ways that can be seen as “normal” coincides in the current situation with acting by following government guidelines and looking around to see how many precautions others are taking and adjusting ourselves to such a general standard.

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Have our Worries reached a New standard?

At this point, it’s reasonable to question whether the current circumstances and new behaviours we all have had to adapt to cope with the Pandemic have forever shifted the way to deal with germs and take precautions. Although it seems that at present, the extent to which we take precautions against germs/contamination has increased due to the increased threat of illness/death due to COVID, it is likely that in the medium and long term, our attitudes will return towards the pre-pandemic baseline. At present, although COVID-19 is a real threat, which spreads easily, provoking a high death toll, people may likely overestimate the probability of contracting the virus or dying from it even though the odds are against this. This is mainly due to the media, which seem to often report on extreme cases. The more salient are in our minds such worst-case scenarios, the greater our perception of threat.

Tips to Manage germ-OCD during COVID-19

1) Try to limit the number of times you disinfect surfaces to once a day. Pick a surface that is more often touched.

2) Challenge your beliefs that all surfaces need to be disinfected. For example, by asking yourself, “How many times has that couch been used in the last few days?”, “Have there been visitors/guests who may have touched it?”. If the couch has only been used by you and you have had no visitors, then maybe there is no need to disinfect it!

3) Limit handwashing with soap and water to 20 seconds. Try to do it only after you’ve been in places with other people around, before eating, after using the bathroom, and after coughing or sneezing. A hand sanitiser is a good alternative if you don’t have soap/water available!

4) Let go of Perfectionism. OCD makes us often focus on wanting to be perfect. This might lead to taking excessive/extreme precautions related to COVID-19. Remember that there is no single way to eliminate the threat of COVID-19 entirely. However, using common sense rather than Perfectionism is what the current situation requires and will protect you from the mental and emotional issues that Perfectionism will bring.

5) Watch out for OCD thoughts. Remember that germ-related OCD and fears of contamination thrive in a COVID-19 world. Your anxiety is likely to make you overestimate the probability that you might catch the virus or contaminate others.

6) Allow yourself to take the precautions recommended by the official guidelines, for example, the government and the World Health Organisation, and nothing more.

7) Limit the amount of time spent watching or reading news about COVID-19 to only once a day. The more you digest COVID-19 related news, the higher the chances that worries and even intrusive thoughts about COVID-19 and fears of contamination will show up.

8) Reach out to friends and family. Cultivating and strengthening your relationships with others is even more critical during the Pandemic. Set up time to check in with your support network, whether by phone, video chat, or in-person (if possible/allowed by the law).

9) If your OCD and fears of contamination/germs are seriously impacting your life, making it difficult to do your job, enjoy relationships and leisure time, ask for professional help. In these cases, talk about it with your therapist, dial 111, contact your GP or get in touch with us for a free 15 minute consultation.

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Dealing with OCD during a Pandemic: The Bottom Line

We are still very much in an emergency. All precautions must be taken to prevent avoidable infections and further deaths. However, it is perfectly possible to maintain caution and protect ourselves and others while also avoiding negatively affecting our mental health by placing an extreme and unnecessary strain on ourselves by catastrophising and engaging in behaviours that will make us more anxious, unhappy and isolated.

 

Additional resources:

NHS OCD Information

 

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