A Pandemic Is Hell For Everyone, But Especially For Those With OCD

Coronavirus anxiety can trigger major symptoms for people with obsessive-compulsive disorder. Here's what to do about it.

In these dark times, silly homemade videos encouraging people to vigilantly wash their hands to curb the spread of the coronavirus have been a rare source of levity for many people. The lineup has been eclectic and powerful, as if half of A-list Hollywood were competing to create the most viral “Sesame Street” special of all time. Jimmy Fallon played guitar for his two singing daughters, Neil Diamond rewrote “Sweet Caroline,” Miley Cyrus lent her lyrics to an instructional meme, and Gloria Gaynor belted out “I Will Survive” next to a bathroom sink.

I’ve laughed at a few of the hand-washing videos, too. But for the most part, they serve as a reminder of a bleak chapter in my life, one that I fight every day to not repeat. It’s always difficult to have obsessive-compulsive disorder, and for many people with OCD, this global pandemic is an unprecedented challenge.

“I’ve certainly observed in my clients ― and in my community ― just how profoundly activating this moment is for people with OCD, OCD-spectrum and mental health concerns,” said Annalise Ophelian, a San Francisco-based psychotherapist. “A lot of what’s going on right now will feel like it’s undoing progress that was made in treatment.”

OCD can manifest in many different ways, all of them connected to a central tension, according to Jeff Szymanski, the executive director of the Boston-based International OCD Foundation.

“The core struggle for those who have OCD is the need for certainty along with a constant struggle to try to get away from anxiety,” he said.

For those who have contamination OCD ― a subset of the mental health condition in which people are terrified of getting an infection ― germs present the ultimate uncertainty. They’re an invisible threat that cannot be avoided. With work, you can achieve hard-earned moments of clarity where you know that, while life may be uncertain, it’s unlikely you’re at a heightened risk of catching any particular illness. But an outbreak as widespread and deadly as COVID-19 can seem to validate those original fears and inflame them even further.

Stephanie Jones, a woman in the United Kingdom who has contamination OCD, told HuffPost that she has severely curtailed her time outside over the last month. As a social worker, she’s considered an essential employee. However, she’s received permission to work from home three days a week and takes a taxi instead of public transportation to her job when she does go in.

At the same time, Tim Abbott, who lives with contamination OCD in Australia, said that the public response to the pandemic has somewhat eased his mind.

“Knowing that everyone is cleaning their hands and surfaces makes it actually a little easier to be able to cope with being in a social setting,” Abbott said.

People with OCD who have obsessions and rituals that have little to nothing to do with contamination or germs are also handling the pandemic and the quarantines in variable ways.

Personally, a lot of my OCD manifests in rigidity, from meals and exercise to work and places I visit. I’m very grateful and fortunate to be healthy, but suddenly having to be flexible with every aspect of my well-honed daily existence is its own exhausting battle.

For those having difficulties in this new world, here are a few tips from professionals that might help you cope better.

Use your existing skills.

The first thing to remember is that despite the elevated pressures, if you’ve learned tools in therapy, they’re still valid and crucial.

“We have heard from both individuals with OCD and therapists all across the country who are saying the individuals who have been in effective treatment for their OCD are in general faring better than the average person,” Szymanski said. “In part, this appears to be [because] one of the basic skills you learn in treatment is how to accept and live with uncertainty.”

Many of the tools are meant to help you de-escalate and stop what can feel like a violent whirlpool of unwanted thoughts. Ophelian lists helpful behavioral exercises such as thought-stopping, reality-checking and de-catastrophizing. Basically, it’s all about taking a breath and trying to remember that there is no dire threat demanding certain rituals.

In some cases, the unpredictability and severity of COVID-19 might feel like it directly conflicts with that advice. To combat such thoughts as much as possible, recognize the unusual circumstances without jumping to conclusions or concerns that years of hard work in therapy have now been negated.

“What’s important is being able to objectively separate the facts of a situation from the way that you feel about it,” Ophelian said. “The facts of our circumstances have changed, so what we’re striving for is to always be making appropriate behavioral choices for the reality that we’re living in.”

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Keep a regular routine to the best of your ability.

Whether you are newly working at home or have no job at all, you’re likely facing a lot of downtime, possibly in complete isolation. Free time can be an enemy or an ally to people with OCD, depending on their symptoms.

For some people, it’s been a blessing. A friend of mine who has very ritual-based OCD said that working from home has given him the time to think, talk to himself and, if necessary, run through the essential steps to attain some relief.

On the other hand, I find myself trying to stay overly busy and maintain a schedule explicitly because I don’t do well with free time. Szymanski stressed the importance of finding a sustainable rhythm.

“People should continue to socialize virtually, exercise and eat healthy,” he said. “While we are all home, it may be tempting to sleep in, stay up late, or not even get out of our pajamas for the day. However, the more we can stick to good self-care strategies, the better off we should be. So, stick to your regular wake-up and go-to-bed times, eat meals at the same time you were before, etc.”

Socialize while social distancing.

While millions of us are stuck inside, we don’t have to be alone. Just as offices around the country have shifted to Slack conversations and Zoom video calls, so too can friendships. And when you have OCD, taking the conversation outside your own head is a major priority.

Ophelian recommends using social media apps meant for actual socializing, including Zoom, Twitch and Netflix Party, which will help you to stay busy and talk with friends and loved ones. Interconnectivity is crucial to minimizing the negative impact of isolation and the vacuum it creates for harmful thoughts to rush in.

And just as you should use the tools you learned in therapy, you should also do your best to stay in touch with your therapist. There are also teletherapy resources available on the International OCD Foundation and the National Alliance for Mental Illness sites.

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Stay informed, but not too informed.

COVID-19 is an unprecedented global event and it’s vital that you keep up-to-date on the news that directly impacts your life. But, as much as possible, avoid falling into the trap of watching coverage of the pandemic 24/7.

As Ophelian noted, repetitive news cycles work in the same way as repetitive thoughts, and there’s no reason to let either spin through your mind.

“Make sure you’re getting sound information from medical sources ― like the World Health Organization, the [Centers for Disease Control and Prevention], research hospitals ― and avoiding repetitive stories of horror or loss or highly commercial news sources that play information on a loop,” she said.

“Resist the temptation to learn everything there is to know about COVID-19. There is new information every day, but you don’t need to be looking at the news all day to get it,” she added.

Know that this may be hard ― and that’s OK.

Both Ophelian and Szymanski noted that the pandemic may have long-term consequences for some OCD patients, but continuing treatment can help with that. Feeling fear now is natural and shouldn’t trigger a second wave of self-criticism.

“Working on our mental health is an ongoing process. ... Being able to adapt to new situations, even something as unprecedented and extreme as the one we’re in now, doesn’t represent a setback,” Ophelian said.

“You might experience an increase of symptoms, and that’s your body and mind’s way of letting you know you need something: more support, more resources, new interventions,” she said. “Be loving and compassionate to yourself. Your stress is understandable, and it’s not reasonable to expect anyone to manage this alone.”

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