Obsessive-compulsive disorder (OCD) is a mental health disorder that occurs when a person gets caught in a cycle of compulsions and obsessions, recurring thoughts, or behaviors that he or she feels the urge to repeat over and over. Many of those diagnosed with OCD live in fear of germs or contamination or for their overall health daily. During this time of the Covid-19 pandemic, such fear of contamination can be heightened.
Struggling with OCD amidst the global pandemic
“I was washing my hands until they bled and cracked,” said Alice, who requested anonymity. She told American magazine Cosmopolitan that she developed OCD as a child. The feeling is very “intense” and she finds it hard to get away from her thoughts to fight her compulsions. Every time she would look at her hands, she felt like she could see germs and although her hands hurt, she continued to wash them because the advice of frequent handwashing is everywhere. “I couldn’t stop with so much panic around,” she added.
People’s stockpiling also triggered her eating disorder. The first time she saw the shelves empty amidst the pandemic, she felt terrified that she could not get what she needed or she could not eat at her normal routine. Even up to now, shopping still feels stressful to her. US-based The Recovery Village, which provides treatment for mental health disorders, explained that 90% of people with OCD have another co-occurring disorder such as mood disorder or anxiety.
Psychological therapist Beth Anfilogoff said that Alice’s behavior is not a surprise. It can be struggling for a person who is already trying to limit their handwashing behavior ritual to suddenly see the recommendation to frequently handwash in the news and all around them. Covid-19 and isolation are affecting nearly every area of life. This is why it is not a surprise that those diagnosed with OCD are also impacted. Anxiety and stress levels are higher and there’s also uncertainty.
Anfilogoff said that seeking help is important. For people who are already receiving treatment for OCD, they should continue with the treatment. Alice herself admits that the lack of human contact made the situation more difficult. She doesn’t have her usual support network but online therapy and support groups have helped her get through it.
OCD therapy app sessions doubles
Digital health company NOCD, which connects users to a therapist for self-help and OCD tools, has also seen the number of people using their OCD therapy app double since the pandemic started.
OCD therapy platform founder Stephen Smith said via MedCity News that it’s natural for people to worry about their families, their health, or the possibility of infecting others. However, those worries could exacerbate already existing mental health conditions. People diagnosed with OCD, for instance, are feeling a fear that is looping over and over again.
Smith himself was diagnosed with OCD when he was in college and he started the company in 2014 to make OCD therapy easier to access.
OCD is equally common among men and women. According to statistics provided by the Anxiety and Depression Association of America, OCD affects 2.2 million adults or 1.0% of the US population. The average age of the onset of the disorder is 19 with 25% of the cases occurring by age 14. One-third of the affected adults first experienced OCD symptoms during childhood.
While many people with OCD know that their compulsions and obsessions are not rational, they nevertheless still feel a strong need to perform mental compulsions or repetitive behavior. They may even spend several hours a day focusing on their obsessions, performing seemingly senseless rituals.
The Recovery Village also stated that those diagnosed with OCD spend an average of nearly nine years with the disorder. After they reach 30, having new onsets of OCD is rare. The most common OCD obsessions involve contamination of bodily fluids, germs, cleaning chemicals, dirt, contaminants, and disease. OCD obsessions may also involve loss of control, such as fear of the impulse to hurt oneself and others, need for exactness or evenness, fear of throwing or losing important items, and excessive fear of causing harm or damage to others, among others.
Managing the compulsive urge to handwash
Anfilogoff suggests that to manage OCD during a pandemic, they should stick with the handwashing guidelines that are set by the government. This means handwashing when you come home or after coming in contact with other people. They should also notice the function of their behavior because they may be engaging in more ritualistic behavior.
She also suggests that instead of thinking “My hands don’t quite feel clean” they should say “I notice that I’m having the thought that my hands don’t feel clean.” They must remind themselves that their thoughts are not facts. Trying a progressive muscle relaxation technique and taking ten deep, slow breaths will also help.
Interestingly, Anfilogoff has some clients who are finding their disorder more manageable as other people are now experiencing anxieties too and it normalizes those with OCD. Along with exercising, eating a balanced diet, and getting plenty of sleep, labeling one's thoughts is also recommended.
Clinical OCD vs. OCD tendencies
Ilisa Kaufman Psy.D., a Miami-based psychologist who specializes in the treatment of OCD, said that every successful medical student she knows has OCD traits. For instance, they cannot stop thinking about their test the following day so they end up studying a lot. But is this enough to consider clinical OCD? She said that to be one, the symptoms they feel need to prevent or interfere with their social and occupational functioning.
For instance, she had a client who was unable to arrive at his work on time because he had many checking compulsions at home before going out. He would check eight to ten more times that every single electrical appliance is unplugged and turned off before leaving the house. Even if he is already halfway to the office, because of the obsessive doubt, he would return to his house, worrying that the iron may still be left on. Another client was fired from her customer service job because she would not be able to speak on the phone before conducting a mental ritual.
The Covid-19 pandemic is a time of uncertainty and also a moment to reflect on what people with OCD go through every day.