If you or someone you love struggles with obsessive-compulsive disorder (OCD), world events occurring as a result of the COVID-19 coronavirus are likely creating a perfect storm feeding the symptoms of OCD and making typical treatments more difficult.
Understanding Obsessive Compulsive Disorder (OCD) Behavior
According to the International OCD Foundation, 3 million Americans have been diagnosed with OCD. OCD is an anxiety disorder characterized by unwanted thoughts or urges. To manage anxious thoughts, individuals compulsively engage in repetitive behaviors designed to neutralize the perceived threat.
For about one-third of people with OCD, their fears focus on becoming contaminated by germs. So, while most Americans are currently engaging in increased hand-washing and cleaning of surfaces within their environment, individuals whose OCD centers around becoming contaminated by germs may find themselves distressed and increasingly unable to determine where healthy handwashing ends and OCD begins. Those who struggle with germ obsessions always fear touching something contaminated by germs and, thus, contaminating themselves. They cope with this by scrubbing their hands—often to the point they are raw—and avoiding public places. When health officials proclaim it unsafe to be in public, fears generated by OCD seem confirmed and this makes it even more difficult to manage anxious thoughts and behaviors.
How COVID-19 May Affect OCD Behavior
Treatment for OCD involves exposure to the feared situation and then deliberately choosing not to engage in the ritual while working to manage the anxiety this creates. This would mean someone with OCD would typically touch something like a doorknob they feared might be contaminated and then deliberately not wash their hands. Unfortunately, that would be unwise in the midst of coronavirus so normal treatments to manage their illness no longer work well.
However, this doesn’t mean individuals with OCD must lose the ground they have gained or give in to their obsessive thoughts by concluding their fears are accurate. If you or someone you love struggles with OCD, these strategies can help you to maintain the progress achieved prior to COVID-19, and maybe even continue to progress forward.
Tips for Coping with OCD Behavior During COVID-19
Follow Expert Advice
OCD thoughts tell individuals there is no way to stay safe except to engage in rituals to prevent contamination. Those thoughts are based in fear and not fact. To help combat these fear-based thoughts while not engaging in unsafe practices amid the pandemic, follow the advice of trusted organizations. Use the World Health Organization guidelines or the Center for Disease Control guidelines and limit yourself to those guidelines.
For example, the CDC says to wash your hands for 20 seconds with soap and warm water. Make yourself stop washing after 20 seconds and only wash your hands under circumstances like those described in the WHO guidelines. When fear makes you want to do more than this, use the strategies you have devised with your therapist to help manage this fear instead of acting on it. Remind yourself that the CDC and WHO are using facts to make their decisions while OCD thoughts have no data and are only operating on fear—an emotion which often results in poor decision-making.
Normalize Anxious Feelings
Our bodies were designed to feel anxiety in response to external threats which can harm us. This means you—and everyone around you—is experiencing normal anxiety in response to the threat of COVID-19. Acknowledging this anxiety is important and will help you relax and engage in strategies to manage it. It is also important to realize your anxiety may not totally dissipate until the situation has improved. Everyone is working to find ways of managing their anxiety, so check in with friends and family to see what they are doing to cope. You could also search online or talk with your therapist about healthy ways of coping.
Be Gracious with Yourself
Experiencing increased OCD symptoms and finding it difficult to manage them does not represent failure. You are in a unique and intense situation which has heightened everyone’s anxiety. Do what you can to keep your compulsive behaviors managed and give up trying to do this perfectly. If you give in to your compulsions, all is not lost! When you recognize what has happened, stop, take a deep breath, and commit to picking up from here and trying again.
Limit the News
When we becoming aware of something frightening, the part of our brain that wants to make sense of what happened tells us that once we know all of the details, we won’t be anxious. This can cause us to become obsessed with finding out every little detail—even if it means spending hours watching the news and combing the internet. Learning about an event can give us knowledge that prepares us and, thus, lowers anxiety. However, a constant stream of news tends to feed anxiety rather than help inform us. Consider limiting your media intake to no more than ½ hour per day and only from factual sources. Avoid sources that repetitively rehearse death statistics and interviews of people talking about what might happen.
One way to lower anxiety is through connection. Don’t let social isolation keep you from connecting with people who care about you! Make it a priority to connect with at least one individual who knows and cares about you each day. This doesn’t mean you have to make OCD the focus of conversation, although you may want to do this at times. It is important to connect around things which distract you from your OCD and help you keep perspective. One of your support people is your therapist so be sure to make and keep appointments with them. If your support network is limited or struggles to understand your OCD, find resources on-line to help. The International OCD foundation has resources on their website
OCD and COVID-19 are a difficult combination. Take good care of yourself and access the resources and tools you need to navigate these challenging and uncharted waters!
Jean Holthaus, LMSW, LISW has been providing outpatient therapy services since 1995 when she earned her Masters of Social Work degree from the University of Iowa. She has worked for Pine Rest since 1997. She currently serves as manager of the Telehealth Clinic and the Hastings Clinic and is also a Pine Rest Outpatient Regional Director.