Struggling with OCD in global pandemic

Many who are diagnosed with obsessive-compulsive disorder (OCD) live in fear of being contaminated by germs and for their overall health on a regular basis. This fear and anxiety can be heightened during a global pandemic. A Baylor College of Medicine expert explains how vulnerable groups are at risk during times of crisis.

“The manner in which COVID-19 is spread appropriately has us washing our hands, not touching our faces and engaging in social distancing. However, the overall stress that it is causing may be linked to increased onset of problematic anxiety and obsessive-compulsive symptoms, as well as a worsening of symptoms for those who already are diagnosed with OCD or an anxiety disorder,” said Dr. Eric Storch, professor in the Menninger Department of Psychiatry and Behavioral Sciences and vice chair of psychology at Baylor.

For those with OCD, like many others, the stress of a pandemic like coronavirus can exacerbate symptoms, whether it be contamination and cleaning behaviors, or other OCD symptoms such as unwanted and upsetting thoughts about harming others or needing to repeatedly check things. Likewise for those dealing with depression or anxiety, COVID-19 has the potential to intensify pre-existing problems by virtue of increased stressors and difficulty using coping strategies such as getting together with friends or going to the gym. People struggling with mental health concerns may be more vulnerable in times of crisis and increased stress.

During typical OCD treatment, experts recommend directly confronting fears without avoiding situations or performing certain rituals. This helps the person learn that the feared situation typically does not happen, and they are able to accept the uncertainty that pervades life. For example, if you have a fear of driving on the highway because you may get into an accident, you should drive on the highway and learn that accidents usually don’t happen. With the current situation, however, the threat level is elevated, requiring precautions such as those recommended by the CDC and WHO. It is critical to follow precautions and it is also important to practice appropriate self-care. Storch suggests engaging in behaviors with non-elevated levels of risk, such as going for a walk around the neighborhood while practicing social distancing and handwashing in an appropriate but not excessive fashion.

“The key is to follow recommended guidelines but without excess. Don’t avoid going on a walk around the neighborhood or engage in levels of cleaning that are excessively above those recommended by vetted health organizations,” Storch said.

While people are urged to stay home, many have to miss in-person appointments with their doctors. Storch offers guidance on relieving stress without face-to-face treatment sessions for those suffering from mental health issues including OCD:

• Engage in telepsychiatry/telepsychology visits: although it may not seem the same as sitting across from someone, the content and relationship are still strong and present, and outcomes are equivalent to in-person treatment.
• Think about your resources: there are many helpful resources online, including web communities.
• Build out your routine and engage in appropriate self-care: sleeping well, eating well, exercising and not drinking excessive amounts of alcohol.
• Find things to be optimistic about.
• Focus on the fact that there will be a bright light at the end of the tunnel. Enjoy the small gifts, such as mealtimes together, more movie nights, or nonexistent traffic for those essential personnel who are still going to work each day.

“The small things can be really gratifying; being able to maintain your optimism and hope are strong predictors of a more resilient response,” Storch said.