What This Clinical Psychologist Wants You To Know About OCD & COVID-19
"I don't know what to do. I can't leave the house. I literally had a panic attack as I moved toward the door, and my OCD has really escalated."
About one week before our local "stay at home" order was announced, I received this phone call from one of my clients. And she's not alone in how COVID-19 has affected her.
OCD symptoms amid COVID-19.
There are over 2.2 million people in the United States with obsessive-compulsive disorder (OCD), according to the Anxiety and Depression Association of America, and close to another 13 million with either generalized anxiety disorder or panic disorder. Dealing with fears of COVID-19 infection or contamination can make it harder to balance between safe, healthy practices and a worsening of symptoms.
Most of us have experienced at least some measure of anxiety or concern regarding the coronavirus. I've certainly increased my hand-washing and pay a lot more attention to not touching my face. I also discovered that I had a bad habit of putting things in my mouth to hold when my hands were full (keys, mail, etc.), which I've since stopped.
The anxiety that we are experiencing now is similar to what people with OCD experience every day, especially since government and medical experts are strongly recommending cleaning, disinfecting, and isolating—hallmarks of the struggle for many with OCD. And it's hard.
We also know that OCD and anxiety disorders often run in families, so now whole families may be struggling with exacerbated symptoms—all while sheltering in place together.
Thriving in uncertainty.
So, is the situation a lot worse for people with OCD? Truthfully, that depends. Some people who were already dealing with fears regarding contamination or illness are having a harder time, including those who have not been previously diagnosed with OCD. And yet, there are others who are doing pretty well by using the skills they've already developed to deal with the anxiety and uncertainty of their obsessions and compulsions.
One month into "stay at home," the client mentioned above told me her OCD has "calmed down" to pre-COVID-19 levels. She's staying at home, we meet through video conferencing, and she's regularly practicing the skills she's developed over years of managing her OCD—because there's nothing like a global pandemic to reinforce and strengthen the skills you've been practicing.
OCD is about anxiety, uncertainty, and fear—and a drive for control and certainty. Successfully addressing symptoms of OCD is about learning to tolerate discomfort, challenging thoughts born from catastrophizing and overgeneralization, and learning to live with the unknown instead of engaging in compulsive thoughts or behaviors. This is where everyone can take a lesson from those who have been dealing with OCD. The practice of accepting anxiety instead of trying to ignore or overpower those feelings, and treating yourself with compassion are key practices.
How to manage OCD symptoms while responding to COVID-19:
1. Make a reasonable plan.
Create a reasonable plan to follow the recommendations of the CDC and your local government and stick to it. Don't add on additional measures—if you are staying home, you don't need to do a whole house disinfecting multiple times a day.
If contamination is a major focus of your anxiety, remember that there are directions for when we should engage in hand-washing1. Following these guidelines will keep you on track for appropriate—not excessive—hand-washing. Excessive hand-washing can injure your skin, which can make it more susceptible to infection, so stick to the recommendations from the CDC.
Check out your plan with a trusted family member, friend, or mental health professional to ensure you are staying within the bounds of reasonable, not compulsive, precautions.
2. Connect with others.
Connect with friends and family through phone, text, email, video. Isolation is a breeding ground for increased anxiety, so staying in touch will help to keep you in balance.
3. Limit your exposure to the news.
If you notice your anxiety and OCD increases when you watch or hear the news, turn it off and ask a trusted friend or family member to keep you posted on things you need to know. (Here's more on how to limit your news consumption while staying informed.)
The International OCD Foundation also recommends avoiding trying to learn "everything" about COVID-19. "Remind yourself that no one can protect themselves 'perfectly' from COVID-19, and no one expects you to," their guidelines read. "Times like these call for using your common sense instead of going to perfectionistic extremes."
Breathwork is a skill worth having in your back pocket year-round, but especially in times like these that are filled with moments of overwhelming uncertainty and fear.
Taking a few slow, deep breaths right when you're in the midst of feeling overwhelmed calms our nervous system and can thus help to decrease anxiety.
5. Prioritize self-care.
Now, more than ever, it's vital to engage in the activities that bring us comfort and ease. It may be taking a bath or watching a favorite movie or putting on a cozy sweatshirt. If you're having a hard time coming up with strategies, brainstorm with a friend (or your therapist, if you have one).
6. Get some fresh air (while social distancing).
Nature is healing and helps to calm our nervous system. Make this a multisensory experience by noticing as many sights, sounds, smells, and sensations as you can while outside.
7. Practice self-compassion.
Over and over again. Treat yourself the way you would a loved one, with kindness and acceptance. Do your best to decrease negative or self-critical thoughts.
Know that you are not alone. Whatever your struggle, we are all in this together.
Kristina Hallett, Ph.D., ABPP, is a board-certified clinical psychologist with a background in neuroscience. She is the Director of Clinical Training at Bay Path University, and an associate professor in graduate psychology. Hallett has a private practice in Suffield, Connecticut, and over 25 years of experience providing psychotherapy, consultation, and supervision to medical and mental health professionals in addressing relationship and major life issues with a specialty in complex trauma and dissociative disorders.
Hallett is also an executive coach, host of the Be Awesome podcast, and author of two books. She's passionate about stress reduction and self-care. Access her free guide to being stress smart and becoming your own best friend.