OCD sufferers may be experiencing high levels of anxiety during the coronavirus pandemic. Here are some ways to cope.
How many times have you heard people jokingly refer to something “bringing out their OCD” as in, “I get so OCD about the kid’s shoes everywhere.” Yet, Obsessive Compulsive Disorder is no joke. This can be a debilitating disorder that runs people’s lives.
During this pandemic people with OCD may have had an increase in anxiety. We all fear Covid-19 but if you have OCD then this fear can intensify. The majority of people without OCD can be reassured by the things that they can do that are within their control; the 20 second hand washing and the social distancing. When a person has OCD they are convinced that they will catch coronavirus unless they do a certain compulsive behaviour; like repeatedly washing their hands until their hands become sore.
What is OCD?
Obsessive Compulsive Disorder or OCD as it is commonly known, is a mental health condition where the sufferer has obsessive thoughts and compulsive behaviours.
There are three elements to OCD:
Obsession — The sufferer experiences unwanted thoughts or urges; “If I don’t clean every surface with bleach ten times today then my family will all become ill.”
Emotions — The obsession causes intense distress, anxiety and fear.
Compulsion — The sufferer feels that they must perform a compulsive activity as a way to alleviate the distress or anxiety caused by the obsessive thoughts and emotions.
The thoughts that people with OCD have are often about contamination, harming self or others, or a need for symmetry or orderliness.
Most of us have unwanted thoughts during the day. We have thousands of thoughts each day. We can’t always choose our ‘pop up’ thoughts but it doesn’t necessarily mean that we have to attach to them or act upon them, nor do we need to take them seriously or as fact.
The difference between the 80% — 90% of the population that experience intrusive thoughts and those that develop OCD is the personalisation of those thoughts and the feelings that the thoughts must be acted upon. For instance, we might be in bed and have the thought, “my front door is open. Someone will break in.” Most of us would scan our minds and remember that we had locked the door. For people with OCD they would be unable to dismiss the thought and would have to check that the door was locked, maybe over and over, to eliminate feelings of intense fear and anxiety that they are unsafe.
The compulsive behaviour; checking the locked door, might temporarily relieve the anxiety, but soon the sufferer is locked back into the cycle.
With OCD sufferers it is thought that the area of the brain that is overactive is the Anterior Cingulate Cortex. This area of the brain plays an important role in affect regulation; the ability to regulate emotions. The avoidance of painful emotions play a role in OCD and this is why OCD and trauma have been linked.
Ways to cope.
OCD can be treated with exposure response therapy. This is really about facing the fear head on to re-wire the brain and the thinking. A gradual exposure to the fear will eventually desensitize the person. This is done little by little and anxiety levels are monitored with each step.
Take for example, if a person has a fear of contamination and germs. Going to a supermarket might make them feel 100% anxious and they feel that they have to come home, take a 30 minute shower, and disinfect all food packaging (once it is allowed into the house from the garage) to alleviate that anxiety.
So, to start with, the person would visit the supermarket, collect their groceries and take the groceries home. Their anxiety would be 100% for sure but they are facing their fears, remember, to relieve themselves of OCD. They would start exposure treatment by having a 15 minute shower (so they have cut showering by half) and they would bring some packaging in from the garage and maybe a quick wipe over the packaging befor putting it away. Their anxiety would still be high but they would realise that no harm has come to them or their family. Next time they go to the supermarket they do not shower and they bring in further packaging. Their anxiety levels may have come down a little and they can self monitor this. This would be done little by little with a gradual decrease in anxiety levels.
Just a reminder; it is very unlikely that coronavirus can be caught from food packaging.
This is an extreme example given the pandemic that we have, but a person telling themselves that they are highly unlikely to catch covid-19 from the packaging around a cereal box is difficult. This rational thinking will not always fully help their distress.
The fear experienced when you have OCD is about the uncertainty of being contaminated. Ashley Fulwood, Chief executive of OCD-UK, explains that it’s the uncertainty that gives the OCD ‘wiggle room’. He goes on to explain that by telling himself that he will become contaminated and become ill does not allow for wiggle room, and allows himself to get on with his day. It’s a difficult thought to have, and in many ways, what he is doing is allowing the thoughts to just BE thoughts, giving them a nod, and moving on without letting the thought effect his behaviour. This is not easy but it’s the thoughts that we constantly repeat to ourselves that effect our behaviours and our emotions.
The government guidelines on hand washing during the pandemic is soap and water for 20 seconds. It might be tempting to wash for a lot longer, and people that are in treatment for OCD will historically have been told not to wash their hands to begin to tackle their OCD. Getting family support to help them to step away from the bathroom will help to stick to the 20 seconds and using distraction will further help. It’s also worth remembering too that using simple soap will be enough to wash away any of the virus and 20 seconds is enough to work up a lather and breakdown the germs.
Distraction techniques whilst delaying the compulsive behaviour helps to rewire the connections in the brain. So delay washing hands for 5,10 or 15 minutes. During that time distraction will help; make a cup of tea, take a walk, play music and dance.
Experts are not 100% sure what causes OCD but they do know that increasing levels of serotonin in the brain can help alleviate anxiety. Exercise will increase serotonin which will help to improve mood, emotions and wellbeing. Medication can help to kick start the boost to serotonin so that the self work can be done. A diet that is high in tryptophan can also boost serotonin levels. Foods such as eggs, spinach, salmon, poultry, soy and grains.
It takes time, and facing fears is difficult, no doubt about it, but so is living every day in fear. Tackling your fears head on will eventually lead to a life free from fear.