“Crisis doesn't change people; it reveals them.” Eric Walters, The Rule of Three
So, we have that rare occurrence when behaviours that appear as contamination OCD are widely encouraged and advisable. However, for people with OCD, it presents a number of problems. The public might assume that people with OCD will cope well, given they’ve had some practice in this area but this is not the case. Not least because contamination OCD is just one of a number of OCD sub-types, many of which have no issues around contamination or hygiene. For those managing OCD, what is happening now represents the possibility of relapse and for those not managing their OCD it represents the possibility of developing contamination symptoms and or any number of obsessions relating to a global pandemic, economic meltdown and widespread fatalities.
If you have OCD or are caring for someone with OCD, here are some guidelines to assist you through this difficult time:
Catastrophising: or 'awfulising'. Focus away from the problem and towards a flexible solution. Instead of thinking ‘this is terrible’, change that to ‘this is a tough time but with precautions and not panic, I can cope’. If you have had CBT, fall back to your ABC models and rational beliefs. If you are caring for someone with OCD, language can play a huge role, so be careful about using words or phrases that are catastrophic, awful or terrible. Moderate these words and phrases to ones where coping and managing are central.
Limit your on- and offline news exposure: people with OCD can find news and information addictive. The media is designed to draw you in and keep you there. Set yourself a limit and check the TV news/news apps once a day or equiv. Unless you are in media, you don’t need to be up to the minute. Focus on your life/work/family and daily routine. For carers, try not to leave the TV on a news channel and limit reporting what you read on your devices.
Talk about something else: even though it is tempting to lapse into ‘Corona chat’, try to keep your conversations varied and diverse. People with OCD become very narrowly focused, very quickly, which doesn’t help with mindfulness and remaining rational. For carers, try to steer the conversation towards other topics.
Contamination OCD: the relapse rate for contamination OCD is high so if you have this sub-type be careful to protect yourself from relapse. Follow sensible, published guidelines such as washing hands, using sanitiser, not touching face, avoiding unnecessary international travel, etc. It isn’t advisable to avoid all public outings, take prolonged showers, use different clothing for indoors & outdoors, use bleach, boil wash your clothes or isolate yourself without any symptoms. This may be an opportunity to work on some of your other contamination issues, e.g., chemicals, foods, additives, faeces, etc. For carers, if you observe any behaviours that are excessive, raise your concerns without judgment, and if you are both agreed, work together on some mutually agreed exposure tasks.
Hypochondria OCD: for those people with OCD health-related concerns Corona represents a huge trigger. In our experience, if health isn’t your primary sub-type, it is often a symptom that exists alongside other subtypes. Focus away from monitoring your body for coughs or cold symptoms and use mindfulness to remain present without judgment or analysis. If you were to develop symptoms, you will cope better if you are calm and mindful. Refrain from googling the symptoms on a daily basis just in case new symptoms are presented. Carers, try not to get involved in any verbal symptoms lists or……
Reassurance: for people with OCD, seeking reassurance is a compulsion and will exacerbate OCD. Try not to seek reassurance regarding Corona Virus online, via the TV or from others. Once you start it will be difficult to stop. It's like scratching an insect bite. Resist! Carers beware of offering it since the reassurance seeking can be covert and manipulative. Be careful with the more obvious questions, ‘When you were at the supermarket today, did you notice anyone with symptoms?’ or ‘Do you think I was coughing in the night?’ and the less obvious, ‘Did you see that sweaty person in the queue just now?'. If in any doubt, kindly decline to answer.
Responsibility OCD: if you have responsibility OCD your fears of contracting the virus will be matched or outweighed by those of passing it to others. Regardless of the fact that this situation is evidence that we can’t control our environment therefore infecting others is an unfortunate part of human existence. Corona will be a sizeable trigger. Try not to relapse in to behaviours that involve de-contamination, avoidance of others and mental self-recrimination. If you have had CBT therapy, re-visit your self-acceptance work and rational beliefs.
Resist the test: medical testing is very compelling for those with OCD because they believe it offers certainty. In reality, this sense of certainty is temporary and the temptation for further tests will be imminent. Try not to present yourself for a COVID-19 test if you don’t have symptoms or have been exposed. The laboratories will be working at capacity as it is and the impact upon your OCD will be detrimental. Check first with a family member or friend if they think you have valid concerns before calling a health professional. Carers, if you believe that the concerns are OCD-related, offer support and direct them to their therapist or an OCD helpline for advice.
Guide your children: if you have OCD and have children or have children who have already been diagnosed with OCD, then your child will have been set guidelines from school. Encourage your child to understand that flexibility exists and work with them regarding excessive anxiety if the guidelines aren’t followed exactly. Children are being encouraged to wash their hands to a particular count or associated song. If a child has OCD, this can quickly become a ritual, so try to build some flexibility. For example, work on in-between washes that have no count, playing in the garden with dirt and use phrases around coping and managing, e.g., ‘whatever happens, we’ll cope.’
Manage your anxiety: for everyone, even without OCD, this is a good time to work on anxiety management. Get back to your mindfulness skills, pick yourself a daily meditation, do some yoga at home, work out at home using videos and your equipment, focus on sleep, practice correct breathing.
Thinking time: if you have OCD, self-isolating or restricting your movements can mean more solitary time or less active time. OCD thrives in such times. When you have downtime or are less active or alone, thinking takes over the new found space. Be vigilant and fill that time with good mindfulness practice or projects. Don’t sit and think. Carers, encourage the person with OCD to stay as active and engaged with life as you can.
Finally, remember, regardless of the media drama, Corona is not your worst enemy. Living a long life with severe OCD is worse. You are highly likely to survive Corona and the discomfort will be weeks. Severe OCD can last years, tens of years. Be sensible about Corona but be absolutely vigilant about your OCD. Corona may make you sick but lapsing into OCD will derail your life. OCD is still your priority.
Stay mindful, stay rational. If you’ve got through OCD, you’ve got this.
Carers, thank you.