‘Wash hands, put on mask, don’t touch mask, take mask off, sanitise hands. Stay six feet away from people. Use toilet; wash and sanitise hands. Don’t shake hands. Wash hands, eat, and wash hands again. Sneeze into elbow, wash hands. Don’t touch face. Disinfect.’
Sound familiar? If you’re like most people in the world, the answer is ‘yes’.
While following government regulations and protocols, you may ask yourself: ‘How much is too much?’ Too much worrying and cleaning can lead to risky mental health conditions, including obsessive-compulsive disorder (OCD). Anyone who has experienced problems with OCD before the pandemic may find their symptoms increasing in severity. Some people, however, may encounter problems with anxiety or OCD symptoms that they have not noticed before.
What is obsessive-compulsive disorder?
Obsessions are constant, unwanted thoughts that escalate your anxiety. Examples include, constantly worrying about getting sick, getting others sick, or that others might get you sick, or believing that you need to wash your hands excessively throughout the day in order to prevent catching the virus. Compulsions are constant actions, thoughts, or rituals performed in the attempt of coping with obsessions. Examples are over-cleaning, excessive checking, constantly seeking reassurance from others, excessively seeking and cross-checking Covid news, and ruminating about all the things you touched today.
Put ‘o’ and ‘c’ together, plus harmfulness, excessiveness, avoidance, rigidity, distress, and impairment in different parts of life, and you may have OCD. If you are concerned, your best course of action is to meet with a mental health professional such as a psychologist, psychiatrist, social worker, counsellor, or psychotherapist. If you are experiencing OCD, anxiety, depression, or any other mental health symptoms, you are not alone and there are a number of effective treatments available.
Common OCD-related behaviours
OCD can pop its ugly head out in different ways. A common one is the felt need for control over everything – your thoughts, beliefs, emotions and natural instincts, others’ thoughts, behaviours and emotions, everything within our possession, and many more. Closely related to the need for control is inflexibility and perfectionism. Superstitious behaviors are another OCD pattern, along with magical thinking – believing that you can prevent something scary from happening by doing something that has no real connection with the desired outcome. For example, believing that by focusing on your lucky number while walking past people who are not wearing masks will prevent you from contracting the virus. Experiencing one or two of these patterns does not necessarily mean that you have OCD. Think of these as traffic signs – seeing them is helpful. So is working towards changing or coping with them.
Difference between OCD-related behaviours and Covid-required practices
Your local government sets out rules and best practices for keeping yourself and others safe from contracting and spreading Covid. Following these requirements and guidelines and not going above and beyond them, could help keep you safe from OCD-related behaviours. If you feel pressured to do more than suggested because it doesn’t feel ‘just right’, then you may be dipping into OCD territory. If that happens, it’s best to be aware of it and consider making some healthy changes:
- Self-reflection. A healthy mental practice is to reflect on your thoughts and behaviors while doing something that normally triggers anxiety. For example, while disinfecting, be mindful if you feel a need to do more than necessary and reflect on it. Ask yourself: ‘Is this a rational response or an emotional reaction?’ Shifting your focus from subjective feelings to objective facts can help you make healthy choices. Reflect on your personal goals for Covid safety and consider adding flexibility and mental health to your list.
- Acceptance. The irony of trying to stay safe during these ‘unprecedented times’ is no matter how much you prepare, clean, wash hands, disinfect, sanitise, social distance, and wear masks, you may get sick. Accepting uncertainty and your lack of control can be a big step towards positive mental health. Rather than avoiding anxiety triggers, such as the news, seeing other people not following guidelines, or realising you didn’t wash your hands yesterday before eating lunch, lean towards approaching your anxiety, making room for it, and tolerating it. A commonly felt need that brings on OCD behaviours is feeling like you are not doing ‘enough’ – not enough washing, sanitising, etc. Work towards being OK with doing enough.
- Mindfulness. Mindfulness is the practice of focusing one’s awareness on the present moment while accepting one’s senses, bodily sensations, thoughts, and feelings. Practising mindfulness can help us feel relaxed and focused, decrease our levels of stress, anxiety, and isolation, while also improving our brain functioning, blood pressure, heart rate, and immunity, along with other physical and mental benefits. Mindfulness can play a very helpful role with both the awareness and letting go of obsessions and compulsions.
- Self-compassion. What would you say to a close friend who is struggling with obsessions and compulsions? You may try to be empathetic and understanding of what they’re going through, be kind to them, not judge them, and tell them that what they are experiencing is common given the circumstances. Self-compassion is doing all these things for yourself. Kristin Neff is a forerunner in the field of self-compassion; check out her website for solid self-compassion practices. Self-compassion helps us be more understanding and accepting of ourselves. This goes against the feelings of uncertainty and need for control that drive OCD.
- Healthy boundaries. Setting healthy boundaries with yourself and others can help prevent obsessions and compulsions. For example, you are talking with a group of people and a major topic of conversation is the coronavirus. You notice that your chest is tightening and you feel tension in your neck and throat. To cope with your escalating anxiety, you ask to change the topic or remove yourself from the group.
- Life balance. Living a well-rounded life promotes overall health. Maintaining routines, planning out your days, following through, investing time to exercise or move your body, connecting with your social supports, going outside and enjoying nature, and looking for the beauty of everyday life are all good options for taking care of yourself, especially during a pandemic. So are, eating a balanced diet, drinking lots of water, getting into a good sleep routine, meditating, deep breathing, spiritual practice, and doing things that are relaxing and give you a sense of purpose and joy.
- Reaching out for help. Living with and trying to heal from OCD is hard. Mental health professionals with experience in treating OCD can provide a great deal of support and guidance. Many therapists are providing options for access, including face-to-face and/or telehealth opportunities. Check out local therapists in your area.
An earlier version of this article was published on Associates Counselling Services.
Brad Moser provides therapy for children and teens, adults, couples, and families.