“My OCD is always telling me to do more—to scrub my hands a little harder.”
For just about everyone, the COVID-19 pandemic has been a time of change—altering how you see the world, how you interact with loved ones, how (or even if) you work, and how you live your daily life. You’ve probably developed new habits, such as getting groceries less frequently and FaceTiming your friends.
And of course, there’s washing your hands. It’s not that handwashing guidelines have changed—experts have always recommended washing for at least 20 seconds before eating and after using the bathroom, for example—but these guidelines are now being amplified, repeated, and written on every poster.
As important as these handwashing guidelines are, they can be incredibly triggering for people with obsessive-compulsive disorder, or OCD.
“My OCD is contamination-based,” says Georgina Hall, who has lived with OCD for the last eight years. “My obsessions centered on the possibility of causing someone harm by passing on transmissible illnesses, particularly viruses.”
For people with OCD, the COVID-19 pandemic may worsen or revive obsessive thoughts and compulsive behaviors. Hall, who has been open about her mental health journey and her treatment for OCD on her Instagram, admits the pandemic is stirring up some of her old thoughts. “If I don’t follow [the rules] to the satisfaction of my ‘OCD mind,’ I’m a threat to my loved ones and to the community at large,” she says.
Understanding the OCD Mind
Despite being well known, OCD is a frequently misunderstood mental health disorder. Many mistake it as simply having a “type-A personality” or being organized or particular, but OCD is a type of anxiety disorder that causes severe distress to an individual’s life.
OCD comes in many forms—it involves a wide range of recurring thoughts (obsessions) and ritualistic behaviors (compulsions)—but fear of germs and excessive handwashing are one of the most common manifestations of OCD.
Prior to seeking treatment, Hall says she used “extreme handwashing rituals” that often resulted in burns, bruises, and repetitive strain injuries. “I would even restrict my water intake, because going to the bathroom and washing my hands afterwards could take over an hour,” says Hall. Not surprisingly, these severe symptoms limited her ability to engage with work, school, and life itself.
From the outside, you can only see someone’s rituals, but inside, there are deeply unsettling and compelling thoughts and fears driving the behavior. Often, there’s a fear that something catastrophic could happen if the ritual is not carried out.
“At the heart of my condition is an over-inflated sense of responsibility to protect others from harm,” says Hall. “I’m not concerned about getting sick, but passing on an illness is my worst nightmare. That makes the COVID-19 world (where there is a reasonable chance of that happening) a scary one for me.”
OCD in the COVID-19 World
Like many people with OCD, Hall has undergone cognitive behavioral therapy (CBT) and exposure and response therapy (ERP), which are two of the most common therapies used for this anxiety disorder.
CBT is a type of therapy that works to challenge negative thought patterns in order to alter unwanted behaviors. ERP—which is actually a subtype of CBT—helps the individual face their fears and refrain from using the ritualized behavior. In other words, you know that you can skip washing your hands and nothing terrible will happen—generally speaking.
But during the COVID-19 pandemic, when unwashed hands could facilitate the spread of the novel coronavirus, it can be a major challenge for people with OCD to simultaneously navigate recovery and COVID-19 prevention.
“As diligently as I follow the measures put in place by public health experts, my OCD is always telling me to do more—to scrub my hands a little harder, to use water that’s a little hotter,” says Hall. “I have the ordinary protective measures to adhere to, but my OCD is sneaking its own rules in there, too.”
Coping with OCD During COVID-19
While there are many environmental stressors that could make treating or maintaining recovery from OCD difficult, there are also healthy ways to cope, while doing your best to help slow the spread of COVID-19.
“I developed an excellent ‘tool kit’ of coping mechanisms during my previous CBT sessions, which I’m trying to put into action when I catch my compulsions escalating,” says Hall.
For example, while she can’t stop washing her hands, she can be mindful of how she’s washing her hands, and what she’s thinking while doing it. “I can create my own exposure exercises by halting an OCD ritual before it’s ‘complete,’ and working my way past the anxiety that causes me,” she says.
Additionally, she says it’s helpful to remember that this virus “goes beyond the realm of individual responsibility, and that all any of us can do is follow public health advice diligently, but not excessively.”
While the COVID-19 pandemic has been challenging for everyone, and particularly for people with mental illnesses like OCD, Hall says she’s been pleasantly surprised by the displays of community and camaraderie she has seen, including friends and colleagues revealing their own OCD diagnosis.
“COVID-19 has separated us physically, but it has also brought us together in surprising and heartwarming ways,” says Hall. “I am terribly sad for anybody who is suffering in these uncertain times, [but] I am heartened by the possibility that we might allow this to shape us as a more open-minded, sensitive, connected global community.”