OCD and coronavirus: How to manage obsessive compulsive disorder in a pandemic

For those with OCD, advice on washing hands and avoiding germs could potentially trigger serious mental health issues

We’ve all heard the repeated advice: stay inside, distance yourself from others, wash your hands, wash your hands, wash your hands.

It’s a mild inconvenience for some, a huge inconvenience for others, but for those with OCD, the advice could potentially trigger serious mental health issues.

What is OCD?

OCD, or obsessive-compulsive disorder, is a common condition which affects around 1.2 per cent of the population. People with OCD usually experience two things: obsessive thoughts and compulsive behaviours. An obsession is a repetitive, unwanted, distressing and intrusive thought, image or urge which causes disgust or unease; while a compulsion is a repetitive behaviour or mental act (silently repeating ‘special’ words, images, or numbers) which someone with OCD feels they must do to relieve the distress caused by the obsessive thought. A common portrayal of OCD is someone who obsessively cleans or who repeatedly washes their hands.

Many people without OCD may experience obsessions and compulsions, but the feature which separates OCD from isolated symptoms is the intrusiveness of the obsession and the impact of the compulsion. Obsessions will differ from person to person, but common themes include the fear of causing harm and the fear of contamination.

Frequent hand washing advice could exacerbate symptoms of OCD (PA)
(PA)

Why could OCD be difficult to manage during a pandemic?

The outbreak of coronavirus has led to concern, and some panic and fear. Dr Andrew Iles is a consultant psychiatrist at the Priory Group, and treats patients for mental health conditions, including OCD. He says that people with OCD who have received treatment for their illness may be left in a state of conflict. “Treatment encourages people with OCD to confront their obsessions and to resist the urge to carry out the compulsive act. In times such as these, when people are being told to be extra cautious about environmental hygiene and hand washing, it is likely that people with OCD may feel that their fears were justified all along. That they are right to be worried”.

Some fears have resulted from those with mental health issues worrying about whether or not they will be able to get their medication from pharmacies during the period of isolation. Pharmacist Thorrun Govind has said that planning and preparation will of course help – organising your prescription before you need it, and not running out. She points out however, that stockpiling will have a negative effect. “We are providing for everyone”, Govind says, “a lot of pharmacy teams are really busy right now, so organisation is key”.

Lauren, who asked to only be referred to by her first name, lives with OCD. She was diagnosed in 2018, has received help through her GP, and is currently on the waiting list for help from her local Community Mental Health Team. She has struggled with compulsive hand-washing and fears of harming people because of being contaminated, but says the struggle has deepened since the outbreak of coronavirus.

“I'm experiencing constant thoughts that I should have done more to stop the spread of coronavirus”, Lauren says. “Being told to frequently wash hands by health professionals, the government and at work is triggering and feeds the OCD. I haven't had treatment yet, so I do not feel safe to not follow my compulsions. My hands are cracked and burned because I washed them in bleach because I felt so contaminated”.

The recent stockpiling and wealth on online information has also affected Lauren: “I broke down in tears in a local shop because I was not able to find any soap or hand sanitiser. This has overtaken my life completely. It is also really difficult to stay away from the media and to not check it several times a day. I think if I am not aware of what is going on I will be responsible for contamination”.

An OCD sufferer told us she washed her hands in bleach rather than soap and water or hand sanitiser 
PA

What can be done to help?

Whilst medication and talking therapy are recommended in the treatment of OCD, for those that cannot access it, there are other ways to self-soothe and get help for OCD during this time. As Dr Iles recommends:

  • There are many apps, breathing exercises, relaxation and distraction techniques, and mindfulness exercises, which can be useful
  • Those with OCD who are affected by talk of coronavirus should take a break from the news. This does not mean ignoring the news, but limiting the times when you listen to or read the news.
  • Follow official advice on hand-washing, but going to excessive lengths will be counterproductive. Only clean your hands for the recommended amount of time, and only ever with soap and water. 
  • Make sure you maintain social contact by phone or video call.

The important message for a person who fears contamination is that their environment is not the dangerous place they fear it to be, and the risk of contamination is not as high as they think it is.

Could the pandemic lead to more people developing OCD?

According to Dr Iles, the coronavirus threat may result in more people who were already predisposed to developing OCD showing symptoms for the first time. However, it is important to remember that it is unlikely that the disorder would develop in people who do not have pre-existing vulnerabilities. These vulnerabilities include a genetic predisposition, certain life experiences and a tendency to worry. People with health anxiety may be equally if not more affected by this novel threat, but there is help out there for people who need it, including online therapy.

There is helpful information available from OCD UK.

If you are struggling with your mental health more generally while self-isolating or social distancing, here are 5 tips that could help from community pharmacist Thorrun Govind:

  1. Treat yourself: Make sure you’ve got some great things planned in for your week – whether that’s a good book, a favourite meal or a bar of chocolate.
  2. Use social media for good: Social distancing and self-isolation don’t mean that you can’t be social, so make full use of social media. There are great ways to stay in contact with people, without actually being in close proximity to them.
  3. Get dressed:If you’re working from home, it can be easy to feel like work consumes your day. Try and get into a routine – it’s great to get dressed into your work clothes, and change out of them at the end of the day so that you continue to have a work-life balance.
  4. You can do indoor exercise: Exercise can be vital to our mental wellbeing. Just because you’re not outside doesn’t mean that you can’t move your body. You can always video call friends and family and encourage them to join too!
  5. Eat varied and drink water: Having a variety of foods on your plate and making sure you’re not eating the same thing every day is really great for your spirits, and great for your mental health​

There is more information available on the NHS website.

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