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July 14, 2020
“There’s a large perception that people with obsessive compulsive disorder (OCD) are struggling more than usual as we deal with the coronavirus. In reality, it’s a pretty complex picture,” said Nathaniel Van Kirk, PhD, coordinator of Clinical Assessment for McLean’s OCD Institute.
Based on recent discussions he has had with patients, Van Kirk believes that the ways individuals with OCD are dealing with the pandemic depends on the nature of their condition. “For some, it may exacerbate their symptoms, especially if their symptoms or obsessions are in line with contamination or getting sick or fear of being responsible for harm coming to others through potentially passing the virus on to someone else,” he explained.
Others, however, are experiencing no change at all. “I’ve talked to many people with OCD who have said they don’t feel overly concerned with COVID-19. It’s not one of the things they worry about, and it pales in comparison to some of the other worries that they may have,” he said.
“Feelings of uncertainty and pending fear are not novel for those with OCD,” he added. He said that these individuals “may feel more prepared to cope with the uncertainty, especially if they are engaged in or have completed therapy for OCD, because they’ve been practicing it day in and day out.”
Still, the coronavirus crisis presents profound challenges for those whose OCD symptoms align with current concerns. For example, guidance on how good hygiene can stop the spread of the virus may cause some to go to extremes. “The CDC has issued handwashing guidelines, but someone with OCD may feel an intense urge or drive to take it much further, feeling that more must be better, especially when feelings of anxiety or uncertainty take hold,” Van Kirk said.
He explained that someone living with OCD may focus solely on one part of the hygiene guidelines and ignore the rest. “Extreme anxiety can cause you to get tunnel vision where we may not be following the recommendations the way we should be because we’re so hyper-focused on a specific piece of it that you forget about the other aspects of the CDC’s guidance,” he said. “It’s an example of how rituals develop. It’s an attempt to get rid of uncertainty and the anxiety that goes with it.”
Van Kirk and his colleagues work with people in such situations to “find a healthy balance between physical and mental health.” They help patients follow best practices while resisting urges to take hygienic behaviors to damaging extremes.
Another problem for people with OCD can stem from the constant stream of news and information about the pandemic. “OCD takes one point of information and causes it to explode. One story or one headline can become all-consuming,” Van Kirk said. “It can be hard to filter fact and relative risk from what anxiety is amplifying.”
“Feelings of uncertainty and pending fear are not novel for those with OCD. These individuals may feel more prepared to cope with the uncertainty, especially if they are engaged in or have completed therapy for OCD, because they’ve been practicing it day in and day out.”– Dr. Nathaniel Van Kirk
To address this problem, Van Kirk advises his patients to focus on trusted sources of information and follow established rules and guidelines. “In today’s world, we can only focus on the things that we can control and the information that comes from solid sources like the CDC and the WHO,” Van Kirk said. “But with that comes an acceptance that we can’t be 100% certain that what we’re doing now will guarantee 100% safety. We can only do the best we can, and that can be unnerving.”
In many ways, the coronavirus crisis may increase the general public’s understanding of OCD. “Anxiety tends to be higher today because it is across the board. Everyone is getting a sense of what it’s like to live with obsessions and anxiety every day,” said Van Kirk. “Fears such as ‘what if I’m asymptomatic?’ or ‘what if I harm somebody without even knowing it?’ are the kinds of concerns that someone with OCD struggles with every day.”
For everyone—those with OCD and those without—Van Kirk recommends balance and perspective. “We need to keep up with the guidelines but not chase headlines and let anxiety take over,” he said. “There’s a level of uncertainty we have to accept to navigate our everyday life while also observing best practices.”
McLean Hospital is a world leader in OCD treatment and research. If you or a loved one are struggling with managing obsessive compulsive disorder, we are here to help.
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