How Does the COVID-19 Pandemic Affect People with Obsessive-Compulsive Disorder?

What you need to know

• The COVID-19 pandemic can significantly worsen symptoms for people with Obsessive-Compulsive Disorder (OCD), especially those with contamination fears.
• Following official health guidelines is sufficient for protection; excessive cleaning or handwashing does not provide additional safety.
• Accurate, personalized information about COVID-19 risks can help people with OCD manage their anxiety and prevent symptom escalation.

Understanding OCD in the Context of COVID-19

Obsessive-Compulsive Disorder (OCD) is a mental health condition characterized by unwanted, intrusive thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that a person feels driven to perform to alleviate anxiety. The content of obsessions isn’t random; it’s often triggered by external events and related to current concerns. This means that major events like the COVID-19 pandemic can have a significant impact on people with OCD.

Who is most at risk?

The researchers identify several groups of people who are particularly vulnerable to developing or experiencing worsened OCD symptoms during the COVID-19 pandemic:

1. Those with fears about becoming contaminated themselves
2. People who fear unknowingly spreading contamination and causing harm to others
3. Individuals who tend to seek reassurance by excessively searching for COVID-19 news
4. People who overestimate threats

Even individuals without pre-existing OCD may be at risk of developing compulsive behaviors. For example, the emphasis on frequent, thorough handwashing during the pandemic might lead some people to engage in excessive handwashing as a way to relieve anxiety, potentially developing into a compulsive behavior over time.

Managing OCD Symptoms During a Pandemic

The researchers offer several key pieces of advice for people with OCD and those at risk of developing symptoms during the COVID-19 pandemic:

Stick to Official Guidelines

One of the most important messages for people with OCD is that following the recommendations of official health organizations, such as the Centers for Disease Control and Prevention (CDC), is sufficient for protection against COVID-19. There’s no need to:

• Wash hands for longer than recommended
• Use stronger disinfectants
• Clean surfaces in the home more frequently if there hasn’t been contact with external objects

For people with contamination-related OCD, it’s crucial to understand that these extra precautions don’t provide additional safety and may actually reinforce OCD symptoms.

Understanding Transmission Risk

People with OCD often worry about inadvertently spreading the virus to others, even when they’ve been isolating and following all guidelines. To address this, it’s helpful to understand how COVID-19 spreads:

• The main way the disease spreads is through respiratory droplets from coughing or sneezing.
• If a person is following social distancing rules and doesn’t need to self-isolate due to symptoms, the chance of inadvertently passing on COVID-19 is minimal.

This information can help reduce anxiety about accidentally harming others.

Managing Information Seeking

People with OCD often engage in excessive reassurance-seeking behavior, which can manifest as constantly checking news and information about COVID-19. To manage this:

• Limit information gathering to reliable sources like the CDC and World Health Organization (WHO).
• Check these sources only once or twice daily.
• For children and young people, parents should provide updates from these sources once or twice daily and avoid repeated reassurance.

Realistic Risk Assessment

A key strategy in managing OCD-related anxiety is to establish realistic estimates of risk. The researchers suggest using a common equation from cognitive behavioral therapy:

Anxiety ∝ (Perceived probability of harm × Perceived seriousness of harm) ÷ (Perceived ability to cope with danger + Perceived ‘rescue factors’)

This equation helps break down anxiety into manageable components. For example:

• Perceived probability of harm: What’s the actual likelihood of contracting COVID-19 in your area?
• Perceived seriousness of harm: If you did contract COVID-19, how severe would it likely be given your age and health status?
• Perceived ability to cope: What resources and support do you have to help you manage if you did get sick?
• Perceived ‘rescue factors’: What medical treatments are available if needed?

By obtaining realistic estimates for each of these factors, people with OCD can develop a more balanced view of the risks associated with COVID-19.

Personalized Risk Information

While public health messages necessarily focus on the risks of COVID-19 to encourage compliance with safety measures, for people with OCD, it’s important to provide a more nuanced picture. This might include:

• Information about the total world population compared to the number of confirmed cases and deaths
• Age-specific and health condition-specific risk information
• Emphasizing that most cases are not severe and many people recover at home or with hospital treatment

This personalized, accurate information about risks can help prevent the development or worsening of OCD symptoms.

The Importance of Professional Help

While these strategies can be helpful, it’s important to note that managing OCD, especially during a stressful time like a pandemic, often requires professional help. Cognitive Behavioral Therapy (CBT), particularly a type called Exposure and Response Prevention (ERP), is the gold standard treatment for OCD. If you’re struggling with OCD symptoms, reaching out to a mental health professional who specializes in OCD can provide valuable support and guidance.

Conclusions

• The COVID-19 pandemic presents unique challenges for people with OCD, particularly those with contamination-related symptoms.
• Following official health guidelines is sufficient; excessive cleaning or precautions are not necessary and may worsen OCD symptoms.
• Managing information intake, understanding realistic risks, and focusing on coping abilities can help manage OCD-related anxiety during the pandemic.
• Professional help is often necessary for managing OCD, especially during stressful times like a pandemic.

By understanding these concepts and implementing appropriate strategies, people with OCD can better navigate the challenges posed by the COVID-19 pandemic and maintain their mental health.