The coronavirus crisis and managing my OCD

Over the past few weeks, as the Covid-19 coronavirus has made its way around the world, I’ve found myself preoccupied with worry. Am I washing my hands enough? Am I touching my face? What am I touching on the subway? What if I get infected and don’t realize it, and unknowingly pass on the virus to older or immunocompromised loved ones? Maybe I should start wearing a surgical mask when I visit my parents. Maybe I should stop visiting my parents. Maybe I should stop leaving the house.

As someone who lives with OCD, I’m used to having my anxious thoughts take over — and, thanks to the work I’ve done in therapy, I’m usually pretty good at flagging thoughts as anxiety and OCD rather than a legitimate concern. But as the coronavirus outbreak has put the world on high alert, many of the thoughts I’d ordinarily dismiss as a product of my anxiety have started to seem like rational worry, and I find it harder to push back.

Although many people associate OCD with obsessive cleanliness — a habit that might seem helpful in the midst of an outbreak — the reality is much more complicated. For many people, OCD involves extreme hypochondria or intrusive thoughts about harm coming to oneself or loved ones. The stress of an outbreak can exacerbate those fears, leading to a resulting increase in compulsive behavior, like time-consuming rituals that disrupt one’s life, or extreme self-isolation.

It’s not just people who live with OCD. For anyone with generalized anxiety or other mental disorders that make one prone to excessive worrying and irrational behavior, outbreaks can be a particularly dangerous time. As we work to protect ourselves from pathogens, it’s easy to get caught up in panic — and that panic can threaten the tenuous control we maintain over our mental health.

So how can you avoid infection without spiraling out of control?

For starters, avoid the temptation to learn everything you possibly can about Covid-19. While more information might seem like the best defense against illness, it’s far more likely to ramp up your panic — especially if you’re getting that information from a place like Twitter, where the takes are fast, furious, and frequently unverified. On social media, “the information is coming so fast and so thick and so unverified that it’s very easy to get overwhelmed,” says bioethicist Kelly Hills. “If you don’t need to stay on top of this for your job or your academic work, don’t.”

Hills recommends limiting your Covid-19 news consumption to once a day, and only getting that news from a trusted, verified source. While staying informed is important, sensationalistic coverage is far more likely to inflame panic and cause more harm. “We have to regulate and make choices about what we are exposing ourselves to,” says therapist Jenn Brandel, noting that managing anxiety around outbreaks requires us to focus on facts rather than emotions. If it’s friends and family, rather than the news, who are inundating you with Covid-19 updates, it’s okay to mute them on social media, or ask them not to message you with anything related to the crisis.

Second, set a basic safety regimen — and avoid the temptation to add to it. As you’ve likely heard, regular hand-washing is one of the most essential components of coronavirus prevention, but washing your hands repeatedly, for far more than 20 seconds at a time, is moving out of disease prevention territory and into compulsion territory. Too much hand-washing can actually work against that effort.

“If you are washing your hands so much that they are raw or chafed, you are washing your hands too much,” says Hills. Washing your hands, she points out, isn’t about preventing an infection from seeping in through your skin; it’s about removing pathogens before you pass them on to points of entry like your eyes, nose, and mouth. If your hand-washing leads your skin to crack and bleed, you’ve created a new entry point for the virus — meaning you could be more, not less, likely to get infected. (If you or a loved one are at elevated risk due to a comorbidity, Hills notes you can also wipe down light switches, phones, countertops, and other frequently touched surfaces with a Clorox wipe once a day — but once a day should be sufficient, and the entire process should only take a few minutes.)

If you’re worried that a self-quarantine might amp up your anxiety or depression, staying on top of your general fitness and wellness regimen is even more important during a stressful time like this one. Make sure you’re sleeping enough, eating a balanced diet, and getting some exercise. Even if you’re unable to leave the house, there are plenty of at-home workouts (everything from aerobics to Zumba) that you can use to get your heart racing from activity rather than anxiety.

And if you’re feeling really overwhelmed, remember that you don’t have to go through this alone. Therapy, Brandel says, can be an important part of managing your mental health during a crisis. If therapy isn’t an option for you, a trusted source — a doctor, a family, or a friend — who can help you analyze what is a rational concern or safety measure, and what is a panicked, anxious overreaction, is another excellent option.

And as social distancing becomes more widespread, with more of us finding ourselves having to work from home or stay in to care for children who can’t go to school, it’s good to plan some strategies to stay in touch with your support system remotely. Group chats and video chat can be a great way to feel connected to friends and family, but it’s also a good idea to check if your therapist is available to do sessions remotely over video chat or phone.

In my case, it’s been helpful to talk things through with friends and family, making a safety plan I can stick to that doesn’t go overboard. When I feel the urge to wash my hands, I stop and think about whether there’s actually a chance I’ve picked up new pathogens since I last scrubbed them, applying the same mindfulness techniques I’ve always applied to help manage my intrusive thoughts and compulsions.

Ultimately, the best way to get through these trying times is to just “keep doing your work,” says Brandel. “It’s easier to do our work around managing intrusive thoughts or managing compulsive impulses when we’re in the best of conditions. These aren’t the best conditions for someone with OCD [or other mental illnesses] — these are going to be hard conditions. But the work is still the same.”

Whether you’re struggling with OCD, generalized anxiety, or another mental illness that’s feeling more intensified in these trying times, you’ll be able to get through this outbreak the same way you get through everything: taking it day by day.

Lux Alptraum’s work has appeared in a wide range of publications including the New York Times, Cosmopolitan, and Hustler. Her first book, Faking It: The Lies Women Tell About Sex — And the Truths They Reveal, explores our cultural obsession with feminine deceit. Find her on Twitter @luxalptraum.

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