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A major epidemic is uniquely and perversely cruel to sufferers of OCD. OCD fixates on invisible and immaterial threats to your wellbeing; OCD demands repetitive ritual behaviors to prevent such dangers; and OCD treatment, through Exposure Response Prevention therapy, requires the sufferer to confront that danger and risk harm without protecting themselves.
The coronavirus epidemic has flipped all of this upside-down.
Suddenly, using Purell every time you touch a doorknob isn’t a symptom of mental illness, and suddenly, risking exposure is no longer therapeutic but legitimately dangerous. If you’re managing social anxiety or a depressive disorder, the struggle to leave the house has become an edict to stay inside. The uncertainty and anxiety that contribute to many disorders are suddenly externally validated.
First of all—and I wish there were a way to express this more emphatically and persuasively through writing—I cannot express how sorry I am that you have to deal with this. I wish this were a kinder, healthier world. I wish I could do something to help you in a meaningful, substantial way. As an OCD sufferer, I can only hope my writing adequately coveys my sympathy for the pain you’re experiencing, and that my advice is at least somewhat useful.
To balance virus prevention against obsessive-compulsive tendencies, you need to consciously and deliberately recalibrate your health practices to stay safe without going overboard into compulsive behaviors—and then maintain that hygienic routine, no more and no less, even in moments of extreme stress or fear. When confronted with a health crisis, your OCD will exploit the uncertainty to demand increasingly extreme preventative behaviors, far beyond anything productive or reasonable. You need to determine what specific preventative measures are worth taking, and then you need to hold yourself to that. You need to make a plan and stick with it.
Just as physical contact can transmit a virus, social and televised media can transmit infectious, self-perpetuating thoughts. This is not to say you should cut yourself off from the outside world—rather, determine how much information you actually need to stay safe and informed, and cut off the rest. Obsession is like fire—to burn sustainably it requires fuel. Exposing an obsessive mind to the 24/7 news cycle in a time of global uncertainty is worse than just adding kindling: it’s a constant pump of unknown, hazardous, and variably flammable chemicals.
A major flaw of the human mind is that it cannot, by definition, examine itself objectively. To correct for this, you need to reach out to others who can keep an eye on you and provide objective feedback on your thoughts and actions—people who can help you recognize when you’ve been pulled down into obsession. Most important is to continue contact with treatment providers, if possible, through phone and video conferencing. But also stay in regular contact with friends and family who know you well and will recognize when you’re spiraling.
Finally, you need to be kind to yourself. Remember your coping skills and “emergency” strategies and put them to use. You may find it helpful to distract yourself with new activities or stimuli—practicing a favorite hobby or skill, or even learning new ones, to keep your brain occupied and prevent your idle thoughts from turning into symptoms. Keeping active and productive can be transformative, but be careful not to overdo it. Going for a run could be a great, healthy practice, or it could be an opportunity for your restless mind to obsess. You need to monitor your activities and stick to what works.
I wish I could conclude this essay optimistically without resorting to platitudes or providing the kind of superficial reassurance that ultimately only perpetuates OCD symptoms. I wish I could tell you everything will be okay. But I can’t, because in all honesty, right now, the outcome of this epidemic is still uncertain. The only assurance I can offer with any certainty is that over the course of human history, many, many brilliant people have been rationally convinced that they were living in the end times—yet there is solid precedent of human civilization not ending. A modern epidemic is scary and frustrating, but we no longer need to fight off giant infectious rats, and we have legitimate preventative measures that do not involve leeches or drinking mercury or sacrificing goats.
The best encouragement I can offer is this: If you’re already fighting against the disorder—if you’ve confronted the worst of your symptoms, if you’ve survived your worst days—then you’ve already proven that you’re strong enough to get through this.
Copyright, Fletcher Wortmann, 2020.
Author of Triggered: A Memoir of Obsessive-Compulsive Disorder (St. Martin’s Press), named one of Booklist’s “Top 10 Science & Health Books of 2012.”
Read my Psychology Today blog: Triggered
