Managing OCD During the End Days of COVID

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After the turmoil of the past few years, it’s encouraging to see some more positive news, especially around the waning danger of COVID. Most of us are looking forward to resuming normal activities as the virus moves from pandemic to endemic phase. However, anyone suffering from an anxiety disorder—especially OCD—may discover the transition back to normal life has its own challenges.

In "Living With COVID as the Pandemic Wanes," I explored why the transition from the pandemic may prove uniquely triggering for OCD sufferers. Today, I’d like to offer some proactive advice about how to manage OCD symptoms through this period of transition.

Consult With Your Treatment Providers

Instead of trying to navigate the transition on your own, consult with your therapist and/or physician, and build a plan that will help you confront and overcome your unhealthy anxiety, while avoiding legitimate danger.

One of the main challenges of the pandemic was that it made the most effective therapy for OCD essentially impossible. OCD is typically treated with exposure-response prevention (ERP) therapy: With the help of a therapist, the sufferer confronts a trigger for their symptoms but consciously resists using any protective rituals. This gradually teaches them to manage their anxiety without resorting to obsessive-compulsive behaviors. So if, for example, you obsess about contracting a deadly virus and compulsively wash your hands, your ERP might include touching a toilet seat and then deliberately choosing not to wash your hands.

You can see why the pandemic would present a huge problem for OCD sufferers. When the pandemic hit, and everything got flipped upside down, high-anxiety, low-risk ERP exercises were not possible—suddenly, they were legitimately dangerous. So, as the world returns to normal, you need to consult with a physician and a therapist about how you can strike a healthy balance between minimizing ongoing risks while resuming your ERP exercises.

Develop a Plan and Stick to It

I must emphasize that expert advice is critical here. OCD makes it very difficult to objectively determine risk and appropriate management strategies. It exaggerates risk and encourages rumination and circular thinking over decisive action. If you try to work out a plan on your own, your OCD may trick you into wasting an hour seeking out up-to-the-moment statistics about vaccination rates and new variants in your community, just to determine whether or not you should wear rubber gloves to the grocery store on a Thursday. The moment you begin to second-guess yourself, to give in to your anxiety around uncertainty, you are giving your OCD an opportunity to take over and derail the entire process.

You can avoid all of that by building a plan with health experts you trust, and then committing to it. When your OCD tries to get you to second-guess this plan, remind yourself that your treatment providers know a lot more about both COVID and OCD than you do and that their recommendations represent a wiser course of action than anything you can come up with on your own. Having a plan you know you can stick to, especially in moments of extreme anxiety, will make it easier to avoid getting mired in OCD thinking.

Watch Your Internet Usage

One tactical recommendation is to carefully monitor your internet usage in order to reduce your reassurance-seeking, procrastination, and avoidance behaviors.

While quarantine protected us from viral infections, it ironically exposed us to an infinite vector of toxic misinformation. I’m sure you’re aware of the multitude of ways the internet is dangerous to your mental health, but people don’t talk enough about how it can reinforce obsessive-compulsive thinking.

When you are anxious about the state of the world, the first thing you do is check the news, to see if things are improving or (more likely, you suspect) getting worse. Rather than providing concrete answers, the internet worsens your sense of uncertainty and anxiety with vague op-eds and unsourced articles; meanwhile, every new page carries the promise and/or threat of a world-changing story with just one more click of that refresh button. Like most OCD rituals, this form of pathological web browsing pretends to offer a solution to anxiety while actually making it worse, reinforcing the cycle with each repetition.

Unlike OCD, the internet is not an accident of human psychology, and many websites are maliciously designed to put you in a sustained fugue state of engagement and emotional arousal. The Skinner box mechanics that many websites exploit, encouraging sustained engagement using occasional rewards, can feed directly into OCD reassurance-seeking, which rewards repetitive behavior with occasional reductions in anxiety.

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Returning to normal life after COVID is already a major undertaking, even without bad habits holding you back. If you’re climbing Mt. Everest, you leave the cigarettes at home; and if you’re managing OCD symptoms during a time of global uncertainty, turn off the anxiety box. Some strategies include:

• Use your smartphone’s “screen time” features to restrict your web browsing;
• Download an app to block access to your favorite websites;
• If all else fails, smash every screen in your house with a sledgehammer and then buy a flip phone.

Internet addiction is a handicap you can’t afford when you’re on this difficult path.

Building and following an individual plan to help manage your personal challenges can help address potential OCD pitfalls as COVID wanes.

Copyright Fletcher Wortmann, 2022. Please credit the original author, Fletcher Wortmann, and Psychology Today.

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