OCD and the Covid-19 Pandemic
Undeniably, Covid-19 has changed the world in more ways than one. The widespread uncertainty sparked by a global pandemic has had a profound impact on vulnerable populations. And, a culture of worry has spiked anxiety in many people who did not previously suffer.
For individuals with a diagnosis of OCD, the reality of contracting a threatening illness or being afraid of germs already existed before the pandemic. If you or a loved one suffer from OCD, you likely already know firsthand the myriad of challenges prompted by the Covid- 19 pandemic.
First, let's understand what OCD is and isn’t. Obsessive compulsive disorder is an anxiety disorder in which an unwanted thought (obsession) leads to a ritual (compulsion). OCD typically begins during childhood and adolescence and can affect any gender. Nevertheless, there are various subtypes of OCD, and contamination is frequently the focus. Contamination OCD is the obsessive thought of germs and illnesses that bring distress and alleviating this distress with excessive behavior. Examples of how this extreme behavior may display itself with constant hand washing, fear of getting sick, and fear of bodily fluids. According to ADDA (Anxiety & Depression Association of America), OCD affects 2.2 million adults, 1% of the U.S. population. Because this issue impacts so many, there is a strong probability that you will encounter someone with OCD in your lifetime. Therefore, it is vital to look at how people who have contamination of OCD manage their stress during this pandemic.
It is not the same for everyone!
Has Covid-19 worsened the condition of individuals suffering from OCD, or brought out new and emergent cases of OCD in previously asymptotic individuals?
According to the American Psychological Association, "The situation amid COVID-19 may be leading health authorities and loved ones to unintentionally reinforce obsessions and compulsions for people with OCD and illness anxiety disorder. Ongoing and frequent reminders of social distancing, handwashing, and wearing facemasks to protect us from contracting or spreading the virus reinforce and add validity to compulsions that many diagnosed with contamination OCD were already doing. For individuals suffering from OCD, it’s nearly impossible to distinguish ritualistic behaviors from matters of safety precaution.
A recent study evaluated patients who are diagnosed with OCD. This study administered a Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) to compose a severity score before and after the lockdown. The data shows an increase in obsessions and compulsions, worsening since the lockdown. Nonetheless, it is essential to look at how OCD affects everyone differently. Behaviors and thoughts could vary on a spectrum.
Many who had undiagnosed or diagnosed OCD may have felt as though they had prepared for the pandemic for their entire lives! Some have even an exhibited "I told you so" moments. All the contamination anxieties that came before this pandemic were validated. At the beginning of the pandemic, many OCD patients felt MORE comfortable, since others were doing their part by washing their hands, social distancing, and wearing face masks. However, after several months, symptoms became worse than ever. As a result, medical providers began to increase or add medication for their patients.
While the pandemic rages on, OCD patients, especially kids from ages 8-12, are having an understandably tough time. Online learning and virtual activities (including counseling) have taken a toll on kids who depended on exposures to social interactions for their continued stability and wellbeing. For some children, hand washing behaviors have become a means of managing compulsive thoughts. When in-person school, activities, and therapy returned, many of our clients would have preferred to stay home to avoid stress due to new hygiene norms and the fear of contracting the virus or passing on the virus.
While we have seen an uptick in OCD behaviors and symptoms in our practice, Suzan Song, the Division of Child/Adolescent & Family Psychiatry director at George Washington University points out, "rituals and obsessions are just getting worse because of general mental health.” So, as always, take good care of yourselves, normalize conversations about mental health, and seek help proactively if you’re concerned about yourself or a loved one. Lastly, please remember that this information is not a substitute for medical or psychological advice, and is simply intended to educate, inform, and open a larger dialog about mental health. If you have questions or concerns about yourself or a loved one who may be exhibiting signs of OCD, please reach out directly to discuss a consultation.
References
Landau, E. (2020, October 6). Stress over pandemic makes OCD symptoms worse in some children. The Washington Post.
Mclean Harvard Medical School Affiliate. (2020, October 4). Everything you need to know about OCD in the age of covid-19. Living With OCD During the Coronavirus Crisis | McLean Hospital.
O'Neill, E. (2020, November 1). Pandemic raises special concerns for those with obsessive compulsive disorder. NPR.
Prestia Davide, Pozza Andrea, Olcese Martina, EscelsiorAndrea, Dettore Davide, Amore Mario (2020, September). The impact of the COVID-19 pandemic on patients with OCD: Effects of contamination symptoms and remission state before the quarantine in a preliminary naturalistic study. Psychiatry Research.
Rivera, R. M., & Carballea, D. (2020). Coronavirus: A trigger for OCD and illness anxiety disorder? Psychological Trauma: Theory, Research, Practice, and Policy, 12(S1), S66.
