"One is supposed to wash your hands frequently for 20 seconds. For someone with OCD, this can be very confusing because what is frequently?"
The emphasis on cleaning and disinfecting in the wake of COVID-19 is gearing us towards maintaining better hygiene, but the constant fear of being infected has also added to our stress levels. More so in the case of those who have already been obsessed with cleanliness.
The data for people with OCD (obsessive compulsive disorder) in our country is reportedly sparse. According to National Health Portal of India the lifetime prevalence of OCD in general population is “two-three per cent, that means two to three persons in every hundred persons have OCD in their lifetime.” OCD involves obsessing over excessive thoughts that lead to repetitive behaviours that are beyond one’s control. It affects men and women equally.
People with OCD feel an obsessive need to perform cleaning rituals to be in control. In case of the coronavirus pandemic, however, the preventive guidelines in line with cleanliness and hygiene could add to their confusion, psychologist Ann Philipose told indianexpress.com. “One is supposed to wash your hands frequently for 20 seconds. For someone with OCD, this can be very confusing because what is frequently? It is not about washing hands for 20 seconds; for a person with OCD, it is about continuing after those 20 seconds.”
“It is important to understand that such a scenario could lead to more triggers, and is likely to cause people a lot more anxiety. So, an individual who may not otherwise have an anxiety-related issue, is also a lot more vigilant now, and if they have do have a pre-existing condition, then the hypervigilance will increase, along with an increase in the levels of stress and anxiety,” said Kamna Chhibber, Head of Department, Mental Health and Behavioral Sciences, Fortis Memorial Research Institute, Gurugram.
With people being completely confined in their homes as a result of quarantine, it is more likely that one would tend to overthink, with limited options available to distract oneself. Add to that the compelling need to be up-to-date with every (mis)information about the pandemic on social media, WhatsApp or other platforms. “There is constant conversation about coronavirus everywhere so it is not a great mental state to be in. So I try not to read about it constantly. I read books, watch something or may be do something else,” said Manjusha Madhu who has OCD.
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For Kavita Roy (name changed), on the other hand, who was diagnosed with OCD around 2015, the biggest challenge is to consciously dismiss obsessive thoughts even she knows they are irrational. “The situation is pretty bad. There is this constant niggling voice in my head. For instance, I dusted my room thrice and washed my hands each time. I use hand sanitiser compulsively. I also wear disposable gloves or I feel uncomfortable. I know that much of it does not make any sense so I try and stop. Work helps. It’s easier when I’m in office though. Work from home and not being around people is difficult to cope with. I speak to my therapist. It becomes relatively easier to manage after talking to her. But then it starts again after a while,” she said.
How to cope with the obsession
Doctors recommended the following tips for people to alleviate anxiety or obsessive behaviour at the time:
1. Stay connected to the people from whom you have been seeking help and support all along — your therapist or psychiatrist. Make sure the treatment process is not interrupted. Find out if your therapist can do a session over the phone or at least stay connected over some virtual platform. This is a sensitive time when a lapse can easily occur, so if you are not taking the right intervention, the illness can flare up.
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2. One of the ways to contain the anxiety is by charting out the things you need to do at home and following a structure. This would be helpful in managing a lot of preoccupying thoughts and you will be able to distract yourself.
3. Seek support from the family members available in the house and use their help to ensure you are not stuck in the repetitive obsessive rituals.
4. It is important to remember that many of the thoughts that may be generated out of panic may not have a rational basis. Engaging in the compulsive part of a behaviour is not going to be helpful in taking care of health and hygiene at home.
5. Make sure you only look at the reliable sources of information. If you think things on social media could add to your distress, it is best to avoid exposing yourself to it too much. You need to consider reducing the amount of time you are spending on gagdets, news channels or other portals. We just need to be aware of the basic preventive measures and follow them.
6. Follow the recommended guidelines for prevention but make sure you do not go beyond that. Do not be too hard on yourself. There is a lot of uncertainty and you need to accept that. Most importantly, be kind to yourself.
Here’s a quick Coronavirus guide from Express Explained to keep you updated: Are smokers at high risk form coronavirus? | Can Vitamin-C prevent or cure coronavirus infection? | What exactly is community spread of coronavirus? | How long can the Covid-19 virus survive on a surface? | Amid the lockdown, what is allowed, what is prohibited?
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