Managing OCD Symptoms During the Pandemic: Finding Balance in Hygiene

Q: Managing OCD Symptoms During the Pandemic: Finding Balance in Hygiene

Hello： Obsessive-Compulsive Disorder (OCD) involves obsessions, which are intrusive thoughts, and compulsions, which are repetitive behaviors. <br>There are many types of obsessive thoughts, and they can lead to significant anxiety. <br>It's important not to dismiss medication; s

Obsessive-compulsive disorder (OCD) has worsened during the pandemic?

Hello, I would like to ask a question about obsessive-compulsive disorder (OCD): I started seeing a doctor for OCD in October 2018, primarily with symptoms of fear of dirt.
During this time, the doctor gradually adjusted my medication, and by July 2020, I had stopped taking it.
My recovery was quite good, and I was gradually able to return to normal life.
However, since the COVID-19 pandemic worsened in May 2021, I have become increasingly concerned about cleanliness in order to prevent infection.
I have noticed a resurgence of compulsive cleaning behaviors, particularly with handwashing and using alcohol-based sanitizers.
I find it difficult to distinguish whether my handwashing and use of sanitizers are normal hygiene practices or if they have exceeded what is typical.
This has significantly impacted my daily life.
My biggest concern now is that after handling money or using public machines and facilities, or visiting crowded places like hair salons and hospitals, I feel the need to clean excessively.
For example, after handling money, I wash my hands multiple times; after using an ATM, I spray my hands with sanitizer excessively; and after visiting a hair salon or hospital, I clean the areas in my car where I sat or touched multiple times with alcohol.
Additionally, I have issues with indirect contact; for instance, if I touch something before my hands are clean, I feel that my hands become dirty again if I touch that same object after cleaning.
I would like to ask if you could provide some advice, aside from medication, on how to differentiate between normal hygiene practices and excessive cleaning.
How can I determine what constitutes adequate cleanliness without needing to repeatedly wipe surfaces, while still maintaining effective infection prevention and not impacting my daily life? Thank you very much for your response!

Xiao C, 40~49 year old female. Ask Date: 2022/03/16

Dr. Wang Yaoting reply Psychiatry

Hello: Obsessive-Compulsive Disorder (OCD) involves obsessions, which are intrusive thoughts, and compulsions, which are repetitive behaviors.
There are many types of obsessive thoughts, and they can lead to significant anxiety.
It's important not to dismiss medication; serotonin-based medications have been shown to be the most effective in clinical settings.
Non-pharmacological approaches include reading books related to OCD, where you can learn coping strategies for symptoms, as well as engaging in regular exercise, meditation, and getting sunlight.
Sometimes, you can practice self-reflection by asking yourself whether a particular worry is an obsessive thought when it arises, helping you to differentiate it.
If you have someone around you to consult, discussing your thoughts with them can also be beneficial.
When you recognize that a thought is obsessive, try to accept it and focus on the present moment, which can effectively reduce compulsive behaviors.
If you find it difficult to differentiate, try to redirect your attention.
I hope this answers your question :)

Reply Date: 2022/03/16

More Info

Managing obsessive-compulsive disorder (OCD) symptoms, particularly those related to hygiene, can be particularly challenging during a pandemic. Your experience of heightened anxiety and compulsive behaviors surrounding cleanliness is not uncommon, especially given the increased emphasis on hygiene due to COVID-19. It’s important to recognize that while maintaining good hygiene is crucial for health, the line between healthy practices and compulsive behaviors can become blurred, especially for individuals with OCD.

Firstly, it’s essential to understand that OCD is characterized by intrusive thoughts (obsessions) that lead to repetitive behaviors (compulsions) aimed at reducing anxiety. In your case, the fear of germs and contamination has manifested in compulsive handwashing and the use of sanitizers. While these behaviors may have been manageable prior to the pandemic, the current environment has likely exacerbated your symptoms, making it difficult to distinguish between appropriate hygiene practices and compulsive actions.

Here are some strategies to help you find balance in managing your OCD symptoms during this time:
1. Set Clear Guidelines for Hygiene: Establish a routine that includes specific times for handwashing and sanitizing. For example, wash your hands after using the restroom, before eating, and after being in public places. Limit the number of times you wash your hands or use sanitizer to these specific instances. This can help create a structured approach to hygiene that feels manageable.

2. Mindfulness and Awareness: Practice mindfulness techniques to help you become more aware of your thoughts and feelings without judgment. When you feel the urge to wash your hands excessively, take a moment to pause and assess whether the situation truly warrants it. Ask yourself if you have already washed your hands in accordance with your established guidelines.

3. Gradual Exposure: Gradually expose yourself to situations that trigger your compulsive behaviors. For instance, if you feel the need to sanitize after touching a public surface, try to resist the urge and observe how you feel. Start with less anxiety-provoking situations and work your way up to more challenging ones. This can help desensitize you to the anxiety associated with these triggers.

4. Limit Information Intake: While it’s important to stay informed about health guidelines, excessive exposure to news about the pandemic can heighten anxiety. Set boundaries on how much news you consume daily, and focus on reliable sources for information.

5. Seek Professional Help: If you haven’t already, consider reaching out to a mental health professional who specializes in OCD. Cognitive-behavioral therapy (CBT), particularly exposure and response prevention (ERP), is an effective treatment for OCD. A therapist can help you develop coping strategies tailored to your specific situation.

6. Support Groups: Connecting with others who experience similar challenges can be beneficial. Support groups, whether in-person or online, provide a space to share experiences and coping strategies.

7. Self-Compassion: Be kind to yourself. Acknowledge that managing OCD is a process that takes time and effort. Celebrate small victories, such as successfully resisting a compulsion or adhering to your hygiene guidelines.

8. Healthy Coping Mechanisms: Engage in activities that promote relaxation and reduce anxiety, such as exercise, meditation, or hobbies that you enjoy. These can serve as healthy distractions from obsessive thoughts.

In conclusion, while it’s crucial to maintain hygiene during the pandemic, it’s equally important to recognize when behaviors become compulsive and interfere with daily life. By setting clear guidelines, practicing mindfulness, and seeking professional support, you can find a balance that allows you to prioritize your health without compromising your mental well-being. Remember, you’re not alone in this struggle, and there are resources available to help you navigate these challenges.

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