I was recently interviewed for an article on how the behaviors people use to avoid getting Covid 19 might make OCD worse or cause OCD to develop. After my interview the reporter notified me that the story was “killed” by the editor of the publication because he wanted to publish a story that suggested living through the pandemic would result in an increase in OCD or the development of OCD.
I explained to the reporter in my interview that OCD is considered a biological disorder that researchers believe is a “gateway” problem in the brain. Essentially, a person with OCD has what we call a “sticky” brain. Intrusive thoughts (and for that matter uncomfortable feelings and sensations) get “caught” in the brain and create anxiety, because those thoughts are disturbing to the person. The content of those thoughts can be about anything. Everyone has intrusive thoughts that come and go, but people with OCD get stuck in their thoughts. OCD related to contamination (and the fear of getting sick or dying) is just one type of OCD. Some of the contamination obsessions my patients have had include getting HIV from touching one’s shoes, contracting a deadly eye infection from condensation dripping from AC units, or “catching” the Hantavirus from seeing mouse excrement.
These are unlikely events, but ones that some of my contamination OCD patients have been fearful of. Typically OCD focuses on a remote threat and conflates probability with severity.
On the other hand, Covid-19 is a real, ubiquitous threat. It’s a highly contagious and dangerous virus that has infected persons on every continent and killed almost a million people worldwide (as of September 2020). The behaviors we engage in to mitigate the spread of the virus may look similar to behaviors folks with OCD engage in, but they are executed for different reasons. Washing our hands for twenty seconds, wearing a facemask, and keeping six feet away from others are behaviors that we have been instructed to do to protect ourselves and others. An OCD sufferer’s behaviors, on the other hand, are dictated by faulty wiring in the brain that lets their intrusive thoughts and anxiety determine what kinds of behaviors (compulsions) they should do. In my practice treating OCD patients, since the pandemic began almost no one is having OCD about Covid-19. And in fact, I’ve heard from former OCD patients that they feel well equipped to handle Covid-19 because they have learned to deal with uncertainty and not engage in excessive de-contamination rituals.
Certainly there are stresses and associated feelings of fatigue and depletion due to the pandemic, which may exacerbate a person’s OCD, but the content of the obsessions is about their particular OCD, not necessarily contamination OCD. Currently, I have patients who have obsessions about urinary function, breathing “correctly”, losing control and randomly killing someone, what they may have said or not said to others, whether they are in the “right” relationship, depersonalization, and perfectionism. But none about Covid-19.
We are all living in a collective trauma at the moment due to the pandemic, but it doesn’t mean that we will develop OCD. Once we emerge from this pandemic –whether that is when we have a safe and effective vaccine and/or very effective treatments for Covid-19 – is when we can get on with our lives. Yes, some folks may have more trouble than others due to suffering from prior mental health issues or experiencing excessive trauma such as being a front line worker, or having had or lost a loved one to Covid-19. But most of us will be able to relax our vigilance about getting the virus and move on with our lives, without acquiring OCD.
Patricia Thornton, PhD specializes in the treatment of anxiety disorders and OCD. She practices in New York City.