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More than 2 million Americans – around 1 percent of the population – have some level of obsessive-compulsive disorder (OCD).
OCD can create repeated, unwanted thoughts (obsessions) or behaviors (compulsions) that can be irrational, cause distress, and be difficult to overcome. People may have a fear of germs, a focus on perfection, or unwanted or aggressive thoughts. This can lead to actions like repetitive handwashing, a need to have everything in order, or constant checking on things.
The disease COVID-19 caused by novel coronavirus SARS-CoV-2 has caused millions of illnesses and hundreds of thousands of deaths worldwide.
The pandemic may cause greater anxiety in people, whether they have a diagnosed anxiety disorder or not. Others may not feel much of an effect at all.
The same goes for people with OCD.
“The COVID pandemic may or may not have an effect on people with OCD,” says Robert Hudak, MD, medical director of the OCD Intensive Outpatient Program at UPMC Western Psychiatric Hospital. “Some people may not experience any exacerbations, and others may notice their symptoms markedly increase. It’s variable and impossible to predict who may worsen and who won’t.”
OCD Symptoms Vs. COVID-19
“OCD is an illness that is characterized by intrusive thoughts,” Dr. Hudak says. “People are worried about things that they know are nonsensical or are odd or unusual in some way. They can’t control those odd or unusual worries.”
There are several different types of obsessions and compulsions that OCD can cause. COVID-19 may or may not affect some of these symptoms.
Cleanliness
Many people with OCD are obsessed with cleanliness and germs. Those obsessions can lead to compulsions like frequent handwashing or sanitizing surfaces and objects.
COVID-19 can spread through touching surfaces infected with the coronavirus and then touching your mouth, nose, or eyes with unwashed hands. Because of this, the Centers for Disease Control and Prevention recommends frequent handwashing and sanitizing frequently touched surfaces.
It may seem that the worry over COVID-19 and contamination may affect people with OCD who obsess over cleanliness. However, Dr. Hudak says that’s not necessarily the case.
“Their fear has always been some nonexistent germs. They’re worried about things that don’t exist,” Dr. Hudak says. “Here is a microscopic virus that does exist. There is something to be worried about, and there are specific guidelines to deal with it. They can handle the reality of the situation, so it doesn’t necessarily cause intrusive thoughts.”
The International OCD Foundation recommends people with cleanliness obsessions follow the CDC”s recommendations for COVID-19 prevention. This includes:
- Disinfecting surfaces once a day, focusing on the areas you touch the most, like tabletops, countertops, doorknobs, or light switches.
- Washing your hands frequently with soap and water, scrubbing for 20 seconds before rinsing. Wash your hands when it’s most necessary (after coughing or sneezing, after using the bathroom, before cooking/eating, and after being outside or in the public).
If you have OCD and believe the COVID-19 situation is causing your cleanliness obsession to worsen, talk to your specialist for advice.
Perfectionism
Many people with OCD struggle with perfectionism – striving for yourself to be perfect, or for things around you to be perfect. That can lead to actions that range from constant self-analysis or self-criticism, to organizing and reorganizing items in the home.
The International OCD Foundation says COVID-19 may cause you to ramp up your perfectionism, becoming obsessed with protection. The foundation recommends talking to someone you trust – therapists, family members, friends, etc. – about protective steps you should be taking.
Harm OCD
Some people suffer from harm OCD. In some cases, harm OCD can create worry that you might harm yourself or others; in others, it can lead to thoughts of doing so.
COVID-19 might exacerbate harm OCD. It can cause increased anxiety about infecting someone else. It could create compulsions, making you act more dangerously.
If you recognize increased harmful thoughts or compulsions, talk to your therapist about what you can do to contain them.
How to Manage OCD During COVID-19
COVID-19 may cause some people to experience worse OCD symptoms. However, Dr. Hudak says many more people with OCD might feel no effect at all.
“OCD is an illness where the symptoms don’t make sense, and they don’t follow a logical, coherent pattern,” Dr. Hudak says. “To try to apply this idea that the virus is going to make people who fear germs even worse, logically that seems to make sense. But in an illness that doesn’t make sense, you can’t expect that to happen.”
To manage your OCD symptoms during COVID-19, you can do many different things:
- Seek news from trustworthy sources: When you look for COVID-19 information, go to sources like the Centers for Disease Control and Prevention or the World Health Organization.
- Don’t go into information overload: Set limits for how much COVID-19 coverage you seek out.
- Follow prevention guidelines: Follow the CDC guidelines for how to prevent COVID-19, including regular handwashing, sanitizing common surfaces, and practicing social distancing.
- Don’t ignore your OCD: If you notice your symptoms are happening more often or getting worse, talk to your therapist or someone else you trust. They can offer advice about what you should do.
- Take it easy on yourself: There’s nothing wrong with you if you’re feeling more anxious or stressed – that’s normal in uncertain times.
For more information, contact UPMC Western Psychiatric Hospital at 412-624-2100.
Editor's Note: This article was originally published on , and was last reviewed on .