You Might Not Have Known That You Have OCD Until Now
The "doubting disease" is hitting especially hard during quarantine.
Posted May 15, 2020
While the COVID-19 pandemic has radically shifted all of our lives, you might feel like you’ve been more severely affected than those around you. Perhaps your concerns about contamination with the virus have become so overwhelming that they occupy much of your waking thought. Maybe your usual systems to distract yourself from your disturbing thoughts have been compromised by shelter-in-place orders and you are left spinning on your own. If you feel haunted by distressing thoughts and find that no amount of reassurance or distraction makes them stop, you might have OCD.
The Neuroscience of OCD
Obsessive-compulsive disorder comes in many shapes and sizes—an unrelenting fear of germs is just one of them. OCD has two parts: obsessions and compulsions. Obsessions are distressing thoughts or mental images that scare you, make you feel like you or a loved one is in danger, or make you question if you are a good person. Compulsions are the actions that you do to try to make those thoughts go away like seeking reassurance, washing your hands, or checking that a terrible thing didn’t happen. The problem with compulsions is that they don’t actually work. No amount of checking truly makes you feel better; the thought is always there waiting for you somehow.
OCD is much more common than most people realize. Approximately 2% of the world population will meet criteria for an OCD diagnosis at some point in their lives. OCD also tends to run in families and having an immediate family member with OCD substantially increases your risk for having OCD yourself. This means that having OCD is not your fault—it lives in your genes, just like your risk for diabetes or high blood pressure. People with OCD can’t “just stop worrying” because your brain won’t allow you to. OCD is caused by miscommunication between several brain structures that makes it difficult to stop doing certain behaviors even when you want to; it’s like the “brake” function of your mind is damaged so the accelerator takes over. That’s why you find yourself doing the same things over and over (like checking or asking for reassurance) even though a part of you knows it won’t work.
You’re Not Alone
Many people suffer in silence for years with OCD before being diagnosed and receiving proper treatment. In fact, the average amount of time between the onset of first OCD symptoms and diagnosis is 15 years! Tragically, there are many reasons for this—ongoing stigma of mental illness and psychotherapy, miseducation about OCD in the general public, inaccurate portrayals of OCD in media, and even poor understanding of OCD diagnosis and treatment by non-specialized therapists. Many people with OCD spend years learning to hide their symptoms and being told by well-intentioned loved ones to “stop worrying so much—everything’s fine.” Without the education to understand what OCD is, many sufferers spend years not knowing that they have OCD. It is common for people with OCD to believe that there’s something wrong with them or that if they just try hard enough, they’ll stop ruminating. This can lead to debilitating shame and self-blame. In reality, you can’t “just stop.” OCD lies to you and tells you that this next reassurance will be the one that sticks, the one that finally makes you feel better.
OCD and COVID-19
The coronavirus pandemic has hit people with OCD particularly hard. The core feature of OCD is discomfort with uncertainty; people with OCD are on a constant hunt for certainty that everything is going to be alright. However, certainty is rarely achievable, so OCD leaves sufferers searching in vain. The COVID-19 pandemic is one giant confrontation with uncertainty. You can’t know for sure who has it, how long this new way of life will last, or how humanity will ultimately be impacted. Even if the content of your thoughts is not about the virus itself, many OCD sufferers have had a significant increase in their symptoms in recent weeks.
OCD is not the same as general anxiety about the pandemic. Although people around you may be frightened or even traumatized by the pandemic, OCD is distinct in how it causes people to suffer. OCD is unrelenting in giving you things to worry about. Because the virus cannot be seen with the naked eye, OCD will make you question the cleanliness of your hands, furniture, and loved ones repeatedly, sometimes for hours or days. You might find that you are almost constantly checking what you have washed to reassure yourself that you cannot possibly have the virus in your home or on your body. But the reassurance never lasts long. There’s always a renewed worry waiting for you as soon as you start to feel better.
If the virus does not feature in your mind but you are haunted by other unrelenting, uncomfortable, or terrifying thoughts, you may still have OCD. OCD takes many forms including (but not limited to) harm OCD (being afraid that you will unwittingly hurt yourself or someone else), relationship OCD (unrelenting fear that you and your partner are not right for each other), hyperawareness OCD (deep concern/distraction with a body process like swallowing or blinking), pedophile, incest, or homosexuality OCD (fearing that you will violate a sexual taboo or ‘norm’), and emotional/mental contamination OCD (fearing that your mind will be contaminated with something and you will never be the same again). All subtypes of OCD can be negatively affected by high stress, isolation, and boredom. The quarantine orders mean that many people are left alone with their thoughts for hours and hours each day. Your usual routine that you had in place to distract yourself from your thoughts may have all but disappeared in recent weeks, leaving you under constant attack.
If you are just coming to terms with the idea that you might have OCD, there’s hope. A specialized therapy called exposure and response prevention (ERP) is very successful at treating people with OCD. Working with a therapist who is an OCD expert is crucial for your recovery. The International OCD Foundation (iocdf.org) has listings in all 50 states for specialists in OCD recovery. More good news: most oversight bodies, states, and insurance companies are allowing for clients to see therapists in other states during this time. The IOCDF also has a page for OCD suffers struggling with COVID-19 among its many resources.
Seeing a therapist for the first time is hard enough. Making an appointment to do a video session is even more difficult for many. Know that your future therapist understands that and wants to do their best to make you feel comfortable. If, for some reason, you are struggling to connect with the therapist you chose, try working with someone else. There is absolutely someone out there who will feel like a good fit for you.
OCD is debilitating and many people are realizing for the first time that they have had OCD for years. Even though you might be in terrible pain now, you are not alone and there is help. With hard work and time, OCD can get so much better.