Anxiety

Are COVID-19 Hygiene Practices Triggering Anxiety for You?

All this hand washing can bring out people's obsessive-compulsive tendencies.

Posted Apr 21, 2020

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Even though I'm not normally a "germophobe," I've noticed that COVID-19 hygiene practices have been triggering some obsessive-compulsive behaviors for me. 

For instance, I've noticed that 20 seconds of handwashing no longer feels like enough, and that each time I go shopping I seem to raise my standards for how thoroughly I spray bleach all over the cart. It started out, I would just spray the handle's and baby seat area, and now I spray the whole thing. 

One of the ways anxiety can manifest is as obsessive-compulsive tendencies. Since I know I'm not alone in this, I wanted to shed some light on how to manage it. The hyperfocus on hygiene and very serious threat of COVID-19, combined with background anxiety about factors like the economy, has the potential to be triggering these tendencies in many people. Even if you don't typically have obsessive-compulsive tendencies, you might be noticing some creeping in.

How to recognize obsessive-compulsive behaviors

These are examples of some patterns you might have noticed. Many people may have noticed a couple of these rather than all of them.

  • You're double or triple washing your hands, such as counting to 40 or 60 instead of 20.
  • You impose rules for yourself beyond expert guidelines, such as "I must wash each part of my hand for 20 seconds."
  • You start finding yourself miscounting how long you've washed your hands for, so you start counting again.
  • You're using neutralizing strategies when you make a mistake (like if you accidentally touch your face or your mask, or pass too close to someone) that aren't strictly logical. For instance, you would say a very long prayer if this happened or would double-up on other hygiene precautions, like spending twice as long wiping down your shopping cart with bleach. (Note that here I'm referring to neutralizing strategies that don't reduce your exposure risk from whatever specific event has occurred.)
  • You're being very rigid — for example, you have a "lucky" cashier line at the grocery store and don't want to go to another line.
  • You're imposing precautions on other people that are beyond the expert guidelines, even if it's causing tension or other people are telling you that you're being too controlling.

Is any of this harmful?  

Probably not, for most people. In the situation we're in, being too cautious about hygiene is objectively better than being not cautious enough. And, there's a big difference between having a few OCD tendencies and having a clinical disorder. That said, if you notice that any of the behaviors you're engaging in are escalating, then you might want to put some limits on yourself. 

The type of pattern to look out for is if hand washing for 40 seconds is good enough this week, but next week only 60 seconds is good enough. Or, if using three wipes to clean a shopping cart if good enough this week, but next week you're using five wipes. Or, if you're getting more rigid about your rules for yourself or others (beyond expert guidelines), or any of your neutralizing strategies are getting more excessive or strict. If you want to say one prayer if you accidentally pass too close to someone, go for it. If you start to need to say your prayer three times, then you might want to scale back.

Why does this happen?

  • In general, most people have the thinking pattern "If X is good, then 2X must be better." When people are anxious, they go the extra mile to help relieve that anxiety, as in the case of double washing your hands.  
  • Our brains also love to make cause-and-effect connections where none actually exists. For instance, let's say you accidentally touch your face after touching the self-checkout screen. You neutralize your anxiety until you can wash by doing something comforting like saying a prayer. When you do this, your brain will often subconsciously jump to the conclusion that the prayer was the only reason you didn't get sick. This isn't typically an issue, except if you start finding yourself upping all your neutralizing rituals whenever you're feeling more anxious than usual. Doing this can start a cycle whereby whatever was good enough before isn't now, and the increased amount becomes your new baseline.  
  • The more people do compulsive behaviors, the more rigid they tend to get about whether they've done them exactly correctly. You may find yourself doing things like washing your hands but then having a nagging thought you didn't do it 100% correctly, so you go back and start again. Again, being overcautious is desirable in our current situation, but put some limits on it if you start to notice it's becoming out of hand or illogical, or there are some other consequences, like your hands are getting sore and cracked.

If you're feeling newly obsessive-compulsive now, will you go back to "normal" when COVID-19 concerns ease?

Situation cues control most of our habits. When the situation returns to normal, your habits will likely most likely return to normal too. It's more likely most of us will go back to washing our hands for not long enough or not wiping shopping carts at all than people will overdo good hygiene. 

If you're naturally anxious, you're likely to want to return to normal more slowly than some other people around you. Overall, that inclination is probably a strength compared to people who want to have a 49-person party the minute they're allowed to have gatherings under 50 people.

How to cope

  • If you have any concerns about new obsessive-compulsive tendencies escalating, set some limits for yourself, like doing no more than 2X of what is logical/recommended. 
  • Increase your other strategies for managing your stress and anxiety. It's very likely that the times you feel like doing extra handwashing etc. are the times when your anxiety has been already triggered and heightened by broader fears, like about economic issues or politics. If you're doing all the basics well, like keeping up good routines around exercise, sleep, food, and relaxation, then you'll be less vulnerable to using compulsive strategies to try to keep a lid on your feelings.  
  • Remind yourself that your natural instinct to be extra cautious makes a lot of sense. People who are anxiety-prone sometimes see it as shameful or a weakness, but it can also be a great strength. 
  • If setting limits on yourself feels too hard and improving your general anxiety management generally isn't cutting it, consider getting a self-help workbook for obsessive-compulsive disorder, or doing a session or two with a therapist who treats it. Even if you don't have a clinical disorder, getting on top of it early should help you nip any problems in the bud. Self-help workbooks that are based on Cognitive Behavioral Therapy will explain how and why obsessive-compulsive behaviors escalate in more detail than I have here.

Check Psychology Today’s directory of therapists for a professional near you.