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  • Managing COVID-Safety Without Feeding Into OCD

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    Managing COVID-Safety Without Feeding Into OCD

    The COVID-19 pandemic continues to have massive impacts on day-to-day life. In addition to the direct health effects that contracting the disease can have, the existence of the pandemic and the safety measures to reduce its spread can worsen or even create mental health concerns. The evolving nature of the pandemic, along with the sheer volume of information and opinion circulating, creates a great deal of uncertainty. How long will this last? What are the right steps to keep ourselves and others safe? Am I doing enough? Too much?

    Uncertainty like this can be particularly hard to sit with for many people. For those with anxiety and OCD, this is especially the case. With the stakes so high, it is disturbing to have questions without clear answers – but this is the unfortunate reality of our situation. When dealing with doubt and uncertainty, the natural response is to seek reassurance and certainty. However, doing so frequently traps us in a cycle that increases our anxiety. For example, if we feel uncertain about whether we can contract COVID by handling the mail, we might turn to Google for answers. When we find information online that says catching COVID like this is very unlikely, we might feel temporarily reassured. But shortly after, we begin to doubt – “wait, ‘very unlikely,’ but not impossible?” We then might engage in more and more research, trying to get a definitive answer that might not yet exist. We might also then decide on some self-created safety-procedure like wiping the mail down with disinfectant and leaving it to sit for 24 hours. This process of seeking certainty frequently backfires, resulting in more anxiety and more avoidance. For those with OCD, this is a familiar process – seeking relief by giving into avoidance or compulsion urges, only for the distress to grow over time.

    But how do we engage in appropriate COVID safety measures without feeding into the OCD/anxiety process? How do we stay responsibly informed about the ever-changing situation without researching compulsively? How do we wash our hands more frequently, as experts have been advising, without washing compulsively?

    These are tricky questions to answer, but a good place to start is to ensure that anxiety is not the main cue for our COVID safety actions. If something is important to do, but has the potential to be compulsive, it is useful to ask ourselves when the action will be helpful, or “legitimate.” If we are washing our hands whenever we feel anxious or uncertain, we are strengthening OCD. If we are washing our hands only in circumstances we decided on ahead of time (e.g., after returning home from being in public), we are less likely to be strengthening OCD. For actions like reading/watching the news, it is helpful to decide upon a rough schedule/frequency. If I decide ahead of time that I’ll only check [COVID] news once a day in the afternoon, I’m staying informed. If I check over and over throughout the day, this is more likely to worsen anxiety and reduce my tolerance of uncertainty. We also want to make sure that the intensity of our COVID-safety actions are not overboard. The CDC (Centers for Disease Control and Prevention) recommends 20 seconds of scrubbing during hand-washing, but anxiety tries to motivate us to wash longer, or repeat the washing “just to be safe.” Resisting anxiety-motivated actions requires us to be able to sit with a certain degree of uncertainty, but building this skill is critical to breaking out of the cycles that anxiety and OCD trap us in.

    To create a set of guidelines for taking appropriate and not compulsive COVID-safety measures, start with looking at the recommendations of credible, expert sources. For things that don’t have expert recommendations (e.g., the frequency we should check the news), ask yourself the question “what’s the minimum time/intensity I think I actually need for this action?” Once you’ve set some guidelines, do your best to resist anxiety’s attempts to get you to exceed them. Try to treat the guidelines as just a matter of course. Follow them, but attempt to do so with a casual approach. Allow yourself to multitask or be distracted while following the guidelines from time-to-time.

    One way to think about following these guidelines is like following the rules of a board game. Once you’ve learned the rules, you play the game following them. You don’t change the rules because you feel anxious (e.g., “the dice say I rolled a 6, but I’ll only move 3 spaces, just to be safe”). You only check the rule book when there’s honest confusion. You don’t scrutinize your every move to make 100% sure that you’re following the rules correctly. The rules are followed, but they fade into the background.

    Being COVID safe doesn’t have to make OCD worse if we limit ourselves to carefully selected safety measures and use them when needed, rather than when anxious.

    Blog post by Michael A. Lent, Ph.D.