Going back to basics can help OCD sufferers when it comes to COVID-19

The worldwide COVID-19 pandemic is having an impact on some people with obsessive-compulsive disorder. Some of it is negative, but some of it is positive, experts say.

Del Camp, chief clinical officer with Ozark Center in Joplin, said anecdotal information is showing while some OCD sufferers, blindsided by the sudden eruption of the pandemic back in March, are dealing with heightened anxiety and repetitive behaviors — such as hand-washing and checking the news for the latest pandemic news — others have been able to take the sudden uncertainty in stride. Mostly because the people around them are adopting the behaviors they’d incorporated in their lives for years.

“Part of the issues with having OCD,” Camp said, “is that you feel different. You feel like your behavior is noticeably different from others, and that drives its own anxiety level.”

The growth of COVID-19 over the last three months into nearly every aspect of a person’s life has in some ways evened the playing field for some OCD sufferers.

“For some, it’s been a relief because everyone is now doing some of what they’d been doing all along,” Camp said. “Everybody is now worried about whether somebody is sick or not; everybody is worried about touching doorknobs; everybody is worried about touching the pen at the restaurant to sign their name.”

This connection with the public has made their repetitive behavior less noticeable or feeling less awkward than before.

“The more (they) feel connected to others, and the safer (they) feel in relationships, the better (they) are likely to feel,” Camp said. “For some people, whose symptoms were largely manageable, they can talk to someone or have their medications adjusted … and (they’ll) be right back on track.

“I’ve heard people say they feel better about their symptoms,” he said, “but that doesn’t necessarily mean their symptoms are better.”

For other, however, the chaotic and uncertain nature of the pandemic — centered on hypervigilance, deadly germs and contamination — has been enough to throw them significantly off track.

“The things that they used to do in order to effectively manage their condition,” Camp said, “are no longer effective.”

For example, the real possibility of illness may cause people with OCD to take extreme measures to keep themselves and their families safe, such as repetitive hand-washing, cleaning or being afraid to leave the home out of fear of harming others through contamination. Their fears may also lead to hoarding items, such as medications, alcohol-based hand sanitizers and toilet paper.

“One of the problems is with a pandemic, your world shrinks dramatically. You don’t get to go out and do things you normally would, or options are now curtailed or modified to a level where you’re constantly reminded that there is a risk (out there).”

To help overcome heightened OCD fears, Camp said, sufferers should go back to the basics by “stepping outside yourself” to see if responses to the pandemic and its risk are reasonable.

“If I’m willing to starve myself rather than going out and getting food, then the chances are that that’s an overreaction to what’s happening,” Camp said. “Remember, that’s the OCD talking, not COVID talking. There are plenty of social distancing and (masking) and things like that that you can do, and still be OK in those circumstances.

“It’s about understanding that even at its worst, you will survive (the anxiety),” Camp said. And by not engaging in compulsive behaviors, the more the anxiety levels will subside.

“If you fear something,” he continued, “and you run away from it, it gets bigger every step you take. So, if you just simply turn around and deal with it, then there’s a part of your mind that says, ‘It can’t be that scary because I’m facing it.'”

Expecting spike

Based on the numbers Del Camp has seen, there has been a rise in numbers of those suffering from depression, substance abuse and anxiety, in which obsessive-compulsive disorder is an anxiety disorder.

“If you think about it, we haven’t really been at this long enough to see a big spike on the mental health side,” Camp said. “That will be the real second wave, which is mental health issues, that are coming up. But I suspect we will see a significant spike in anxiety in the coming months, and for OCD I would not be surprised to see at least a moderately level surge, because it really has thrown off a lot of individuals who had coping mechanisms in place.”

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Ask The Doctors | Advice

When it comes to helping someone with a hoarding disorder, persuasion, logic or arguments don’t work. Neither does force. Instead, experts recommend beginning by clearly stating your concerns for the person’s health and safety. Most hoarders know that something is wrong, and that their living situations are both peculiar and dangerous. Then, provide avenues of assistance. Some people find help with cognitive behavioral therapy, in which the individual is guided to identify and understand their thinking patterns, and then focus on gradual change. Individual therapy with a specialist in hoarding disorders can be helpful, as can group therapy, which allows the person to see they are not alone. You can find more information and resources at the Anxiety and Depression Association of America’s website, at adaa.org.

New study provides evidence for “healthy immigrant effect” suggesting immigrants are less likely to ha …

A Canadian study found that immigrants had 30% lower odds of being diagnosed with an anxiety disorder than Canadian-born adults. The study was published in the International Journal of Environmental Research and Public Health.

Anxiety disorders are among the most commonly diagnosed disabilities around the globe. Previous research suggests that the risk for anxiety disorders varies according to demographic, socio-economic, and health-related factors. Interestingly, despite the fact that immigrants face certain hardships and unique disadvantages compared to nonimmigrants, new research has found that immigrants show lower rates of anxiety.

“Our research team is interested in analyzing Canadian Longitudinal Study on Aging data to examine factors which affect mental health,” said Karen Davison, North American Primary Care Research Group Fellow and Health Science Program Chair at Kwantlen Polytechnic University in Surrey, who led the study.

“Given that anxiety disorders have such a high global burden related to disability, we were particularly interested in examining various social, economic, health, and nutrition-related factors and their relationships with the condition. This information could help to improve health practices, programs, and policies for adults.”

Davison and her team conducted a study to explore the relationship between immigrant status and anxiety disorders with a focus on older adults. They further explored nutritional and health-related factors that might mitigate the risk for anxiety disorders among all Canadians.

The researchers analyzed baseline data from the ongoing Canadian Longitudinal Study on Aging, resulting in a sample of 26,991 Canadian residents between the ages of 45-85. The survey measured self-reported lifetime anxiety disorder with the question, “Has a doctor ever told you that you have an anxiety disorder such as a phobia, obsessive-compulsive disorder or a panic disorder?” The study also included various demographic, economic, health, and nutritional measures.

Across the sample, 8.5% of respondents reported being diagnosed with an anxiety disorder at some point in their lifetime. Interestingly, while 9% of Canadian-born respondents reported an anxiety diagnosis, only 6% of immigrants did. When accounting for age and sex, this represented 30% lower odds of being diagnosed with anxiety for immigrants.

The authors offered several explanations for what researchers call the “healthy immigrant effect.” Canada uses a points-based immigration system, which classifies a person’s eligibility to immigrate to Canada according to their skills and qualifications. Those accepted to immigrate generally have a higher education and better work experience, qualities that may lessen their susceptibility to anxiety disorders.

“Another potential explanation … is that potential immigrants with anxiety disorders would find the challenges of relocation too anxiety inducing and would therefore not choose to immigrate,” the authors wrote.

Certain health factors impacted the likelihood of an anxiety disorder diagnosis. Having at least one existing health condition, experiencing chronic pain, being categorized as underweight, having a higher percentage of body fat, or smoking 100 or more cigarettes over one’s lifetime were each associated with increased odds of being diagnosed with anxiety.

Nutritional factors also impacted reports of anxiety. Across the sample, those who consumed two or more fiber sources a day or one or more pastries a day were more likely to be diagnosed with an anxiety disorder. Alternatively, those who consumed 0.5 to 2 sources of pulses and nuts per day or three or more sources of fruit and vegetables per day were less likely to have anxiety. This may be because fruits, vegetables, and nuts contain high levels of zinc, magnesium, and vitamin B, which have been associated with reduced anxiety.

“We believe the main message of this study is that after accounting for many social, economic, health, and nutrition-related factors, a significant relationship was found between fruit and vegetable intakes and having been diagnosed with an anxiety disorder. It is well established that fruit and vegetable intakes are associated with physical health. This study lends to the increasing evidence that shows there are also links with mental health,” Davison told PsyPost.

“In this study we found that lower intakes of calcium rich foods with high vitamin D content are associated with lower odds of anxiety disorders. However, as the number of sources consumed increased, the trends in the odds ratios showed what seemed to be a positive or dose-response type relationship. For future studies we would like to examine supplement sources of calcium and vitamin D which are commonly taken by older adults and their relationship with anxiety disorders. In addition, for future work we plan to examine biomarkers and genomic markers related to calcium and vitamin D which may help us to better understand these relationships.”

“Another finding we would like to highlight is the associations we found with higher percent body fat and anxiety. This relationship may be due to mechanisms related to immune-inflammatory activation. Previous research has shown that individuals with high body fat and mental ill health have increased inflammatory markers, such as C-reactive protein, interleukin-6, and tumour necrosis factor-alpha. The activation of certain immune system cells in response to ongoing chronic inflammation, has been linked with poor mental health. Certainly more research is needed to better understand the possible links between body composition and anxiety,” Davison added.

The authors concluded that their findings offer insight into nutritional, health-rated, and social factors associated with anxiety disorder diagnoses among immigrants and Canadian-born residents of Canada. These insights could help inform treatment for middle age and older adults with anxiety.

The study, “Nutritional Factors, Physical Health and Immigrant Status Are Associated with Anxiety Disorders among Middle-Aged and Older Adults: Findings from Baseline Data of The Canadian Longitudinal Study on Aging (CLSA)”, was authored by Karen M. Davison, Shen (Lamson) Lin, Hongmei Tong, Karen M. Kobayashi, Jose G. Mora-Almanza, and Esme Fuller-Thomson.

Having Disturbing Thoughts as a New Parent? Here’s How to Cope

While intrusive thoughts can be terrifying, the problem lies in how we interpret them, Dr. Abramowitz said. Labeling such notions as “negative” causes the brain to give them more weight, which is why parents who judge their invasive thoughts often struggle to let them go.

Dr. Abramowitz and his colleague, Nichole Fairbrother, Ph.D., a psychologist and researcher at the University of British Columbia, said intrusive thoughts pop up in new parenthood for a reason. In their research, the psychologists found that the immense responsibility parents feel for keeping their newborns alive can bring on disturbing thoughts about harm striking their babies, especially during the first six months of their children’s lives.

Dr. Fairbrother said: “I remember gazing at my baby’s delicate hands and thinking, ‘I could just cut those right off with the garden clippers,’ but because I’m an anxiety researcher, I wasn’t upset by it.”

Even though intrusive thoughts might seem puzzling, Dr. Fairbrother said, they’re often adaptive. “If a mother worries about the stroller rolling into traffic, she’s going to grip the handle more tightly,” she explained.

For parents bothered by their intrusive thoughts, certain exercises and steps can reduce the anxiety they create. A few suggestions:

One way to disarm intrusive thoughts is to recognize that they don’t define who you are. Repeating the bothersome thought in a singsong voice or saying it aloud, over and over again can help, said Stefan Hofmann, Ph.D., a clinical psychologist and anxiety researcher at Boston University. This behavioral technique, known as distancing, can unhook thoughts from emotions, helping the mind to change direction. No longer seeing the thoughts as a threat, parents begin to realize that “thoughts are nothing more than just thoughts,” Dr. Hofmann explained.

“A mother may think about pushing the stroller down the stairs, but that doesn’t mean she’ll act on it,” he said.

Trying to ignore intrusive thoughts and upsetting feelings only makes them louder. Carla Naumburg, Ph.D., a clinical social worker and parent coach, said acknowledge intrusive thoughts by practicing a mindfulness exercise called noticing, which is paying attention, without judgment to our thoughts and feelings as they arise.

When COVID-19 health measures and obsessive-compulsive disorder collide during pandemic

While we all need to continue practising public-health recommendations as the COVID-19 pandemic continues, those very actions—hand washing, avoiding touching things in public, sanitizing and cleaning surfaces—may appear similar to those performed by people with obsessive-compulsive disorder (OCD).

There are, however, significant differences between the two activities.

In a phone interview, psychologist Maureen Whittal, who cofounded Vancouver-based Anxiety Canada in 1999 and is an expert in cognitive behavioural therapy, explained the difference between someone being vigilant and someone with OCD.

According to Anxiety Canada, people with OCD may experience obsessive thoughts about self-doubt or harming others that create anxiety or distress, or they may have compulsions to engage in deliberate actions—including repeated checking of things like switches and plugs, arranging objects in specific orders, or unnecessary hoarding—to prevent something terrible from happening.

Where hygienic behaviour crosses the line depends on the reason or intent behind the behaviour, Whittal explained, particularly when people rely heavily upon “internal cues of anxiety to guide behaviour” instead of because of being advised to do so. In other words, people with OCD tend to base their actions upon emotion or what feels right instead of facts and objective logic.

For instance, Whittal said, they may be saying to themselves: “if I feel anxious, something must be dangerous, so I’ve got to do something to keep myself safe.” They may even repeat the hand washing, say, if they didn’t feel it was thorough enough.

So the actions of people with OCD are attempts to prevent a feared consequence. But underlying the fear, Whittal explained, is a specific negative belief about themselves, such as “I’m not good enough” or “I’m an awful person” if they make a mistake. If the “bad thing” doesn’t happen, she said, they may feel that their actions were successful and their behaviour may become reinforced.

Interestingly, Whittal said, most of those with OCD are aware that what they’re doing doesn’t make sense, but they will often have an ongoing feeling of doubt and “a mixing up of knowing and certainty”. A person with OCD who is asked, for example, if they locked their door after leaving home would have to be 100-percent certain to answer “yes”.

OCD occurs in about one to two percent of the population, and Whittal said she has seen heightened severity of the disorder during the pandemic due to increased stress.

She said she began speaking about COVID-19 to people with OCD in February, and many of them became more anxious in March due to future uncertainty. The lockdown, she said, was actually easier for them because the rules were clear, but when restrictions were loosened and public-health officials began saying “use your judgment”, Whittal said, “that’s a tough place for someone with OCD”.

Whittal tells people with OCD that public-health messages aren’t meant for people who are already responsible like themselves but are “meant for people who need that reminder”.

“It’s not uncommon for folks with OCD to have incredible amounts of responsibility and feeling like, ‘It’s my job to protect other people,’ and, of course, that’s what public health has been telling us,” she said.

She also advises people with OCD to reduce searches for COVID-19 information and to limit such data to those from primary or reputable sources—such as the B.C. Centre for Disease Control or Health Canada—while avoiding blogs or unestablished sources. Those seeking more information about OCD can visit the Anxiety Canada website, which has a specific section on anxiety during the pandemic.

More

How Those with Obsessive-Compulsive Disorder Cope With Angst of COVID

Before the COVID-19 pandemic took hold in the United States, Chris Trondsen felt his life was finally under control. As someone who has battled obsessive-compulsive disorder and other mental health issues since early childhood, it’s been a long journey.

“I’ve been doing really, really well,” Trondsen says. “I felt like most of it was pretty much — I wouldn’t say ‘cured’ ― but I definitely felt in remission or under control. But this pandemic has been really difficult for me.”

Trondsen, 38, a Costa Mesa, California, therapist who treats those with obsessive-compulsive and anxiety disorders, has found himself excessively washing his hands once again. He’s experiencing tightness in his chest from anxiety — something he hadn’t felt in so long that it frightened him into getting checked out at an urgent care center. And because he also has body dysmorphic disorder, he says, he’s finding it difficult to ignore his appearance when he’s looking at himself during his many Zoom appointments with clients each day.

From the early days of the coronavirus outbreak, experts and media have warned of a mounting mental health crisis as people contend with a pandemic that has upended their lives. A recent KFF poll found that about 4 in 10 adults say stress from the coronavirus negatively affected their mental health. (KHN is an editorially independent program of KFF, the Kaiser Family Foundation.)

But those with obsessive-compulsive disorder and other serious anxieties face uniquely difficult mental health battles, including trying to distinguish concerns brought on by their conditions from general fears shared by the public about COVID-19. People with OCD have discovered one advantage, though: Those who have undergone successful treatment often have increased abilities to accept the pandemic’s uncertainty.

Katharine Phillips, MD, a psychiatrist at NewYork-Presbyterian and professor at Weill Cornell Medicine, says it’s possible that patients who have been in consistent, good treatment for their OCD are well protected against the stress of COVID-19.

“Whether it’s excessive fears about the virus, excessive fears about possible repercussions to the virus, whether that’s financial effects ― good treatment protects against relapse in these patients,” Phillips says.

Those with OCD feel compelled to repeatedly perform certain behaviors, such as compulsive cleaning, and they may fixate on routines. OCD can also cause nonstop intrusive thoughts.

Carli, who asked that her last name be withheld because she feared professional repercussions, can trace her OCD to age 6. The coronavirus pandemic has sent Carli, a 43-year-old from Jersey City, New Jersey, into a spiral. She’s afraid of the elevators in her building, so she doesn’t leave her apartment. And she’s having trouble distinguishing an OCD compulsion from an appropriate reaction to a dangerous pandemic, asking those without OCD how they’ve reacted.

“The compulsions in my head have definitely gotten worse, but in terms of wearing a mask and cleaning my groceries and going into stores, it’s really hard to gauge what is a normal reaction and what is my OCD,” Carli says. “I try to ask people, Are you doing this? Are you doing that?”

Elizabeth McIngvale, director of the McLean OCD Institute in Houston, says she has noticed patients struggling to differentiate reactions, as Carli describes. Her response is that whereas guidelines such as hand-washing from the Centers for Disease Control and Prevention are generally easily accomplished, OCD compulsions are usually never satisfied.

McIngvale was diagnosed with OCD when she was 12, with behaviors like taking six- to eight-hour showers and washing her hands for so long they bled. McIngvale receives therapy weekly.

“It’s just a part of my life and how I maintain my progress,” McIngvale says.

Lately, she’s found herself consumed with fears of harming or infecting others with the COVID-19 virus — a symptom of her OCD. But, generally, with the tools she’s gained through treatment, she says she’s been handling the pandemic better than some people around her.

“The pandemic, in general, was a new experience for everybody, but for me, feeling anxiety and feeling uncomfortable wasn’t new,” McIngvale says.

“OCD patients are resilient,” she adds. Treatment is based on “leaning into uncertainty and so we’ve also seen patients who are far along in their treatment during this time be able to manage really well and actually teach others how to live with uncertainty and with anxiety.”

Wendy Sparrow, 44, an author from Port Orchard, Washington, has OCD, agoraphobia (fear of places or situations that might cause panic) and post-traumatic stress disorder. Sparrow has been in therapy several times but now takes medication and practices mindfulness and meditation.

At the beginning of the pandemic, she wasn’t fazed because she’s used to sanitizing frequently and she doesn’t mind staying home. Instead, she has felt her symptoms worsening as her home no longer felt like a safe space and her fears of fatal contamination heightened.

“The world feels germier than normal and anyone who leaves this house is subjected to a barrage of questions when they return,” Sparrow writes in an email.

Depending on how long the pandemic lasts, Sparrow says, she may revisit therapy so she can adopt more therapeutic practices. Trondsen, too, is considering therapy again, even though he knows the tools to combat OCD by heart and uses them to help his clients.

“I definitely am needing therapy,” Trondsen says. “I realized that even if it’s not specifically to relearn tools for the disorders … it’s more so for my mental well-being.”

Carli has struggled with finding the right treatment for her OCD.

But a recent change is helping. As the pandemic intensified this spring, many doctors and mental health providers moved to telehealth appointments — and insurers agreed to cover them ― to cut down on the risks of spreading the virus. In April, she started using an app that connects people with OCD to licensed therapists. While skeptical at first, she has appreciated the convenience of teletherapy.

“I never want to go back to actually being in a therapist’s office,” Carli says. “Therapy is something that’s really uncomfortable for a lot of people, including me. And to be able to be on my own turf makes me feel a little more powerful.”

Patrick McGrath, a psychologist and head of clinical services at NOCD, the telehealth platform Carli uses, says he’s found that teletherapy with his patients is also beneficial because it allows him to better understand “how their OCD is interfering in their day-to-day life.”

Trondsen hopes the pandemic will bring increased awareness of OCD and related disorders. Occasionally, he’s felt that his troubles during this pandemic have been dismissed or looped into the general stress everyone is feeling.

“I think that there needs to be a better understanding of how intense this is for people with OCD,” he says.

KHN (Kaiser Health News) is a nonprofit news service covering health issues. It is an editorially independent program of KFF (Kaiser Family Foundation), which is not affiliated with Kaiser Permanente.

Double jeopardy: Dealing with OCD during a pandemic

Picture used for illustration.

Elizabeth Lawrence

Before the COVID-19 pandemic took hold in the United States, Chris Trondsen felt his life was finally under control. As someone who has battled obsessive-compulsive disorder and other mental health issues since early childhood, it’s been a long journey.

“I’ve been doing really, really well,” Trondsen said. “I felt like most of it was pretty much — I wouldn’t say ‘cured’ — but I definitely felt in remission or under control. But this pandemic has been really difficult for me.”

Trondsen, 38, a Costa Mesa, California, therapist who treats those with obsessive-compulsive and anxiety disorders, has found himself excessively washing his hands once again. He’s experiencing tightness in his chest from anxiety — something he hadn’t felt in so long that it frightened him into getting checked out at an urgent care centre. And because he also has body dysmorphic disorder, he said, he’s finding it difficult to ignore his appearance when he’s looking at himself during his many Zoom appointments with clients each day.

From the early days of the coronavirus outbreak, experts and media have warned of a mounting mental health crisis as people contend with a pandemic that has upended their lives. A recent KFF poll found that about 4 in 10 adults say stress from the coronavirus negatively affected their mental health.

But those with obsessive-compulsive disorder and other serious anxieties face uniquely difficult mental health battles, including trying to distinguish concerns brought on by their conditions from general fears shared by the public about COVID-19. People with OCD have discovered one advantage, though: Those who have undergone successful treatment often have increased abilities to accept the pandemic’s uncertainty.

Dr. Katharine Phillips, a psychiatrist at NewYork-Presbyterian and professor at Weill Cornell Medicine, said it’s possible that patients who have been in consistent, good treatment for their OCD are well protected against the stress of COVID-19.

“Whether it’s excessive fears about the virus, excessive fears about possible repercussions to the virus, whether that’s financial effects — good treatment protects against relapse in these patients,” Phillips said.

Those with OCD feel compelled to repeatedly perform certain behaviours, such as compulsive cleaning, and they may fixate on routines. OCD can also cause nonstop intrusive thoughts.

Carli can trace her OCD to age 6. The coronavirus pandemic has sent Carli, a 43-year-old from New Jersey, into a spiral. She’s afraid of the elevators in her building, so she doesn’t leave her apartment. And she’s having trouble distinguishing an OCD compulsion from an appropriate reaction to a dangerous pandemic, asking those without OCD how they’ve reacted.

“The compulsions in my head have definitely gotten worse, but in terms of wearing a mask and cleaning my groceries and going into stores, it’s really hard to gauge what is a normal reaction and what is my OCD,” Carli said. “I try to ask people, Are you doing this? Are you doing that?” 


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Elizabeth McIngvale, director of the McLean OCD Institute in Houston, said she has noticed patients struggling to differentiate reactions, as Carli described. Her response is that whereas guidelines such as hand-washing from the Centers for Disease Control and Prevention are generally easily accomplished, OCD compulsions are usually never satisfied.

McIngvale was diagnosed with OCD when she was 12, with behaviours like taking six- to eight-hour showers and washing her hands for so long they bled. McIngvale receives therapy weekly.

“It’s just a part of my life and how I maintain my progress,” McIngvale said.

Lately, she’s found herself consumed with fears of harming or infecting others with the COVID-19 virus — a symptom of her OCD. But, generally, with the tools she’s gained through treatment, she said she’s been handling the pandemic better than some people around her.

“The pandemic, in general, was a new experience for everybody, but for me, feeling anxiety and feeling uncomfortable wasn’t new,” McIngvale said.

“OCD patients are resilient,” she added. Treatment is based on “leaning into uncertainty and so we’ve also seen patients who are far along in their treatment during this time be able to manage really well and actually teach others how to live with uncertainty and with anxiety.”

Wendy Sparrow, 44, an author from Port Orchard, Washington, has OCD, agoraphobia (fear of places or situations that might cause panic) and post-traumatic stress disorder. Sparrow has been in therapy several times but now takes medication and practices mindfulness and meditation.

At the beginning of the pandemic, she wasn’t fazed because she’s used to sanitizing frequently and she doesn’t mind staying home. Instead, she has felt her symptoms worsening as her home no longer felt like a safe space and her fears of fatal contamination heightened.

“The world feels germier than normal and anyone who leaves this house is subjected to a barrage of questions when they return,” Sparrow wrote in an email.

Depending on how long the pandemic lasts, Sparrow said, she may revisit therapy so she can adopt more therapeutic practices. Trondsen, too, is considering therapy again, even though he knows the tools to combat OCD by heart and uses them to help his clients.

Carli has struggled with finding the right treatment for her OCD.

But a recent change is helping. As the pandemic intensified this spring, many doctors and mental health providers moved to telehealth appointments — and insurers agreed to cover them — to cut down on the risks of spreading the virus. In April, she started using an app that connects people with OCD to licensed therapists. While sceptical at first, she has appreciated the convenience of teletherapy.

“I never want to go back to actually being in a therapist’s office,” Carli said. “Therapy is something that’s really uncomfortable for a lot of people, including me. And to be able to be on my own turf makes me feel a little more powerful.”

TNS

Where OCD meets covid-19

Before the covid-19 pandemic took hold in the United States, Chris Trondsen felt his life was finally under control. As someone who has battled obsessive-compulsive disorder and other mental health issues since early childhood, it’s been a long journey.

“I’ve been doing really, really well,” Trondsen said. “I felt like most of it was pretty much — I wouldn’t say ‘cured’ — but I definitely felt in remission or under control. But this pandemic has been really difficult for me.”

Trondsen, 38, a Costa Mesa, Calif., therapist who treats those with obsessive-compulsive and anxiety disorders, has found himself excessively washing his hands once again. He’s experiencing tightness in his chest from anxiety — something he hadn’t felt in so long that it frightened him into getting checked out at an urgent care center. And because he also has body dysmorphic disorder, he said, he’s finding it difficult to ignore his appearance when he’s looking at himself during his many Zoom appointments with clients each day.

From the early days of the coronavirus outbreak, experts and media have warned of a mounting mental health crisis as people contend with a pandemic that has upended their lives. A recent Kaiser Family Foundation poll found about four in 10 adults say stress from the coronavirus negatively affected their mental health.

[CORONAVIRUS: Click here for our complete coverage » arkansasonline.com/coronavirus]

But those with obsessive-compulsive disorder and other serious anxieties face uniquely difficult mental health battles, including trying to distinguish concerns brought on by their conditions from general fears shared by the public about covid-19. People with OCD have discovered one advantage, though: Those who have undergone successful treatment often have increased abilities to accept the pandemic’s uncertainty.

Dr. Katharine Phillips, a psychiatrist at NewYork-Presbyterian and professor at Weill Cornell Medicine, said it’s possible that patients who have been in consistent, good treatment for their OCD are well protected against the stress of covid-19.

“Whether it’s excessive fears about the virus, excessive fears about possible repercussions to the virus, whether that’s financial effects — good treatment protects against relapse in these patients,” Phillips said.

Those with OCD feel compelled to repeatedly do certain behaviors, such as compulsive cleaning, and they may fixate on routines. OCD can also cause nonstop intrusive thoughts.

Carli, who asked her last name be withheld because she feared professional repercussions, can trace her OCD to age 6. The coronavirus pandemic has sent Carli, a 43-year-old from Jersey City, N.J., into a spiral. She’s afraid of the elevators in her building, so she doesn’t leave her apartment. And she’s having trouble distinguishing an OCD compulsion from an appropriate reaction to a dangerous pandemic, asking those without OCD how they’ve reacted.

“The compulsions in my head have definitely gotten worse, but in terms of wearing a mask and cleaning my groceries and going into stores, it’s really hard to gauge what is a normal reaction and what is my OCD,” Carli said. “I try to ask people, Are you doing this? Are you doing that?”

Elizabeth McIngvale, director of the McLean OCD Institute in Houston, said she’s noticed patients struggling to differentiate reactions, as Carli described. Her response is that whereas guidelines such as hand-washing from the Centers for Disease Control and Prevention are generally easily accomplished, OCD compulsions are usually never satisfied.

McIngvale was diagnosed with OCD when she was 12, with behaviors like taking six- to eight-hour showers and washing her hands for so long they bled. McIngvale receives therapy weekly.

“It’s just a part of my life and how I maintain my progress,” McIngvale said.

Lately, she’s found herself consumed with fears of harming or infecting others with the covid-19 virus — a symptom of her OCD. But, generally, with the tools she’s gained through treatment, she said she’s been handling the pandemic better than some people around her.

“The pandemic, in general, was a new experience for everybody, but for me, feeling anxiety and feeling uncomfortable wasn’t new,” McIngvale said.

“OCD patients are resilient,” she added. Treatment is based on “leaning into uncertainty and so we’ve also seen patients who are far along in their treatment during this time be able to manage really well and actually teach others how to live with uncertainty and with anxiety.”

Wendy Sparrow, 44, an author from Port Orchard, Wash., has OCD, agoraphobia (fear of places or situations that might cause panic) and post-traumatic stress disorder. Sparrow has been in therapy several times but now takes medication and practices mindfulness and meditation.

At the beginning of the pandemic, she wasn’t fazed because she’s used to sanitizing frequently and she doesn’t mind staying home. Instead, she has felt her symptoms worsening as her home no longer felt like a safe space and her fears of fatal contamination heightened.

“The world feels germier than normal and anyone who leaves this house is subjected to a barrage of questions when they return,” Sparrow wrote in an email.

Depending on how long the pandemic lasts, Sparrow said, she may revisit therapy so she can adopt more therapeutic practices. Trondsen, too, is considering therapy again, even though he knows the tools to combat OCD by heart and uses them to help his clients.

“I definitely am needing therapy,” Trondsen said. “I realized that even if it’s not specifically to relearn tools for the disorders … it’s more so for my mental well-being.”

Carli has struggled with finding the right treatment for her OCD.

But a recent change is helping. As the pandemic intensified this spring, many doctors and mental health providers moved to telehealth appointments — and insurers agreed to cover them — to cut down on the risks of spreading the virus. In April, she started using an app that connects people with OCD to licensed therapists. While skeptical at first, she has appreciated the convenience of teletherapy.

“I never want to go back to actually being in a therapist’s office,” Carli said. “Therapy is something that’s really uncomfortable for a lot of people, including me. And to be able to be on my own turf makes me feel a little more powerful.”

Patrick McGrath, a psychologist and head of clinical services at NOCD, the telehealth platform Carli uses, said he’s found teletherapy with his patients is also beneficial because it allows him to better understand “how their OCD is interfering in their day-to-day life.”

Trondsen hopes the pandemic will bring increased awareness of OCD and related disorders. Occasionally, he’s felt that his troubles during this pandemic have been dismissed or looped into the general stress everyone is feeling.

“I think that there needs to be a better understanding of how intense this is for people with OCD,” he said.

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How people with obsessive-compulsive disorder cope with added anxiety of COVID-19

Before the COVID-19 pandemic took hold in the United States, Chris Trondsen felt his life was finally under control. As someone who has battled obsessive-compulsive disorder and other mental health issues since early childhood, it’s been a long journey.

“I’ve been doing really, really well,” Trondsen said. “I felt like most of it was pretty much — I wouldn’t say ‘cured’ ― but I definitely felt in remission or under control. But this pandemic has been really difficult for me.”

Trondsen, 38, a Costa Mesa, California, therapist who treats those with obsessive-compulsive and anxiety disorders, has found himself excessively washing his hands once again. He’s experiencing tightness in his chest from anxiety — something he hadn’t felt in so long that it frightened him into getting checked out at an urgent care center. And because he also has body dysmorphic disorder, he said, he’s finding it difficult to ignore his appearance when he’s looking at himself during his many Zoom appointments with clients each day.

From the early days of the coronavirus outbreak, experts and media have warned of a mounting mental health crisis as people contend with a pandemic that has upended their lives. A recent KFF poll found that about 4 in 10 adults say stress from the coronavirus negatively affected their mental health. (KHN is an editorially independent program of KFF, the Kaiser Family Foundation.)

But those with obsessive-compulsive disorder and other serious anxieties face uniquely difficult mental health battles, including trying to distinguish concerns brought on by their conditions from general fears shared by the public about COVID-19. People with OCD have discovered one advantage, though: Those who have undergone successful treatment often have increased abilities to accept the pandemic’s uncertainty.

Dr. Katharine Phillips, a psychiatrist at NewYork-Presbyterian and professor at Weill Cornell Medicine, said it’s possible that patients who have been in consistent, good treatment for their OCD are well protected against the stress of COVID-19.

“Whether it’s excessive fears about the virus, excessive fears about possible repercussions to the virus, whether that’s financial effects ― good treatment protects against relapse in these patients,” Phillips said.

Those with OCD feel compelled to repeatedly perform certain behaviors, such as compulsive cleaning, and they may fixate on routines. OCD can also cause nonstop intrusive thoughts.

Carli, who asked that her last name be withheld because she feared professional repercussions, can trace her OCD to age 6. The coronavirus pandemic has sent Carli, a 43-year-old from Jersey City, New Jersey, into a spiral. She’s afraid of the elevators in her building, so she doesn’t leave her apartment. And she’s having trouble distinguishing an OCD compulsion from an appropriate reaction to a dangerous pandemic, asking those without OCD how they’ve reacted.

“The compulsions in my head have definitely gotten worse, but in terms of wearing a mask and cleaning my groceries and going into stores, it’s really hard to gauge what is a normal reaction and what is my OCD,” Carli said. “I try to ask people, Are you doing this? Are you doing that?”

Elizabeth McIngvale, director of the McLean OCD Institute in Houston, said she has noticed patients struggling to differentiate reactions, as Carli described. Her response is that whereas guidelines such as hand-washing from the Centers for Disease Control and Prevention are generally easily accomplished, OCD compulsions are usually never satisfied.

McIngvale was diagnosed with OCD when she was 12, with behaviors like taking six- to eight-hour showers and washing her hands for so long they bled. McIngvale receives therapy weekly.

“It’s just a part of my life and how I maintain my progress,” McIngvale said.

Lately, she’s found herself consumed with fears of harming or infecting others with the COVID-19 virus — a symptom of her OCD. But, generally, with the tools she’s gained through treatment, she said she’s been handling the pandemic better than some people around her.

“The pandemic, in general, was a new experience for everybody, but for me, feeling anxiety and feeling uncomfortable wasn’t new,” McIngvale said.

“OCD patients are resilient,” she added. Treatment is based on “leaning into uncertainty and so we’ve also seen patients who are far along in their treatment during this time be able to manage really well and actually teach others how to live with uncertainty and with anxiety.”

Wendy Sparrow, 44, an author from Port Orchard, Washington, has OCD, agoraphobia (fear of places or situations that might cause panic) and post-traumatic stress disorder. Sparrow has been in therapy several times but now takes medication and practices mindfulness and meditation.

At the beginning of the pandemic, she wasn’t fazed because she’s used to sanitizing frequently and she doesn’t mind staying home. Instead, she has felt her symptoms worsening as her home no longer felt like a safe space and her fears of fatal contamination heightened.

“The world feels germier than normal and anyone who leaves this house is subjected to a barrage of questions when they return,” Sparrow wrote in an email.

Depending on how long the pandemic lasts, Sparrow said, she may revisit therapy so she can adopt more therapeutic practices. Trondsen, too, is considering therapy again, even though he knows the tools to combat OCD by heart and uses them to help his clients.

“I definitely am needing therapy,” Trondsen said. “I realized that even if it’s not specifically to relearn tools for the disorders … it’s more so for my mental well-being.”

Carli has struggled with finding the right treatment for her OCD.

But a recent change is helping. As the pandemic intensified this spring, many doctors and mental health providers moved to telehealth appointments — and insurers agreed to cover them ― to cut down on the risks of spreading the virus. In April, she started using an app that connects people with OCD to licensed therapists. While skeptical at first, she has appreciated the convenience of teletherapy.

“I never want to go back to actually being in a therapist’s office,” Carli said. “Therapy is something that’s really uncomfortable for a lot of people, including me. And to be able to be on my own turf makes me feel a little more powerful.”

Patrick McGrath, a psychologist and head of clinical services at NOCD, the telehealth platform Carli uses, said he’s found that teletherapy with his patients is also beneficial because it allows him to better understand “how their OCD is interfering in their day-to-day life.”

Trondsen hopes the pandemic will bring increased awareness of OCD and related disorders. Occasionally, he’s felt that his troubles during this pandemic have been dismissed or looped into the general stress everyone is feeling.

“I think that there needs to be a better understanding of how intense this is for people with OCD,” he said.

This article was originally published by Kaiser Health News (KHN), a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

What it’s like to have OCD during a pandemic

It didn’t start out with excessive behaviors. First it was washing my hands longer, avoiding a few larger gatherings, and using hand sanitizer. Before long, however, I was opening drawers with my feet and elbows and letting delivery items sit for days before touching them. My anxiety was incredibly high, and it affected my appetite. After a couple of months, I had lost around 15 lbs and was a prisoner in my home.

I suffer from Obsessive Compulsive Disorder (OCD), a psychological condition that causes intrusive thoughts and obsessions leading to intense anxiety. Relief comes through compulsive behaviors. Obsessions can take many different forms, such as thoughts of contamination or fears of harm coming to family or friends.

Similarly, compulsions can be anything from washing hands, tapping objects, or seeking reassurances. Many times there is no obvious connection between the obsessive thought and the compulsive behavior. It can often be difficult to tell the difference between behaviors caused by OCD and those that are perhaps just overly meticulous. The real difference comes from observing how much distress the obsessive thoughts cause and the degree with which they interfere with your daily life.

As a child, I was known as a worrier. There were many things that caused me anxiety, such as failing at school, severe weather, and my house burning down. It wasn’t until high school, when my obsessions shifted to a religious theme, that it was clear something was wrong. At that point, my OCD took the form of scrupulosity, where I would go to confession multiple times a week and ruminate over whether I had committed a moral or venial sin or said my penance in just the right way.

One of the biggest challenges that the new coronavirus has presented — whether or not you suffer from OCD — is uncertainty. For many of us, it’s been unclear whether spraying certain items is necessary or excessive, for example. Is it safe to handle mail or food packaging? How much distance from someone really is safest? Since the coronavirus is so new, even those without mental illness aren’t sure how to answer these questions. When scientific and medical officials admit that there is much that is unknown about the coronavirus, the difference between obsessive and prudent is very murky.

The challenge for me is that OCD demands certainty. I must know that there aren’t any germs on my hands or that the person who just coughed is not sick. Life in general offers no guarantees, of course, and so things become more difficult when I’m faced with true uncertainty.

A pandemic can also cause flare ups in non-contamination themed OCD. For example, if I suffer from scrupulosity, I might find that uncertainties regarding the lethality of the coronavirus cause anxiety over dying in a state of mortal sin. Again, the difference between a healthy concern and obsession can be difficult to discern.

Unfortunately, mental illness does not spare those with faith. Due to a general lack of understanding regarding mental health, there are significant challenges for Christians who experience anxiety, depression, or other disorders. One of the most common misunderstandings among those of faith is that the symptoms of mental illness are caused by a lack of faith. There is a tendency among some Christians to think that we can relieve anxiety simply by praying. We might also believe that struggles with depression are due to despair of God’s love.

Although mental and spiritual health do affect one another, we must not make the mistake of thinking that one can take the place of the other. Even holy saints, such as St. Ignatius of Loyola, St. Alphonsus Liguori, and St. Therese of Lisieux may have suffered from obsessive and anxiety disorders. Catholics may also find consolation in praying to St. Dymphna, the patron saint of nervous disorders and mental illness. We need to remember that it is perfectly acceptable to need both a spiritual director and a therapist.

Never forget that there is help available if you struggle with mental health disorders. We must not fear that somehow seeking out a therapist means we have given up on God. The Father in Heaven who created us also gave us the tools we need for healing. We have the sacraments for our souls, doctors for our bodies, and therapists for our minds. Thanks be to God, I was able to find help even in the midst of a pandemic. Through teletherapy, I began treatment that has slowly helped me gain greater control over my obsessions. I still have work to do, but I know that God will guide me through this time and I will look back on this period as a time of grace.

How Those With Obsessive-Compulsive Disorder Cope With Added Angst Of COVID

Before the COVID-19 pandemic took hold in the United States, Chris Trondsen felt his life was finally under control. As someone who has battled obsessive-compulsive disorder and other mental health issues since early childhood, it’s been a long journey.

“I’ve been doing really, really well,” Trondsen said. “I felt like most of it was pretty much — I wouldn’t say ‘cured’ ― but I definitely felt in remission or under control. But this pandemic has been really difficult for me.”

Trondsen, 38, a Costa Mesa, California, therapist who treats those with obsessive-compulsive and anxiety disorders, has found himself excessively washing his hands once again. He’s experiencing tightness in his chest from anxiety — something he hadn’t felt in so long that it frightened him into getting checked out at an urgent care center. And because he also has body dysmorphic disorder, he said, he’s finding it difficult to ignore his appearance when he’s looking at himself during his many Zoom appointments with clients each day.

Chris Trondsen, a California therapist who in the past struggled with obsessive-compulsive disorder, says “this pandemic has been really difficult for me.” OCD symptoms have resurfaced that he hadn’t experienced in years.(Courtesy of Chris Trondsen)

From the early days of the coronavirus outbreak, experts and media have warned of a mounting mental health crisis as people contend with a pandemic that has upended their lives. A recent KFF poll found that about 4 in 10 adults say stress from the coronavirus negatively affected their mental health. (KHN is an editorially independent program of KFF, the Kaiser Family Foundation.)

But those with obsessive-compulsive disorder and other serious anxieties face uniquely difficult mental health battles, including trying to distinguish concerns brought on by their conditions from general fears shared by the public about COVID-19. People with OCD have discovered one advantage, though: Those who have undergone successful treatment often have increased abilities to accept the pandemic’s uncertainty.

Dr. Katharine Phillips, a psychiatrist at NewYork-Presbyterian and professor at Weill Cornell Medicine, said it’s possible that patients who have been in consistent, good treatment for their OCD are well protected against the stress of COVID-19.

“Whether it’s excessive fears about the virus, excessive fears about possible repercussions to the virus, whether that’s financial effects ― good treatment protects against relapse in these patients,” Phillips said.

Those with OCD feel compelled to repeatedly perform certain behaviors, such as compulsive cleaning, and they may fixate on routines. OCD can also cause nonstop intrusive thoughts.

Carli, who asked that her last name be withheld because she feared professional repercussions, can trace her OCD to age 6. The coronavirus pandemic has sent Carli, a 43-year-old from Jersey City, New Jersey, into a spiral. She’s afraid of the elevators in her building, so she doesn’t leave her apartment. And she’s having trouble distinguishing an OCD compulsion from an appropriate reaction to a dangerous pandemic, asking those without OCD how they’ve reacted.

“The compulsions in my head have definitely gotten worse, but in terms of wearing a mask and cleaning my groceries and going into stores, it’s really hard to gauge what is a normal reaction and what is my OCD,” Carli said. “I try to ask people, Are you doing this? Are you doing that?”

Elizabeth McIngvale, director of the McLean OCD Institute in Houston, said she has noticed patients struggling to differentiate reactions, as Carli described. Her response is that whereas guidelines such as hand-washing from the Centers for Disease Control and Prevention are generally easily accomplished, OCD compulsions are usually never satisfied.

McIngvale was diagnosed with OCD when she was 12, with behaviors like taking six- to eight-hour showers and washing her hands for so long they bled. McIngvale receives therapy weekly.

“It’s just a part of my life and how I maintain my progress,” McIngvale said.

Lately, she’s found herself consumed with fears of harming or infecting others with the COVID-19 virus — a symptom of her OCD. But, generally, with the tools she’s gained through treatment, she said she’s been handling the pandemic better than some people around her.

“The pandemic, in general, was a new experience for everybody, but for me, feeling anxiety and feeling uncomfortable wasn’t new,” McIngvale said.

“OCD patients are resilient,” she added. Treatment is based on “leaning into uncertainty and so we’ve also seen patients who are far along in their treatment during this time be able to manage really well and actually teach others how to live with uncertainty and with anxiety.”

Wendy Sparrow, 44, an author from Port Orchard, Washington, has OCD, agoraphobia (fear of places or situations that might cause panic) and post-traumatic stress disorder. Sparrow has been in therapy several times but now takes medication and practices mindfulness and meditation.

Wendy Sparrow says initially she wasn’t fazed by COVID-19 because she’s used to sanitizing frequently and doesn’t mind staying home. Instead, she felt her symptoms worsening as her home no longer felt like a safe space.(Courtesy of Wendy Sparrow)

At the beginning of the pandemic, she wasn’t fazed because she’s used to sanitizing frequently and she doesn’t mind staying home. Instead, she has felt her symptoms worsening as her home no longer felt like a safe space and her fears of fatal contamination heightened.

“The world feels germier than normal and anyone who leaves this house is subjected to a barrage of questions when they return,” Sparrow wrote in an email.

Depending on how long the pandemic lasts, Sparrow said, she may revisit therapy so she can adopt more therapeutic practices. Trondsen, too, is considering therapy again, even though he knows the tools to combat OCD by heart and uses them to help his clients.

“I definitely am needing therapy,” Trondsen said. “I realized that even if it’s not specifically to relearn tools for the disorders … it’s more so for my mental well-being.”

Carli has struggled with finding the right treatment for her OCD.

But a recent change is helping. As the pandemic intensified this spring, many doctors and mental health providers moved to telehealth appointments — and insurers agreed to cover them ― to cut down on the risks of spreading the virus. In April, she started using an app that connects people with OCD to licensed therapists. While skeptical at first, she has appreciated the convenience of teletherapy.

“I never want to go back to actually being in a therapist’s office,” Carli said. “Therapy is something that’s really uncomfortable for a lot of people, including me. And to be able to be on my own turf makes me feel a little more powerful.”

Patrick McGrath, a psychologist and head of clinical services at NOCD, the telehealth platform Carli uses, said he’s found that teletherapy with his patients is also beneficial because it allows him to better understand “how their OCD is interfering in their day-to-day life.”

Trondsen hopes the pandemic will bring increased awareness of OCD and related disorders. Occasionally, he’s felt that his troubles during this pandemic have been dismissed or looped into the general stress everyone is feeling.

“I think that there needs to be a better understanding of how intense this is for people with OCD,” he said.

Related Topics

Mental Health Public Health


Father’s Day feature

Zach Ribble had been suffering from significant anxiety, depression and obsessive-compulsive disorder (OCD) for many years. 

“The constant struggle of getting out of bed and putting on a ‘happy face’ had slowly worn away at me,” he said. 

After Ribble stopped reading his Bible and turned his back on his faith, his wife, Jennifer, decided that she needed to speak up.

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In his new book “Unchained: Spiritually Smart Ways to Eliminate Anxiety, Find Peace, and Live Free for God,” Ribble shares his struggle to turn his life around for his family after a conversation with Jennifer.

Jennifer had sat Ribble down and told him he had changed before her eyes. He was not the same man that she had married. They were not communicating or sharing time together, and their relationship seemed more like a chore. Jennifer realized that if she didn’t speak up, it would be too late to change. 

“Things were getting too heavy for me to bear alone and I needed my husband back,” she said. 

The conversation had been a wake-up call for Ribble, inspiring him to focus on what really matters in life.

For many years after Ribble graduated from Central Michigan University in 2008, he and his wife had been trying to have a baby. After Jennifer suffered a miscarriage in 2014, the situation seemed hopeless. 

Two days after Ribble’s recommitment to his faith and family, Jennifer discovered she was pregnant. 

“I believed that was a sign that we were both ready to be parents, I’m so glad to be a dad and I’m so glad that I went through those struggles in life in order to be a good father,” Ribble said. “Every year when Father’s Day comes, it’s a reminder that we may go through suffering in life, but it’s worth it for family.”

Ribble’s transformation motivated him to write his story and share it with the world.

Just two days after its release on May 24, Ribble’s expectations were exceeded when the book reached “Amazon #1 Best Seller.”

“For me, my goal is to make a difference to as many people as possible, and this book is just the beginning,” Ribble said.

Ribble and his wife now live in Galesburg with their two daughters, 2-year-old Zoe and 1-year-old Alexis. Ribble’s favorite thing to do with his family is to spend time at the beach. 

This year for Father’s Day, Ribble said he plans to grill some burgers outside and enjoy a beautiful day, celebrating the publication of his book with his family.

“Zach is the best dad,” Jennifer said. “As soon as he became a dad, it has brought out the best in him and all the qualities that made me fall in love with him have been illuminated even more.”