The hellish side of handwashing: how coronavirus is affecting people with OCD

Boris Johnson does it while singing Happy Birthday twice. For Jacob Rees-Mogg, it’s the national anthem. And as soap supplies run low, it seems much of Britain is following their example and heeding the official guidance to wash hands thoroughly and often, in order to minimise the spread of the coronavirus.

It is good public health advice, of course. Indeed, one question raised by the rush for soap is just what all those people without any in the house did before. But for some people with obsessive-compulsive disorder (OCD), to be warned they must scrub to protect themselves from an invisible enemy, and to do so in a ritualistic way with internal musical accompaniment, is akin to inviting a demon to come for tea. Some of these people have spent years trying not to wash their hands, often as a prescribed part of their treatment.

“It’s definitely put a lot of the internal OCD dialogue back into my life. It’s being reinforced by outside, authoritative voices,” says Erica (not her real name), a long-term OCD patient. “It’s a lot harder to tell yourself that the urge to wash your hands is irrational when everyone on your Twitter feed or on the news is saying: ‘Wash your hands. Nobody is washing their hands correctly.’”

The worsening outbreak affects people with OCD in other ways, too. Chiefly, the spike in anxiety about the virus can fuel existing obsessive fears of contamination and trigger destructive compulsive actions. For some people with OCD, coronavirus can become all they think about. “I have seen three patients this week whose OCD has started to focus on coronavirus,” says David Veale, a consultant psychiatrist at the Priory hospital in London. “It is a challenging time for people who have OCD.”

As anyone with the condition will know, of course, OCD is challenging all the time. Often portrayed as a behavioural quirk, OCD is in fact a syndrome defined by recurring irrational thoughts. The compulsive actions – often the most visible feature of the illness – are usually only a response to those intrusive thoughts.

The irrational content of those thoughts is limited only by the spectrum of human imagination. Since I published a book on my experiences with OCD, I have met people obsessed with the idea that if they close their eyes, the whole world will change while they are not looking, or that if they hand-write a letter or a number that contains a closed loop, their family will die. But OCD does tend to cluster around a limited number of themes.

Perhaps the biggest of these is contamination – with generic dirt or germs, or with a specific illness or disease. And these contamination fears are heavily influenced by culture, society and shared health scares. Coronavirus is only the latest.

I have OCD that focuses on HIV and Aids, which makes sense because I grew up in the 1980s when global fear of that condition was at its peak. It wasn’t just me. A generation was traumatised. The US psychiatrist Judith Rapoport wrote in her book, The Boy Who Couldn’t Stop Washing, that by 1989 a third of her OCD patients focused on HIV and Aids. The disease, she wrote, appeared “so terrifying, so irrational that it could have been the creation of an obsessive-compulsive’s worst fantasy”.

In the 1920s, doctors in the US reported a surge in what they called syphilis-phobia, which coincided with a campaign to highlight the dangers of the disease. In the 1960s and 70s there was a spike in irrational fears of asbestos, just as the dangers of the material had come to popular attention. In 2012, Australian scientists reported the first cases of OCD in people who fixate on thoughts about climate change – a bogeyman for the new millennium and one that, like HIV in the 1980s, poses an uncertain, universal threat, depicted in lurid detail by the mass media. (Full disclosure: as the former environment correspondent for this newspaper, I used to write those stories.)

If coronavirus continues to spread, experts expect related cases of OCD to spike as well. The disease and the attention it is receiving are “good for business”, one psychiatrist told me with gallows humour.

Exactly what makes some people predisposed to OCD isn’t clear, but genetics and previous experiences seem to play a role. In some cases, Veale says, the coronavirus threat could bring on OCD for the first time. “If someone’s got the right genes and they’ve had all the right experiences to shape them, then this could be a trigger to set the whole thing off.” There is some evidence that simply asking people to wash their hands can make them more anxious about their health. Psychologists have found that students asked to spend a week using hand sanitiser after they touched money, door handles or other possible sources of germs subsequently reported significantly higher signs of hypochondria.

For Kyle MacNeill, a freelance writer, the 2009 swine flu scare initiated a years-long struggle with OCD. He traces it back to a remark from a family member that he wasn’t washing his hands properly. Combined with the warnings about the virus, the comment sparked an obsession with germs. “I’d wash my hands 20 times in a row,” he says. “On my way out I would accidentally brush against the door handle. It’s very exhausting, you know, having to repeat that process again.” MacNeill’s anxieties were eventually successfully treated and he is not overly worried that coronavirus will set them off again.

What about people who do worry they might convert rational coronavirus anxiety to OCD? What should they look out for? Veale says the signs of OCD are clear and different from the “normal” response to the coronavirus. Fretting about the virus and washing hands a lot don’t qualify on their own. An important difference is that someone with OCD will wash until they feel comfortable or “just right”. “The key issue is the function,” he says. “Is it to reduce the risk of spreading of coronavirus, or is it done ritualistically in a specific order with termination criteria?”

The content of the thoughts and the nature of the anxiety are usually different, too. With OCD, the intrusive thoughts are exaggerated and irrational. One of Veale’s patients with coronavirus OCD, for example, has started to fixate on whether they can catch the disease from Chinese food.

It is important to stress that, as long as it is not excessive, handwashing to minimise the risk of coronavirus spread from other people is a rational response to a genuine threat. But OCD just isn’t rational. Although many patients with OCD do wash their hands repeatedly, it is not always because they think they are dirty. In some cases, it is just a way to find comfort, to ease the mental burden of irrational obsessions that a loved one might die, or that something dreadful will happen to them. For some OCD patients, flicking a light on and off a set number of times can bring that relief. So can tapping, or saying a specific word, or shuffling from foot to foot or an infinite number of other nonsensical routines. For me it was seeking reassurance: checking for blood on a piece of glass I stepped on, or asking health professionals if I could catch HIV by doing this and that. In every case, I already knew the answer was no. But I wanted them to say it because for a second or two I believed and the world seemed a brighter place. The reassurance never lasted but it gave me a hit of happiness that became addictive.

That is why OCD is so hard to treat, and why coronavirus and official advice on handwashing pose such a dilemma for some OCD patients and therapists. Treatment for OCD is based on the principle of exposure-and-response prevention. It exposes a patient to what they are afraid of, to spike their anxiety, but stops them performing the compulsive acts they would usually employ to make themselves feel better. For contamination-related OCD, that response prevention frequently involves getting them to not wash their hands, sometimes for days on end. In theory, the anxiety drips away and the patient realises they need not rely on handwashing to feel better. Being told they do need to repeatedly wash their hands after all could interfere with that recovery.

It is a paradox and one that makes health officials jumpy. I spoke with one NHS psychiatrist who wanted to make the point that OCD patients with handwashing issues should follow the government advice on coronavirus, but not take it too far. They were told by their bosses that they shouldn’t say so publicly because: “It may be a very risky strategy, including if a patient actually does catch the virus.”

For some OCD patients, the risky strategy is the correct one, says Jon Abramowitz, an OCD expert and therapist at the University of North Carolina. He is telling some OCD patients to ignore the official US government health advice on coronavirus and to keep on not washing their hands. “It’s a tough call. What I have said to people is that your risk is low and I don’t think you need to take all these kinds of precautions. And given you have OCD, you’re probably better off not.”

David Adam is the author of The Man Who Couldn’t Stop: The Truth About OCD.

What coronavirus fears are doing to people with anxiety disorders

“You’re having an anxiety reaction if you’re anxiety is increasing in frequency and intensity, and if it’s invading your ability to function,” said Charles Marmar, chair of the department of psychiatry at New York University’s Langone Heath and a specialist in studying and treating PTSD. “You’re having trouble changing the channel from the ‘worry channel’ to focusing your mind on friendships, love, work, hobbies, etcetera.”

Untangling the Web of Comorbid Obsessive-Compulsive Disorder and Medical Illness

1. Hirschtritt ME, Bloch MH, Mathews CA. Obsessive-compulsive disorder: advances in diagnosis and treatment. JAMA. 2017;317:1358-1367.

2. Kessler RC, Berglund P, Chiu WT, et al. The US National Comorbidity Survey Replication (NCS-R): design and field procedures. Int J Methods Psych Res. 2004;13:69-92.

3. Isomura K, Brander G, Chang Z, et al. Metabolic and cardiovascular complications in obsessive-compulsive disorder: a total population, sibling comparison study with long-term follow-up. Biol Psychiatry. 2018;84:324-331.

4. Albert U, Aguglia A, Chiarle A, et al. Metabolic syndrome and obsessive-compulsive disorder: a naturalistic Italian study. Gen Hosp Psychiatry. 2013;35:154-159.

5. Aguglia A, Signorelli MS, Albert U, et al. The impact of general medical conditions in obsessive-compulsive disorder. Psychiatry Invest. 2018;15:246-253.

6. Coupland C, Hill T, Morriss R, et al. Antidepressant use and risk of cardiovascular outcomes in people aged 20 to 64: cohort study using primary care database. BMJ. 2016;352:i1350.

7. Olguner Eker O, Ozsoy S, Eker B, Dogan H. Metabolic effects of antidepressant treatment. Noro Psikivatr Ars. 2017;54:49-56.

8. Salvi V, Mencacci C, Barone-Adesi F. H1-histamine receptor affinity predicts weight gain with antidepressants. Eur Neuropsychopharmacol. 2016;26:1673-1677.

9. Siafis S, Tzachanis D, Samara M, Papazisis G. Antipsychotic drugs: from receptor-binding profiles to metabolic side effects. Curr Neuropharmacol. 2018;16:1210-1223.

10. Anderson RJ, Grigsby AB, Freedland KE, et al. Anxiety and poor glycemic control: a meta-analytic review of the literature. Int J Psychiatry Med. 2002;32:235-247.

11. Martino G, Catalano A, Bellone F, et al. As time goes by: anxiety negatively affects the perceived quality of life in patients with type 2 diabetes of long duration. Front Psychol. 2019;10:1779.

12. Saxena S, Rauch SL. Functional neuroimaging and the neuroanatomy of obsessive-compulsive disorder. Psychiatr Clin North Am. 2000;23:563-586.

13. Vaghi MM, Vertes PE, Kitzbichler MG, et al. Specific frontostriatal circuits for impaired cognitive flexibility and goal-directed planning in obsessive-compulsive disorder: evidence from resting-state functional connectivity. Biol Psychiatry. 2017;81:708-717.

Some with OCD, anxiety disorders are struggling amid coronavirus epidemic.

Anxiety disorders affect some 40 million adults in the United States, according to the Anxiety and Depression Association of America. The International OCD Foundation estimates that about 2 million to 3 million adults nationwide have some form of OCD, a particular anxiety disorder characterized by a cycle of distressing obsessions and compulsions. One OCD subtype centers on contamination fears, which often spur compulsive hand-washing, disinfecting, avoiding contact with perceived contaminants, and other unhealthy coping mechanisms.

Now wash your hands… again: why coronavirus is different when you have obsessive compulsive disorder

When it comes to the threat of coronavirus, the British are supposedly among the most relaxed people in the world, and the least likely to take precautions, according to new research last week. Just five per cent in this country said they were “very scared” by the illness, a YouGov survey found.

But if the majority of the population is (so far) keeping calm and carrying on, not everyone is able to remain so tranquil about the impending doom we keep hearing about. For those who already suffer from mental health conditions such as obsessive compulsive disorder (OCD), the perceived panic surrounding the global spread of the virus is far harder to deal with serenely.

When Telegraph columnist and mental health campaigner Bryony Gordon posted a message on Twitter last week to ask “how many people with contamination OCD are suffering miserably at the moment?” the replies were revealing.

“The whole Coronavirus thing is really triggering,” wrote Rachel Allen, while Julia Bladen-Blake replied: “It’s really taking a lot in me not to succumb to old health anxiety habits that I had to go to therapy for.” A third woman, Jacqueline Strawbridge, said it was “off the scale, just like when those terrifying AIDS adverts came out in the 80s, this is a nightmare for people with OCD.”

At the most severe end of the scale, and illustrating the effect the coronavirus situation is having not only on adults but also on young children with mental health conditions, was the daughter of a woman called Jo who, she says, is “suffering terribly with this. 11 years old and feels like she’s going to die if she touches anything. Doesn’t want to go to school. Terrified from what she picks up on the media.”

OCD, a potentially debilitating condition characterised by obsessive thoughts and compulsive behaviours, affects 1.2 per cent of the UK population, according to the charity Rethink Mental Illness. But a far larger proportion is affected by a variety of anxiety disorders. The NHS says generalised anxiety disorder is estimated to affect up to five per cent of the UK population, while one in six people in the UK will experience a common mental health issue every year.

Many of these will experience fears around matters other than germs, contamination and illness. But for some of those who find it difficult to control their worries around these areas, the rapidly escalating coronavirus crisis is triggering unhelpful thought patterns and behaviours. About 50 per cent of people with OCD have “a fear of contamination from dirt or disease that causes them to wash and clean compulsively,” wrote David A. Clark, a clinical psychologist at the University of New Brunswick, Canada, in an article last week.

Coronavirus: how to stop the anxiety spiralling out of control

As the novel coronavirus proliferates on a global scale, worry and panic is on the rise. And it is no wonder when we are constantly being told how to best protect ourselves from being infected. But how do you stay safe in this climate and simultaneously make sure that the fear doesn’t take over your life, developing into obsessive compulsive disorder or panic?

Fear is a normal, necessary evolutionary response to threat – ultimately designed to keep us safe. Whether the threat is emotional, social or physical, this response is dependent on a complex interaction between our primitive “animal brain” (the limbic system) and our sophisticated cognitive brain (the neo-cortex). These work busily in concert to assess and respond to threats to survival.

Once a threat has been identified, a “fight or flight” response can be triggered. This is the body’s biological response to fear and involves flooding us with adrenaline in a bid to ensure that we are able to escape or defeat any threat, such as a dangerous animal attacking. The response produces a range of intense physical symptoms – palpitations, perspiration, dizziness and difficulty breathing – which are designed to make us run faster and fight harder.

However, this system can be prone to glitches, sometimes responding disproportionately to threats that aren’t actually that serious or imminent. Worrying about health conditions such as heart attacks, stroke and even COVID-19 (the disease caused by the coronavirus) can therefore also trigger a fight-or-flight response.

That’s despite the fact that there is no role for a primitive biological response to COVID-19 – no running or fighting is necessary. Instead, it is our high-level, cognitive neocortex that is required here, a rational and measured approach to infectious disease, without the messy complications of panic.

Sadly, this is easier said than done. Once the fear has kicked in, it can be hard to stop it.

Vulnerable groups

It is highly unlikely that a viral outbreak, even at pandemic levels, will trigger mental health problems in people who don’t already have them or are in the process of developing them. Research shows that most mental health problems start between early adolescence and the mid-20s, with complex factors being involved. Around 10% of the global population experience clinical levels of anxiety at any one time, although some estimates are higher.

People who are chronically and physically unwell – the ones who are the most vulnerable to the coronavirus – are at particular risk of spiralling anxiety. This should not be ignored. Their concern is warranted and is vital in motivating them to take up precautionary measures. But it is important that these individuals have the support they need in dealing with their emotions.

People with health anxiety, preoccupied with health-related information or physical symptoms, are also at risk of worsening mental health as the virus spreads. So are individuals who are prone to frequent or increased “checking”, such as constantly making sure that the oven is off or that the front door is locked. Those at the extreme end of the scale when it comes to such behaviour may be displaying signs of obsessive compulsive disorder.

People who have a lot of background anxiety, and are not easily reassured, may also benefit from assessment and support in the shadow of the coronavirus outbreak. This may include people with generalised anxiety disorder or panic disorder, which have strong physiological features.

Ways to manage the stress

If you find yourself excessively worrying about the coronavirus, this doens’t necessarily mean that you have a psychological disorder. But high levels of emotional distress, whatever the source, should be appropriately and compassionately attended to, particularly if it is interfering with normal day to day activities.

At times of stress and anxiety, we are often prone to using strategies that are designed to help but prove counter-productive. For example, you may Google symptoms to try to calm yourself down, even though it is unlikely to ever make you feel better. When our strategies for de-stressing instead increase our anxiety, it is time to take a step back and ask if there is anything more helpful we can do.

Stop checking.
TeamDAF

There are actually ways to dampen down the physical and emotional symptoms associated with anxiety. One is to stop checking. For example, avoid looking for signs of illness. You are likely to find unfamiliar physical sensations that are harmless but make you feel anxious. Normal physical changes and sensations pass in time, so if you feel your chest tighten, shift your focus onto pleasurable activities and adopt “watchful waiting” in the meantime.

In the case of COVID-19, checking may also include constant monitoring of news updates and social media feeds, which significantly increases anxiety – only serving to reassure us momentarily, if at all. So if you are feeling anxious, consider tuning off automatic notifications and updates on COVID-19.

Instead, do less frequent checks of reliable, impartial sources of information updates on COVID-19. This might include national health websites rather than alarmist news or social media feeds that exacerbate worry unnecessarily. Information can be reassuring if it is rooted in facts. It is often the intolerance of uncertainty that perpetuates anxiety rather than fear of illness itself.

At times of stress and anxiety, hyperventilation and shallow breathing is common. Purposeful, regular breathing can therefore work to reset the fight or flight response and prevent the onset of panic and the unpleasant physical symptoms associated with anxiety. This is also true for exercise, which can help reduce the excess adrenaline build-up associated with anxiety. It can also give much needed perspective.

Perhaps most importantly, don’t isolate yourself. Personal relationships are crucial in maintaining perspective, elevating mood and allowing distraction away from concerns that trouble us. Even in imposed isolation, it is important to combat loneliness and keep talking – for example, via video chats.

We are globally united in living with a very real yet uncertain health threat. Vigilance and precautionary measures are essential. But psychological distress and widespread panic does not have to be part of this experience. Continuing normal daily activities, maintaining perspective and reducing unnecessary stress is key to psychological survival. In other words, where possible, keep calm and carry on.

If you continue to feel anxious or distressed despite trying these techniques, do talk to your GP or refer to a psychologist for evidence-based treatment such as cognitive behavioural therapy.

Coronavirus Is Wreaking Havoc On Our Mental Health

Earlier this week, on a New York subway train, a woman did something that caused me to descend into nothing short of sheer panic: She dropped a melon. It rolled down the car thunderously, careening past the ankles of passengers, until it landed right in front of my feet. My first instinct was to be a good citizen and to pick it up and deliver it to its owner. But a small, nagging voice in the back of my mind that’s grown louder and louder as of late advised me not to. So, instead of actually handing it over to her, I gingerly kicked it over to her. To her credit, she didn’t seem fazed: She picked it up and gave me a thumbs-up.

I spent hours obsessing over this interaction. That’s in part because, a few minutes after this interaction, I thought I spotted the woman who’d dropped the melon surreptitiously coughing, and in a news cycle drenched in constant updates about COVID-19, I was delirious with panic: Had I touched my foot that had touched the melon? Was I outside of the range of six feet required for coronavirus transmission, per the CDC, of the woman who had dropped it? Did I brush past her when I got off the train? Had I washed my hands thoroughly enough when I got off the subway? Had I Purell’ed them thoroughly enough? Would I run out of Purell soon and be unable to afford it now that resellers on Amazon had jacked up the price?








But mostly I just felt guilty about it. I’m not the most socially adept person on the planet, but I still am not in the habit of kicking other people’s personal items when they’re in my line of vision. Had COVID-19 and the ensuing panic fucked with my mind to the degree that basic social morés were just flying out the window?

Truthfully, prior to the advent of COVID-19, I probably would’ve gone through this thought process. I have diagnosed obsessive-compulsive disorder (OCD), an anxiety disorder that manifests itself in obsessive, unwanted thoughts and compulsive behaviors; for me, as is the case for many people with OCD, mine manifests itself in obsessive fears of myself or my family members getting sick, with a healthy dose of germophobia thrown in for good measure.

When the CDC announced its list of best practices for preventing COVID-19, my first thought was that years of engaging in obsessive behaviors such as ruminating on protective measures or washing my hands till they cracked and bled would better equip me for the impending apocalypse. But as the weeks have passed and the virus has spread, with deniers on one side of the spectrum and alarmists on the other, it’s been difficult to ignore just how much the symptoms of my OCD have been exacerbated by the intense media coverage. This is likely true for many people who struggle with anxiety disorders, an umbrella term that describes everything from generalized anxiety disorder to panic disorder to obsessive-compulsive disorder (OCD).

“It’s coming up a lot. In fact, I had a session on it this morning,” says Dr. Nicole Naggar, a psychiatrist in New York. “For those of us who may be more slanted in an anxious way, we can be really vulnerable to the news, especially if we happen to be germophobes too.” Angelina, an immunocompromised person struggling with OCD, whose last name has been withheld at her request, concurs. Angelina lives in Washington state, where an estimated nine people have died from a COVID-19 outbreak, which has exacerbated her fears. “I’ve been trying to stay optimistic but it’s so hard to do when the media is creating this hysteria,” she says.

People with anxiety disorders comprise a sizable percentage of the population. According to the Anxiety and Depression Association of America, nearly 18 percent of the population, or 40 million adults, struggle with some form of anxiety disorder.

Of course, even for those who don’t have a formal diagnosis, the wall-to-wall news coverage of the virus now known as COVID-19 is immensely concerning — and there’s some data to indicate that pandemics can wreak havoc on the general population’s mental health. In the past, depression and anxiety rates have soared following terrorist attacks, even among those who were not directly impacted.

Yet for those predisposed to anxiety, it could prove immensely triggering, says Dr. Robert Schachter, assistant clinical professor at the Icahn School of Medicine at Mount Sinai. “Think of anxiety as this underground river that’s flowing all the time,” he says. “If you have a ‘What if?’ thought” — a fear-inducing hypothetical scenario prompted by headlines about price-jacking on hand sanitizer or photos of abandoned grocery stores in Milan — “then that pokes a hole and gives a reason for the anxiety to come out.”

A trader passes a hand sanitizing station on the floor of the New York Stock Exchange, . Federal Reserve Chairman Jerome Powell noted that the coronavirus poses evolving risks to economic activityVirus Outbreak Economy, New York, USA - 03 Mar 2020

A trader passes a hand-sanitizing station on the floor of the New York Stock Exchange. Photo credit: Richard Drew/AP/Shutterstock

Because there’s relatively little known about COVID-19, there’s a great deal of uncertainty surrounding the virus — and uncertainty, if nothing else, breeds “What ifs.” Even those who don’t necessarily have an anxiety disorder may find themselves felled by such thoughts, says Naggar, who says it is “absolutely possible” that news of coronavirus “could be an exposure or a trauma of sorts that could trigger” them.

Since news of COVID-19 first broke in the United States in December, media coverage has essentially been wall-to-wall. The vast majority of such coverage has centered on what we know about the virus, as well as the administration’s questionable handling of the ensuing health crisis, with President Trump most recently telling pharmaceutical executives to come up with a cure and vaccine all in one. (The World Health Organization (WHO) has said that it will take at least 18 months to develop a vaccine to COVID-19.) Yet very little has focused on the mental health effects of the omnipresent threat of coronavirus, which, combined with the administration’s response to COVID-19, creates “a perfect cocktail” of fear, says Dr. Chloe Carmichael, a clinical psychologist in New York. With previous health crises like SARS and the Ebola virus, the response was not highly politicized. Now, with COVID-19 being touted by right-wing media figures as a call to close borders, “it does seem like the administration’s handling of it has become a political football, which almost kinda supercharges the anxiety about it, says Carmichael.

That’s to say nothing of how little coverage has been afforded to the day-to-day experiences of those in countries where the crisis is more acute, such as China, Japan, Iran, and Italy, where the psychological impact of living with the threat — not to mention the isolation of quarantine — is immense. And there is evidence to suggest that the fallout could linger long after panic over the virus (hopefully! fingers crossed!) recedes. Studies of survivors, health care professionals, and members of surrounding communities impacted by the SARS crisis in Asia and Canada found that people were struggling with mental health issues up to four years after the epidemic had passed. Other studies post-9/11 found that watching news coverage of the attacks produced “substantial stress symptoms,” even in those who were watching from hundreds of miles away.

For those who struggle with anxiety disorders, part of the difficulty of dealing with coverage of COVID-19 stems from being unable to discern between the genuine threat posed by the illness and the inflated threat perpetuated by hysterical media coverage. Schachter refers to these two types of anxiety as “Anxiety One” and “Anxiety Two.” “With the virus there’s a lot of Anxiety One because it is dangerous in some cases,” particularly for the elderly or immunocompromised, says Schachter. “But we really don’t know the extent of it.” Such uncertainty creates prime conditions for the development of Anxiety Two, allowing people to “jump into the void” and make negative assumptions that are unrelated to the actual probability of contracting or dying from the virus, says Schachter. And this is likely especially true for marginalized people such as low-income people or people of color, who are often more likely than members of the general population to have anxiety disorders and less likely to have access to treatment like cognitive behavioral therapy or medication.

To complicate matters, many people with anxiety disorders adopt compulsive behaviors as a way to alleviate their own obsessive concerns, such as hand-washing or rigorously applying Purell an inordinate number of times a day to avoid contracting illness. Because these are the exact same behaviors recommended by the CDC to avoid contracting COVID-19, that can be confusing and disorienting for people with anxiety to discern between rationally and irrationally motivated behaviors. There’s a distinction between adhering to CDC guidelines as a way to keep yourself safe and doing so in a problematic way, says Carmichael. “If you keep excusing yourself to wash your hands on a date and it starts to interfere with your ability to focus on things, that’s a sign it’s starting to get a little bit overboard,” she says. It’s also a sign you may want to talk to a mental health care professional.

For those who are already finding themselves crippled by anxiety related to coronavirus, however, the question is: How can they alleviate some of that concern, without burying their head in the sand regarding the actual risk? The answer, says Schacter, is not to avoid media coverage of the virus (not that that would really be possible for those of us with access to WiFi, anyway). “Avoiding the media doesn’t help,” he says. “If you get anxious looking at the media, say, ‘Time out, I’m uncomfortable and anxious, let’s look at how realistic my fears are,’ and go through the steps of assessing that.”

That said, it’s probably more helpful to rely on trustworthy outlets (think the actual CDC and WHO websites, not something your uncle posts on Facebook) and steer clear of the types of headlines that are engineered specifically for the purposes of generating clicks, not to help you assess your actual risk level. For me, identifying such content is like identifying pornography: I know it when I see it. “The best coverage I’ve seen is from scientists that actually explain the virus and what it does in our bodies so we can identify it quickly — thus resulting in preventing its spread through proper education and awareness,” says Angelina. “Not stories scaring the shit out of everyone and urging them to clear out their grocery stores.” 

Above all else, now is the time to rely on facts and hard data, both of which are far more reassuring than most media coverage would otherwise suggest. “The fantasy versus the reality of COVID-19 are very different,” says Naggar. For me, it’s been helpful to memorize these statistics the way old white men do 1950s baseball team starting lineups: Thus far, the fatality rate of the virus is two percent, higher than that of the flu but lower than that of, say, SARS (10 percent) or MERS (30 percent). More than 80 percent of coronavirus cases are mild, which has made it easier to spread, but also may potentially render the carrier immune to developing it again in the future. Only 1.2 percent of the overall number of cases in China were among people between the ages of 10 and 19, indicating children are largely protected (a huge relief to parents such as myself); and the elderly and infirm are far more at risk of developing more serious cases, though falling into just one of those categories is not a death sentence in and of itself. (“A healthy 72-year-old is not at as great a risk as an unhealthy 72-year-old,” the health officer for Sacramento County told the Los Angeles Times.)

In short, there is real risk, but for the vast majority of us, the risk is not commensurate with the degree of obsession and panic coverage of the virus has bred, both in people who are panic-prone and those who are not. Is this to say I’ll start licking melons the next time one rolls across a subway car floor? Probably not, but it is a case for looking someone in the eye and handing it back to them like an actual human being — even if you do apply Purell right after.

If you are struggling with mental health conditions, please reach out to a mental health care professional or contact the National Association of Mental Illness (NAMI) Monday through Friday from 10 a.m. to 6 p.m. EST at 800-950-NAMI (6264).

How distrust of the past shapes obsessive-compulsive disorder

Pinpointing an exact cause of OCD can be difficult. As Doidge writes, one particularly afflicted college student put a gun in his mouth and pulled the trigger. Miraculously, he survived, giving himself a lobotomy in the process. Upon recovering, his OCD was cured. He soon returned to college. The damage to his frontal lobes fixed his suffering, so it appears such obsessive checking and worrying is a human trait.

Not that we should ever contemplate such an extreme path. A new study, published in PLOS Computational Biology by researchers at The Hebrew University of Jerusalem, adds to the literature by speculating that OCD sufferers place less trust in their past, creating a negative feedback loop as they age.

There’s a parallel with anxiety disorder. When sufferers experience a panic attack in a certain location, they imprint that environment as a place that causes attacks. When they return, the environment—more accurately, their nervous system responding to the environment—triggers a panic response. Likewise, those with OCD create a mental image of distrust from past habits. When triggered, symptoms of their disorder manifest. They leave the house, walk into the hallway or front yard, and are triggered to check that the lights are off—again, and again, and again.

For this study, lead author Isaac Fradkin and his colleagues studied 58 people with varying degrees of obsessive-compulsive symptoms. The subjects were asked to judge past experiences with recent observations. The more symptoms they expressed, the more likely they were to distrust their past. This caused them to believe that new environments are unpredictable, and therefore should be avoided or distrusted. They were actually more surprised by predictable outcomes than unpredictable ones.

Giving a face to OCD: Young author writes book about disorder

Surrounded by family and friends, 16-year-old Maggie Grace and her mother, Jennifer Watkins, on Wednesday celebrated the launch of their children’s book, “Maggie’s Friend Otis.”

This book allowed a younger Maggie to personify her obsessive-compulsive disorder (OCD), which separated herself from her illness and made the disorder more tolerable.

The hope is that this book can be used as a tool to aid children in coping with OCD and alleviate some of the stigma associated with mental disorders. Maggie and her mother will present at the S.C. Council for Exceptional Children Professional Development Conference later this month in Myrtle Beach. They will share their experiences and talk about how the book can help parents, teachers, counselors and students understand and manage OCD and other anxiety disorders.

Maggie’s anxiety, and later being diagnosed with severe OCD, resulted in her being homeschooled as a rising sixth-grader. One day, Maggie’s assignment was to draw what OCD looks like – and the colorful Otis was created.

“This is how we started referring to Maggie’s OCD,” Watkins said. “Maggie would say, ‘Otis is really bothering me today.’ Or I would say, “I’m not talking to Otis anymore right now.’ Giving it a name made it a whole lot easier to talk about it with her.”

This also helped Maggie realize she had an identity separate from Otis, that her disorder did not define her. In time, when she would have irrational thoughts, Maggie would tell herself, “That’s just Otis. That’s not real.”

“This is a great book for children who feel alone in their struggles with mental health issues,” said Maggie’s therapist, Jeanna Smith. “It is also a good resource to help children identify their own Otis.”

Mackenzie Hall, an elementary school counselor in Lexington County School District 1, said when she met Maggie at a school counseling conference earlier this year, “It was one of the best moments in my life.”

“I will forever cherish this book,” Hall said. “It actually led me to create a school counseling kiosk in our library. Thank you again for writing a book about OCD. It changed my life and inspired me to share my story with others.”

“Maggie’s Friend Otis,” published by Palladian Publications, is available to purchase at A Boutique, 1425 Boiling Springs Road, at Facebook.com/MaggieAndFriend, and at maggieandfriend.com.

For more information, contact maggieandfriend@yahoo.com.

Obsessive-Compulsive Disorder May Be Fueled by a Distrust of the Past

Both Kasper and Vitko may benefit from new research published today in PLOS Computational Biology by Isaac Fradkin, PhD, of The Hebrew University of Jerusalem in Israel, and his colleagues.

Fradkin, who has dedicated his career to studying OCD and treatment outcomes, found via his study that rather than being characterized by inflexible behavior, OCD may manifest in a person as a result of a mistrust of past experiences.

In other words, there could be an underlying reason for the development of OCD.

Fradkin says he was motivated to dive into the study after noticing, time after time, that people with OCD spoke of what he calls the “not just right experience.”

“They can do an action that allegedly reaches a goal, but they just don’t feel quite right about it,” he told Healthline. “The vagueness of this experience and yet the dramatic impact on function made me want to dig deeper.”

His surprise moment?

When the outcome of the study matched his hypothesis exactly.

Fradkin and team used mathematical equations to assess how people with OCD performed on a multiple choice test, and then dug into what made them make the choices they did.

The outcome, he believes, could in time “inform new treatments and therapeutics” for people living with OCD.