Chicago – Chicago-area clinical psychologist Karen Cassiday estimates that three-quarters of her patients in recent therapy sessions described heightened anxiety stemming from the coronavirus epidemic. Other clients have been texting her questions ignited by fears related to the new disease.
Should I come to my appointment or just call in, to avoid being out in public and limit possible exposure?
I bought 10 pounds of rice in case of a quarantine, but I heard others are buying 50 pounds of rice. Should I buy more rice?
While health experts say the risk of contracting the new coronavirus locally remains relatively low, the swirl of news over outbreaks — and the ensuing public reaction — has taken a particularly heavy toll on the mental health of some who have obsessive-compulsive disorder and other anxiety illnesses.
“It’s tripping the wire for many different people,” said Cassiday, owner of the Anxiety Treatment Center of Greater Chicago and former president of the Anxiety and Depression Association of America.
She said patients triggered the most by the recent epidemic tend to fall into three categories: Those with illness anxiety disorder, what was formerly known as hypochondriasis; those with contamination OCD, a subtype of the disorder marked by a fear of germs or sickness; and those with generalized anxiety disorder, an overall pervasive and excessive worry over numerous things.
Cassiday says she’s found the level of panic over the coronavirus to be much higher compared with other recent health scares such as the SARS outbreak of 2003, the 2009 surge in H1N1 cases or the 2014 Ebola crisis in West Africa. She says the reaction has been more akin to fear at the height of the HIV epidemic in the 1980s, which she attributes to the unknown nature of both viruses when they first emerged.
Medical providers and infectious disease experts are still grappling with so many questions about coronavirus: What is the source of the epidemic? Will a vaccine be discovered? Will the outbreak worsen or quell, and when?
“The thing that makes the coronavirus difficult for people with anxiety is the level of uncertainty,” she said. “We know that when there’s uncertainty, then people with anxiety disorders try and narrow down the field of uncertainly to assume the worst-case scenario.”
Social media provides a glimpse at how some are coping with anxiety symptoms in the wake of the coronavirus outbreak, which originated in Wuhan, China and has sickened tens of thousands across the globe. While far fewer coronavirus cases have been reported in the U.S. compared with other countries overseas — and seven have been confirmed in Illinois — the Centers for Disease Control and Prevention has warned American communities to prepare for the disease’s likely eventual spread.
“I wash my hands so much that my hands are dry and even start bleeding sometimes,” said one woman on Twitter. “The coronavirus outbreak definitely isn’t helping. OCD is an anxiety disorder, and I think some people fail to realize that mentally, we’re likely to be affected most out of everyone else.”
“My mum has general anxiety disorder and is terrified of the coronavirus,” read another tweet. “She 100% believes this is the end of mankind. (It’s) heartbreaking to see her like this.”
“As someone recovering from OCD after a few years now, I feel as though OCD is trying to spike like there is no tomorrow,” said another woman on Facebook, “and I’ve been struggling to figure out what is OCD and what is just a normal response.”
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.
Stephen Smith, 26, of Northbrook described his struggle with OCD and severe, intrusive thoughts, which developed when he was in college years ago.
“It feels like you’re literally in prison in your own mind,” Smith said.
He then sought treatment and found relief through exposure and response prevention therapy – repeatedly facing the source of the fear without engaging in compulsions, rituals, avoidance or other unhealthy coping mechanisms. The experience inspired him to launch a mobile treatment platform called NOCD, which connects the user to an OCD-trained therapist and offers treatment via live video appointments.
“If you have OCD, you’re not alone,” said Smith, who doesn’t have contamination fears and hasn’t experienced heightened distress due to coronavirus. “There’s millions of people out there who suffer but also get better once they get access to effective treatment.”
Psychologist Patrick McGrath, head of clinical services for NOCD, cautions the public against trivializing OCD in the kinds of jokes or offhand comments that tend to become more frequent during health epidemics.
“OCD is not a joke,” said McGrath, a member of the Scientific and Clinical Advisory Board of the International OCD Foundation. “It’s not something that’s funny. For people who do have OCD, when they hear people say things like ‘I have a little OCD’ it shows that they don’t understand what the person with OCD is really suffering with.”
Cassiday advises those who are distressed by anxiety symptoms to follow CDC and local health department guidelines, but not to check those sources to excess or take more precautions than recommended. Those with anxiety disorders might feel the urge to go further — more protections, more hand-washing, more avoidance, more assurance-seeking — but these behaviors create a cycle of fear and ultimately exacerbate anxiety, she said.
If social media or news sources become overwhelming, taking a brief break is all right; seek therapy if worries over the health epidemic impair daily routines or the ability to go out in public, Cassiday said.
“Don’t just white-knuckle your way through this outbreak,” she said.
Another coping strategy, she added, is to focus on the positive: Locally, medical providers say the risk of contracting coronavirus is low, the nation has a robust health system, and the United States had more advance notice of the virus than many other countries.
“If someone can view this as practice managing the inevitable uncertainty of life, this can be a really productive situation,” she said. “The only way to live with peace inside your heart is to accept this uncertainty and to live well in the present moment.”