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.

photo

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.”

How to deal with mysophobia – a fear of germs – amid coronavirus


Illustration of an elderly person with a face mask and bottles of hand sanitiser in the background
A psychologist says she’s seen a rise in people’s OCD focusing on a fear of germs (Picture: Ella Byworth for Metro.co.uk)

Amid coronavirus, when we’re told to ‘stay alert’ and stay home to avoid a looming, invisible threat, it makes sense that a simmering fear of germs, dirt, and contamination may boil over.

That fear, mysophobia, is often experienced by those with obsessive compulsive disorder (OCD) – although it’s important to note that OCD comes in many forms and is not always about germs and cleanliness – but one expert says that she’s seen many people newly experiencing the terror as a result of the pandemic.

Dr Martina Paglia, a psychologist at The International Psychology Clinic, tells Metro.co.uk: ‘Mysophobia, a fear of germs in general, usually begins in late childhood or early adolescence.

‘Since the pandemic, some of my clients with OCD have developed specific fear for catching Covid-19 germs.

‘I have clients who have had OCD for 10+ years, and since the pandemic the fear has shifted from generic germs to catching Covid-19.’

Martina gives an example of Rita, someone struggling with mysophobia as part of OCD.

‘Rita came into contact with dirt while cleaning her house,’ Martina explains. ;She start to think: “What if I fall ill or get an infection? What if I make someone else ill?”. As a result, she gets worried about getting sick or making others sick.

‘She starts to display compulsive behaviours, which act to neutralise intrusive thoughts, such as washing her hands several times and other routines such as checking that environments are completely clean in the future.’

It’s those compulsions that show when a phobia has trickled into obsessive compulsive disorder.

The difficulty in recognising and treating this during coronavirus lies in the idea that our compulsions might actually be the ‘correct’ thing to do – excessive hand-washing, refusing to leave the house, and avoiding contact with others are all praised behaviours amid a pandemic.

Add in the soothing effect of these compulsions, and it’s all too easy for these to become the go-to for coping with overwhelming and distressing obsessive thoughts.

‘Obsessive Compulsive Disorder (also known as OCD) is a mental health condition characterised by obsessive and/or compulsive symptoms that cause intense anxiety and fear,’ says Martina. ‘Obsessions can be defined as recurrent, repetitive and persistent thoughts, impulses or images, experienced as intrusive and unwanted.


Corona/isolation/working from home illos
It’s normal to feel fear and anxiety amid a pandemic – but when this becomes overwhelming, it’s vital to seek support (Picture: Ella Byworth for Metro.co.uk)

‘Often those affected by obsessions try to ignore or suppress such thoughts or attempt to neutralise them with other thoughts or actions, without however succeeding. Obsessive thoughts are unpleasant. They can cause fear, anxiety, tension or even disgust.

‘Compulsions can be defined as repetitive behaviours or actions that the individual feels obliged to implement in response to obsession(s) or according to rules that must be applied rigidly. Compulsions can be seen as actions that are aimed at preventing or reducing anxiety.

‘However, these behaviours or actions are not realistically connected with what they are designed to neutralise or prevent, or are clearly excessive.

‘[In the case of Rita], dirt was the precipitating factor that led Rita to experience feelings of anxiety.

‘To reduce this anxiety Rita began to wash her hands repeatedly until she felt calmer. This compulsive/safety behaviour is a perpetuating factor, as Rita will continue to do this in the future, as she has learned that this is an effective way of reducing her anxiety.

‘However, this is blocking her from learning that no-one will become sick as a result of dirt in the environment, or that if they did become ill that this would be minimal.’

A fear or worry about germs is normal and to be expected, especially with all the messaging around coronavirus and the reality of the virus’ devastating effects.

But when that fear becomes overwhelming and is affecting your everyday life, that’s a sign there’s a problem.

So, how can you deal with it?

‘CBT (cognitive behavioural therapy) is the best therapy for OCD,’ says Martina. ‘Exposure therapy is undergone where the client is forced to fight the obsessive thoughts and not to act upon them. It requires some time but it is a process of learning. CBT teaches the client to face the fears because it forces them to face the same situation every time but with better handling. Brainspotting and EMDR therapy can also help treating OCD.

‘It would be helpful for Rita to be exposed to dirt so that she learns that these situations are manageable and that nothing awful happens as a result.

‘Rita would also need to engage in response prevention, which means that she would not engage in her compulsive behaviour. Engagement in compulsive behaviours during exposure work is counterproductive, as this would lead Rita to believe that her rituals are keeping her safe. By preventing herself from engaging in compulsive behaviours Rita learns other ways to manage her anxiety and realizes that it is not the compulsive behaviour that is protecting her.’

It’s crucial that anyone struggling reaches out for help rather than trying to battle through OCD or an overwhelming phobia alone.

It’s still possible to access therapy in lockdown, often in the form of online or over-the-phone appointments, and medication can also help to treat OCD.

Get in touch with your GP or approach a private therapist if you’re finding a fear of germs is becoming overwhelming.

Try to fact-check those intrusive thoughts that tell you disease is all around by remembering that germs are not all bad and the worst-case scenario is rarely the most likely one.

We spoke to microbiologist Nicky Milner earlier in the pandemic, and she had this hope for life during the pandemic and long after it: ‘I would like to see greater public awareness of the invisible world of microorganisms and recognition that not all microorganisms cause infection – in fact, we cannot survive without the good microorganisms, such as those which help us digest our food, for example.’

Do you have a story to share?

Get in touch by emailing MetroLifestyleTeam@Metro.co.uk.

MORE: How to deal with coronavirus panic when you’re experiencing health anxiety

MORE: How the coronavirus pandemic – and being told to stay home and stay alert – could trigger a crisis of agoraphobia

MORE: Lockdown is worsening people’s dermatillomania and making their skin picking compulsion feel inescapable

COVID-19 Worsens Obsessive-Compulsive Disorder–but Therapy Offers Coping Skills

Before the COVID-19 pandemic took hold in the United States, Chris Trondsen felt his life was finally in control. As someone who has battled obsessive-compulsive disorder (OCD) 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.

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 due to fear of professional repercussion, 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.

KHN (Kaiser Health News) is a nonprofit news service covering health issues. KHN is an editorially independent program of KFF (Kaiser Family Foundation) and, along with Policy Analysis and Polling, is one of the three major operating programs of KFF. KFF is not affiliated with Kaiser Permanente.

Read more about the coronavirus outbreak from Scientific American here. And read coverage from our international network of magazines here.

Scientists propose explanation for baffling form of childhood OCD

Pediatric autoimmune neuropsychiatric disorders, or PANDAS, were first proposed in the 1990s. Thought to be triggered by streptococcal infections, they account for an unknown portion of youth OCD cases. But the biology underpinning this disorder has baffled scientists.

The new Yale research, published June 16 in the American Journal of Psychiatry, identifies antibodies that bind to particular brain cells called interneurons as an explanation.

“It is really OCD plus,” said senior author Christopher Pittenger, assistant chair for translational research, associate professor of psychiatry and a researcher in the Yale Child Study Center. “These children have OCD, but they can also have severe separation anxiety, subtle motor symptoms, and show frequent need to urinate. Many refuse to eat.”

While 1% to 3% of children will be diagnosed with OCD by the age of 17, the fraction of OCD cases that can be attributed to PANDAS is unknown. Some doctors say there is not enough evidence to support PANDAS as a distinct diagnosis from OCD. Others, including many parents of children with the syndrome, argue it may account for a large subset of children with OCD.

Pittenger and his team decided to explore the biology of the disorder in a series of experiments involving 27 children who met the strictest criteria for a PANDAS diagnosis and 23 control subjects.

They found that many children with a PANDAS diagnosis possess high levels of an antibody that can attack specific interneurons — neurons that modify the signaling of other nearby cells. These antibodies are concentrated in the striatum, an area of the brain that is associated with voluntary motor control, among other functions, and is known to be involved in OCD. When the antibody binds to these neurons, it reduces their activity.

PANDAS is “real, but probably rare,” Pittenger said.

Adults with Tourette syndrome, a related syndrome characterized by vocal and motor tics, lack the same specific striatal interneurons, suggesting that problems with these cells may play a role in several conditions, Pittenger noted.

His lab aims to explore this biology in other children with OCD and Tourette syndrome to see how widespread interneuron-binding antibodies are in this group of related conditions.

Yale’s Jian Xu is the paper’s first author. The work was principally funded by the National Institute of Mental Health.

Coronavirus has exacerbated my six-year-old’s anxiety

Question: My six-year-old son has developed a phobia of getting sick which early this year started to inhibit his ability to go to friends’ houses and school normally. My wife and I tried various techniques such as giving reassurance, acknowledging his fears and offering empathy.

We tried buying him a “worry monster”, which is a teddy with a zip for a mouth. Basically the child puts the worry into the monster’s mouth, zips it closed and the monster takes the worry away. This teddy has given him some help and comfort, but his anxiety and fears have continued.

Staying Safe From The Coronavirus Without Giving In To OCD Obsessions : Shots – Health News

Cleaning skills that only the most generous would have called eccentric in pre-pandemic times are actually useful as I try to keep myself and my immunocompromised housemate — my girlfriend — safe from catching the coronavirus. But being hypervigilant is exhausting.

Cleaning skills that only the most generous would have called eccentric in pre-pandemic times are actually useful as I try to keep myself and my immunocompromised housemate — my girlfriend — safe from catching the coronavirus. But being hypervigilant is exhausting.

When I was 8 years old, just about all I could think of was how I was going to die that day.

No, I didn’t grow up in the middle of a war zone, though many others on the other side of the world were living through that kind of nightmare in 1996.

I was born and raised in a safe, small town in Idaho where murder was a rarity. It wouldn’t be a gun, a child predator, or a car accident that killed me, I figured.

Instead, because I had a significant form of anxiety that neither I nor my parents recognized at the time — obsessive compulsive disorder — I was convinced that some kind of microscopic creature would be absorbed through my hands and infect every living cell in my body. Maybe it would be bacteria, I thought, or parasites. Or a virus.

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That pencil I borrowed from my second-grade classmate? It had to be totally infested. The handle on the drinking fountain? Crawling with germs.

When I took out the trash or cleaned our cat’s litter box, my mind raced to strategize which hand I would use to turn on every light switch, open and close each door and carefully lift the lid on the garbage can to minimize my exposure to any kind of contamination.

I got good at using my feet, elbows and any other part of my body that lacked opposable thumbs to avoid touching what I deemed to be the life-threatening surfaces of everyday objects.

Now, 23 years later, those skills that only the most generous would have called “eccentric” in pre-pandemic times are actually useful as I try to keep myself and my immunocompromised housemate — my girlfriend — safe.

But those skills come at a cost as I try to balance the need to frequently sanitize our home with the need to keep anxiety-driven compulsion at bay.

One in 40 adults and 1 in 100 children in the United States cope with OCD on a daily basis, according to the National Institutes of Mental Health

There are different flavors of OCD with different degrees and different types of obsessions and compulsions, including what people may have seen on the AE TV show Hoarders. Those who militantly organize their surroundings also might have a touch of it.

One of my symptoms has always been an extreme and focused aversion to contamination, a characteristic I share with an estimated 40% of those who develop OCD, according to Dr. Elias Aboujaoude, a psychiatrist and director of Stanford University’s OCD clinic.

As a child, touching anything I thought was covered with germs canceled out the use of that hand until I had a chance to scour it with soap and water. Until then I would hold my hand as far as possible from my torso.

If I didn’t perfectly perform these draconian mental gymnastics, I knew — without a doubt — I was going to die. Maybe not immediately, but probably within a day or two, I thought.

Logic, which seems like it would be the panacea for irrational fears, is actually cruelly twisted back at you with OCD. No matter how much you reassure yourself that the hellscape you dreamed up in your head isn’t real, the condition amplifies your fears until you perform whatever fantastic ritual you’ve created for yourself to alleviate the anxiety.

By the time I turned 9 — with cognitive behavioral therapy, persistent practice, as well as a lot of patience and support from my parents — I learned to accept the invasive, persistent thoughts for what they were. Just thoughts. Medication also helps cut my base-level anxiety, and it limits the scope of an occasional panic attack.

Today, my OCD is classified as mild to moderate, which means I’m not crippled by anxiety, at least most of the time.

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I haven’t had a major contamination relapse since 2008 when I was in college. I was convinced for months back then that I needed to always keep whatever food I ate or drank within sight, because I thought it would magically be dosed with LSD. Let’s be real, no one would be that generous with their stash.

(That episode ended after I finally got the help of a new therapist after not having seen one for more than a decade).

It’s not uncommon for people with well-controlled OCD to experience a small lapse in compulsive behaviors when under great pressure or stress, psychiatrists find, though for many people, full-blown relapses are, as in my case, rare after successful treatment.

Still, the pandemic has been challenging for a lot of us.

Cases of COVID-19 began to spring up in Idaho, where I live, in mid-March. Since then, thousands more cases have appeared.

As we learned the details of how some patients died — alone, gasping for air, choking on fluid that fills their lungs like a lock system in a dam — I could feel my anxiety rise.

I’ve been lucky enough to be able to work from home. But I’m suddenly finding my cleaning regimen taking up a not-so-insignificant part of my day.

In the home I share with my girlfriend, I take every precaution I can to maintain a contamination-free zone in the house, just as CDC guidelines recommend, though sometimes I go a little overboard.

High-touch objects such as door knobs, light switches, remotes, faucets and countertops are all disinfected multiple times per day. When a package gets delivered, I handle it like a live grenade. It, too, must be zapped of any trace of this disease that could sneak into our house.

I know where every object in this house has been, whether I’ve touched it with a finger that has grazed a doorknob that was nicked by the grocery bags that were left on our doorstep, and whether I’ve recently doused that surface with rubbing alcohol to kill any possible trace of the coronavirus that might have crept in while I wasn’t paying attention.

If the gallon and a half of hand soap doesn’t run out first, the hand lotion will.

I worry that, to my girlfriend, I look like a frazzled conspiracy theorist — as though I’m tracking links and clues on a corkboard filled with pins and ribbons, meticulously tracing every step.

That’s not how she sees me, she says. But for her own mental health, she has been leaving the cleaning up to me.

It’s stressful for her, too. She knows I don’t trust her to decontaminate any delivery or package we receive (and I feel guilty admitting that’s true).

While her mind is consumed with concern over the rising global death toll and whether there’s any end in sight, my mind is also managing dozens of little internal clocks ticking down the hours, minutes and seconds until every microbe will die on the mail pile or on the cloth seat in my car.

There’s a thin line between being hypervigilant and succumbing to my deeper obsessions and compulsions — so far I’ve managed to stay on the right side of that line.

My therapist, who will tell me if I’ve crossed it, is still accessible by video call, thankfully. I’ve taken up exercising on our back porch to burn off some of my anxious energy, and that helps.

I’ve planted my garden full of lettuce, spinach, arugula, fancy purple carrots and radishes. Smelling the rich soil and seeing the vibrant colors of my vegetables transports me away from the day’s news and body count.

Heading back inside, I’ll think about how delicious all these things I’ve grown will be to eat in a month or two. But sometimes another thought breaks through, with a slight sense of dread: “Did I wash my hands?”

James Dawson is writer and reporter for Boise Public Radio.