Living with OCD during COVID-19

Guest-post-for-Ranking-improvementThis month’s guest post is coming to you by Emma. Emma lives by the sea in the south of England, with her hamster, Manuka, and has a (verging on unhealthy) obsession with plants. She also has a diagnosis of OCD and has kindly offered to talk about how she has been coping with OCD during a global pandemic. You can find Emma on instagram or over on Youtube, where she talks about her love of plants, veganism, and wellbeing.  

A note on OCD: OCD is often broken down into different subcategories, and occasionally abbreviated for ease. For example, Relationship OCD (ROCD), Harm OCD (HOCD) are two very common themes. 

Hey there, my name is Emma! I have long been best friends with Laura, almost since primary school(!), I am 26 and have a long history of Obsessive-Compulsive Disorder (OCD), anxiety and depression. To give you a little background, my OCD comes and goes with periods of stress, hormonal changes and alcohol consumption. I am lucky in that I can have prolonged periods of complete relief from OCD, which is not the case for everyone. I also suffer almost exclusively from what is known as Pure-O OCD, where the person will have little to no visible compulsions (the name originates as it was once thought this was a purely obsessive disorder based around intrusive thoughts, when in reality the compulsions take place within the mind of the sufferer).

COVID-19 lockdown has presented many challenges to everyone, regardless of pre-existing mental health issues, but I think there is a particular challenge faced by OCD sufferers. To summarise in brief: the most clinically effective treatment for OCD is Exposure Response-Prevention (ERP) Therapy. With OCD, the more the person engages with their rituals, compulsions and obsessions, the more the brain begins to believe the fear and threat is rational and real. During ERP Therapy, the OCD sufferer is gradually exposed to their fear and must resist the compulsions they face, and sit with the anxiety of resisting those compulsions. While this ‘undoing’ process is traumatic, it’s an incredibly effective method of re-training the brain to understand there is no threat involved and there is no way to avoid the threat through compulsive behaviour. With this in mind, recovery for someone who suffers from a Contamination OCD theme would involve exposing themselves to the perceived contamination and not carrying out compulsions like washing hands, avoiding physical contact, cleaning beyond rational requirement, etc. However, exposing themselves to the object of the contamination fear (COVID-19/other contractable disease) and resisting these compulsions during the COVID-19 pandemic would actually go against the World Health Organisation, government and health authority advice. The fear of the OCD sufferer suddenly becomes a very real, very tangible threat, so it’s easy to see why OCD sufferers are being subjected to a particularly hard time at the moment.

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As for my personal experience – I seem to be going through peaks and troughs of anxiety. When coronavirus first started hitting the news, it coincided with a small change in my antidepressants and I had several days of paranoia about my being contaminated with coronavirus and that I was going to be responsible for the death of all my loved ones. My compulsion was to confess to them all that I may have been exposed, and wash my hands (which, had I indulged it, would have lead to washing my arms, washing my body, washing my clothes and everything in my home). Thankfully after a few days, things settled down and I used many of my old coping strategies from therapy to get myself back on track.

Then, I met up with my mum, who is technically high risk, and had about two weeks of paranoia that she was going to die imminently and it would all be my fault, coupled with anxiety. My compulsions this time were ‘neutralising’ the thoughts with other thoughts, and confession.

Fast forward to lockdown being announced – I actually had much more apprehension about being alone for prolonged periods than anything else, as this is a known trigger for me. On the other hand though, I did feel more prepared for the fears presented by COVID-19 than most. My brain knows how to survive a barrage of negativity and fear narratives – it’s not a new scenario to me. Thankfully, I actually went for the first 7 weeks of lockdown without any major symptoms of OCD, despite some anxiety and low mood, mood swings etc. It took until the announcement of some lockdown measures being relaxed for me to start to feel OCD creeping back in. However, I was able to totally restrict my time spent around other people, my exposure, my safety etc. as I live alone. In OCD world that’s ideal! All our OCD brains really want is to control every perceived risk to the nth degree, with the belief that this will somehow keep ourselves and/or our loved ones safe. As the lockdown measures were relaxed, we had news that we could start to see one person at a social distance of 2 metres. I am blessed and so grateful to have people in my life who love me and want to see me, but following this announcement I had an influx of people wanting to meet up, which amounted to a very big change in a very tiny space of time. This sent my generalised anxiety a bit haywire for a few days. After a week, I met up with one of my closest friends for a socially distanced chat. The chat itself was really lovely, heartwarming and felt good to see one of my beloved humans again. However the next day, I had a panic attack following a run, and my brain became overwhelmed with every little thing that might have contaminated me by meeting with this friend, and how my contamination was going to end up killing my loved ones. It seems sort of funny in a way when reading my intrusive thoughts back, because they look so silly when not experienced as part of your threat-response. My contamination OCD thoughts have subsided somewhat since then, but it’s had the unfortunate effect of triggering an episode of ROCD, which I am currently trying to get a grip on.

So what is it like living with OCD during lockdown? For me, it’s not been an un-liveable hell, as I had slightly worried it might be. However it has certainly triggered a significant decline in my mental health, for which I am slightly reluctant to be going back to my therapist for help with. Reluctant only because we said our final goodbyes just 3  months ago (sod’s law!!). I am pretty lucky, as my fellow OCD sufferers go – I know a lot of people have suffered a very traumatic couple of months. There is reduced availability of therapists (although many are now thankfully doing remote sessions), and avoiding compulsions has become almost impossible where doing so would be against formal government advice.

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From my perspective, the more people understand OCD the better the chance of OCD sufferers having a chance at recovery. The sad reality is most people still mistake OCD for a preference of tidiness and order, when the reality is very different. The one thing I would change? I would love it if people stopped using OCD as a criticism, or a self reflection of a tidiness or pernickety behaviour. There is a huge stigma around OCD and anything we can do to reduce that should be done. OCD should be referenced only when talking about the mental health issue, which is severe and debilitating for most.

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