Rosalyn (not her real name) has no idea what she’s going to do with the three boxes of spaghetti she just dumped in her cart. She doesn’t want them—she definitely doesn’t need them—but never mind, she has to buy them. And boxes of spaghetti weren’t the only unwanted things she picked up in the grocery store that day during the first year of the COVID-19 pandemic. If she grazes an item while looking for another, it will disappear.
“Everything I touch with my hands I have to buy,” she said. “I don’t feel like I have a choice. It’s very likely that I have somehow contaminated the item, and then it will hurt another unsuspecting customer who purchased it. ” So she left the store with a pile of bulging shopping bags — and a lot of guilt. “Once I bought too much, I worried there wouldn’t be enough food left for everyone else.”
Rosalyn is one in 2.3% of American adults diagnosed with obsessive-compulsive disorder, or OCD, according to National Institute of Mental Health. OCD is primarily caused by overactivity in the amygdala, a walnut-sized structure at the base of the brain that processes fear, danger, and the fight-or-flight response. The disorder may manifest as compulsive, repetitive behaviors; worry about getting sick or spreading germs; or an excessive sense of responsibility and fear of putting others at risk, as was the case with Rosalyn. Even those without an official diagnosis are affected; about 25% of Americans will exhibit at least some obsessive-compulsive behavior at some point in their lives, according to a 2008 research published in a magazine nature.
The pandemic has made the lives of people with OCD symptoms so much worse. New research shows that OCD symptoms have become more severe for many people during the pandemic, and new diagnoses have increased. More and more people are visiting doctors’ offices with new cases. Andrew Guzick, clinical psychologist at Baylor College of Medicine, said: “Studies have consistently shown that people without OCD score higher on our OCD assessments than they do on our OCD assessments. before the pandemic. “They are exhibiting more OCD-like behaviors and reporting more of the intrusive fears characteristic of OCD.”
No wonder: The global pandemic is the perfect breeding ground for anxiety. OCD is a suspected disorder. To be which doorknobs are contaminated? Did I leave the stove on? Did I listen to the doctor correctly when she told me that the freckles on my arms are real just blackhead? Let’s reflect this pre-existing uncertainty through the lens of a pandemic that has infected more than 327 million people worldwide, killed 5.5 million and can strike anyone, and people who are already clinically anxious will worry even more.
“OCD thrives when it is not tolerant of uncertainty and recognizes the need to prevent harm, especially when it is related to pollution, so it is not surprising that those who are struggling,” says Guzick. Dealing with this disorder is a difficult time. His meta-analysis, published in October 2021 in Current Psychology Reportfound that 32% of people with OCD experienced worse symptoms during the pandemic.
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OCD is a contextual condition that worsens during times of personal or environmental stress and eases when circumstances become calmer. Since COVID-19 first emerged, a series of studies beyond Guzick have been conducted looking at exacerbation of symptoms in people with the condition, and the findings have been troubling. A study in September 2020 inside International Journal of Environmental Research and Public HealthFor example, surveyed more than 6,000 people with OCD and found that 60% reported worsening of existing OCD symptoms or onset of new symptoms from the early days of the pandemic in late 2019. to the end of March 2020. A November 2021 meta-analysis of 21 studies published year Neuroscience & Behavioral Reviews found that up to 65% of respondents said their OCD condition worsened during the pandemic. However, another study in 2020, published year Department of Psychiatry BMC in October, focused on young people aged 7-21 and found that nearly 45% experienced a worsening of overall OCD symptoms during the first pandemic year.
For those with pollution-related OCD, the pandemic is something to behold – a ‘tell you’ to all those who have yelled at them that they need to wash their hands and social distance first. pandemic is excessive. and unhealthy. “Welcome to mine world!” meme appeared on the internet from people with OCD as the general population begins to adopt exactly the same preventive habits that they have long practiced. But that satisfaction is short-lived — and comes with a long-term cost.
Michael Wheaton, assistant professor of psychology at Barnard College and lead author of a study in June 2021 in Journal of Anxiety Disorders found that 72% of people with OCD have had worse symptoms since the outbreak of the pandemic.
The problem is, people without OCD respond to pandemic-era guidelines very differently than people with the disorder. Washing hands once for 20 seconds after entering a home may have become a common practice for most people of COVID-19 age; Washing hands repeatedly for 20 minutes each time is a response of people with OCD. That’s the kind of overreaction that clinicians worry about is becoming all too common.
“For people with contamination issues, we will talk to them about washing hands when entering the house, but no other hand washing while you are inside your home. We told them we would be run by the CDC [the U.S. Centers for Disease Control and Prevention], not OCD,” said clinical psychologist Anthony Pinto, program director of the Northwell Health OCD Center on the Long Island Jewish Medical Center campus. Pinto also suggests that people with OCD “learn to touch [potentially contaminated] household items after washing. Exposing patients to perceived hazards such as picking up mail or unwashed groceries and then resisting the need for decontamination – a treatment known as exposure and response prevention (ERP) ) – was a mainstay of all OCD treatments long before the pandemic.
The problem with ERP in the age of a pandemic is that, at least at first, it’s unclear whether the exposed part of the process is actually dangerous. In the early days of COVID-19, we opened doors with our elbows, pushed carts with sleeves pulled down in our hands, touched elbows to say hello, and stood at least six feet apart. Even now – especially with the rise of Omicron – no psychologist treating an OCD patient would recommend walking into a crowd of people with unknown viral status, just to reinforce psychological effort of the patient against the anxiety caused by OCD.
Furthermore, ERP has traditionally been meant to be practiced in the supportive presence of the clinician – a setting that is not necessarily comfortable or even available to many people during a pandemic. But ERP practitioners have adapted; remote session via Zoom and other platforms has exploded in the last two years, and many exercises can be performed virtual and assisted on screen like in person. For example, if a patient is afraid to sit in their bed after going out, “we can work with that patient online to go out, then come back and sit in their bed, then lie down.” in bed with their streetwear,” Pinto said. “This is really about experiential learning — letting the patient work through that uncomfortable experience.”
Things get more complicated for people with OCD – the fear is not of putting themselves in danger but of harming others – like Charles. Before home tests were available, every sniffle that Charles (not his real name) heard from his three-year-old son was an alarm signal to send him to the doctor for a test. Another COVID-19 test involved a nasty deep-nose probe. Charles disputes the tests, but his wife is against. When the boy was not tested, Charles was heartbroken.
“I can predict the apocalypse scenario where we wipe out its entire kindergarten because we are cavalier about mild cold symptoms,” he said.
Stress exacerbates OCD in any way, and the more anxious people are, the more people seek a false form of comfort in their rituals. “We found that in students with OCD, when it came to final exams, they were stressed and sometimes their OCD symptoms got worse,” says Wheaton. “They’ve developed this habitual response that when I’m anxious and stressed I turn to compulsivity, because it’s a learned behavior to give me a sense of control.”
The pandemic will eventually end, but for many people with OCD, the anxiety and precautions may not. “The driving force in OCD is the amygdala’s distress signal; Steven Phillipson, founder and director of the Center for Cognitive-Behavioral Psychotherapy in New York City. Confirming contamination for two years can take a long time to undo. Pinto worries that even if the rest of the world eventually drops their masks and forgets about social distancing, people with OCD will continue to cling to the old habits of the pandemic. “Those individuals will have a hard time adapting or trying to return to some normal activities because they want to be 100% safe,” he said. “The only way to get that assurance is to stay closed.”
However, for some people, flame testing is really instructive, forcing them to deal with OCD in ways they’ve never done before. “The COVID era has exacerbated my OCD symptoms, but it is also an opportunity,” says Charles. “I have a long history with cognitive behavioral therapy, and there is certainly no shortage of opportunities to hone those skills. The added stress also led me to see a psychologist and prescription, which also helped a lot.”
“But in the end,” he added with a sad laugh, “will I do it all over again? Oh my god no.”