Managing OCD and related disorders during the COVID-19 Pandemic

For those living with OCD (obsessive-compulsive disorder) and related disorders, times of high stress and anxiety can lead to changing or worsening symptoms. To help manage these growing concerns during the COVID-19 pandemic, we recommend the following:

Set a Safety Plan

With the help of your therapist or support group, including friends and family, create a basic safety plan for maintaining personal hygiene and decreased social contact. Once this is done, try not to add more to it. Recommendations from trusted health organizations including the CDC and WHO include the following:

• Wash your hands for 20 seconds with soap and water after being in a public place, before eating, or after blowing your nose, coughing or sneezing. Use hand sanitizer with 60% alcohol when soap and water are not available. Avoid excessive hand washing which may injure your skin and strip the barrier that protects against infection.
• Disinfect frequently touched surfaces daily including doorknobs, light switches, phones and countertops. Do this once or twice a day and always think about whether you truly need to clean this surface.
• Cover coughs and sneezes with a tissue or use the inside of your elbow.
• Avoid close contact with others (keep about 6 feet) and stay home as much as possible

If you struggle with contamination fears, this safety plan may help relieve some anxiety over how extensive your routine for protecting against COVID-19 truly needs to be.  If you would like to do more than this or you find yourself repeatedly adding more to this list, pick a person who can help you decide what are rational safety measures for you to follow.

If you struggle with perfectionism or fears of harming others, remember that no one expects you to be able to protect yourself or others “perfectly” and that there is no way you can. Lean on your support system to help navigate the uncertainty and sometimes lack of specific guidelines that could create room for your OCD behaviors and worries to take over.

Allow Room for Change

The protective measures we are taking against COVID-19 are our new normal but they are only temporary, and at some point, we will return to our normal lives.  Until then, we have to be open to change.  For those undergoing or seeking in-person services, including exposure and response prevention (ERP) therapy, talk to your health provider about how your treatment plan might change.

Telehealth

Given the need for social isolation to limit the transmission of COVID-19, talk to your health provider about temporarily transitioning your therapy to a video teleconferencing service.  Research has found that ERP therapy can be effectively provided via video teleconferencing for children and adults with OCD.  Not all therapists can provide these services, however, and not all health insurances will cover it.  Check in with your therapist and health insurance to discuss your options.  You may have to temporarily see a different therapist if your current one does not offer teletherapy. Many state Medicaid and Medicare plans cover teletherapy while private insurance coverage varies from state to state, and by insurance plan.

Therapy Goals

The protective measures we are asking everyone to follow might not fall in line with your current goals for treatment, especially if you suffer from contamination fears.  Look to your therapist for guidance in creating a new baseline. It may feel like a setback, but remember this change is temporary, and with support you will be able to get back on track. If you are not currently seeking treatment, consider reaching out to a provider than can help prepare you in case worsening or changing of OCD symptoms occur.

Practice Self Care

Remember to be kind to yourself and to those around you. This isn’t easy. Make time for mental rest, relaxation and physical activity to help keep your mind and body busy.

Limit your Social Media Intake

• Spend 5-10 minutes a day gathering new information on COVID-19.  That should be enough information to stay up to date on protective measures and social isolation guidelines.
• Setting a time limit will help prevent your OCD from taking over and getting hooked on learning all there is to know about COVID-19.  Decreasing exposure to stressful content will also help reduce fears that could worsen OCD behaviors

Stay Physically Active

• Try a new fitness workout
• Master new yoga moves
• Dance to your favorite music
• Schedule walks at home or outside

Find ways to reduce stress and anxiety

• Relaxation (e.g., meditation, mindfulness, hobbies, board/card games)
• Reading, writing, or painting
• Watching movies or TV with family and friends

Stay Connected

• Reach out to loved ones via FaceTime, Skype, Google Hangouts, phone
• Join an online support group to see how others are managing their OCD symptoms
• Reach out to spiritual groups and co-workers