OCD & Coronavirus - What to do to cope

Obsessive-compulsive disorder is a relatively common mental disorder.

· People with OCD experience intrusive and distressing recurring thoughts, urges, or images which can seriously affect daily life

· Priory expert says COVID-19 may cause concern for many people, but someone with OCD may become ‘intensely fearful of being affected by the pathogen’

· Expert advises sufferers to follow all official advice and ‘have a plan in place for when their anxiety reaches high levels’

A Priory expert has urged sufferers of OCD to have a plan in place to help cope with symptoms that may be triggered by news coverage of COVID-19.

Dr Andrew Iles, a consultant psychiatrist who specialises in mental illnesses and mental health problems, and treats patients for Obsessive Compulsive Disorder at the Priory Wellbeing Centre in Oxford, explains: “Obsessive-compulsive disorder (OCD) is a common mental disorder with people experiencing intrusive and distressing recurring thoughts, urges, or images which we call obsessions.

“There are many examples of obsessions, but the common ones include fear of contamination, fear of causing harm and fear of things not being in order. Fear of contamination may lead someone to become obsessed with hand hygiene, general cleanliness and avoiding situations which they might perceive to be high-risk, such as travelling on public transport.

“News of an infectious disease may cause concern for many people, but someone with OCD may become intensely fearful of being affected by the pathogen.”

He said people with OCD who have a history of excessive handwashing, cleaning and avoiding contamination may be ‘triggered’ by news of a viral outbreak such as coronavirus.

“The compulsion to wash or clean is likely to intensify, and for those who have successfully recovered from the compulsion to wash or clean, the symptoms may return.”

Dr Iles said it was unavoidable that news reporting, and health warnings, would lead to concern “because there is no way of avoiding the facts.

“However, instructions to wash hands for at least 20 seconds, to wash hands whenever one arrives home or at work and whenever one handles food will worry people affected with compulsive handwashing.

“One of the defining features of OCD is that there is a tendency to doubt the completion of a compulsive behaviour.

“For example, if someone is affected by the fear that they have not locked the front door, they may have to check the door is locked again and again; they may even have to take a photograph of the engaged lock before they might reassure themselves that the door is locked. Similarly, in the current coronavirus outbreak, people with OCD may find it difficult to stop washing after 20 seconds; the added risks around the virus may leave the person feeling compelled to wash for longer, or they may feel compelled to repeat the handwashing cycle a specific number of times. There may also be doubt about the technique and the effectiveness of the washing. This may lead to the idea that the washing must be repeated; it may also lead people to go to excessive lengths such as using cleaning solutions such as bleach, or abrasive materials such as nailbrushes to satisfy the idea that the hands are still contaminated. The breakdown of the skin’s natural oils will make handwashing painful and will affect the skin’s ability to protect itself from infection.”

He suggests a number of ways sufferers can try to help themselves, and alleviate their symptoms.

While selective serotonin reuptake inhibitors (SSRIs) – a type of antidepressant medicine which can help by altering the balance of chemicals in the brain – and Clomipramine are currently recommended as first-line agents for drug treatment of OCD, there are also many apps and breathing exercises, as well as relaxation techniques and mindfulness exercises, which can be useful, he says.

He advises sufferers to take a break from the news and ensure that while they follow all official advice, they don’t go to excessive lengths which might be counter-productive.

OCD sufferers could see their GP who could refer them to a local psychological therapies service if necessary, he said. There was also helpful information available from OCD-UK, the national OCD charity, run by and for people with experience of OCD, and on the website of the Royal College of Psychiatrists.