Yesterday, my city declared a local disaster emergency. A growing number of presumptive cases of COVID-19 in my county have led officials to close all city facilities. This has given me pause when it comes to the complexities of COVID-19 and anxiety.
I was diagnosed with obsessive-compulsive disorder when I was about 11, and I dealt with many different obsessions over the years. Perhaps the longest-lasting obsession I had revolved around contamination and germs. For the last several years, I’ve been blessedly free of OCD, and when an old obsession pokes its head out, I’m fairly quick to oppose it by doing an exposure. Since the start of the media coverage of COVID-19 in Wuhan, I actively tried not to let it worry me too much. I could feel the pull of anxiety, coaxing me into watching the news coverage and letting it take over my life. Of course, I stayed informed but did my best to not obsess.
Now, my own city is seeing dramatic effects of the virus, both in increasing cases and in the social results of widespread, repetitive media coverage. Many of our city facilities were closed several days ago, and our city council has decided today to close them all. This afternoon, I finally made the trip to my pharmacy, located in a grocery store, to pick up my medications. The sight of so many empty shelves was unnerving. The only fresh vegetable remaining was lettuce. The bread aisle was sparsely populated with hamburger buns and a few loaves of whole wheat. A man asked the pharmacist where the thermometers were and was told there were none left.
I bought my items and went home, then washed my hands several times between unloading groceries, putting them away, and cleaning the counter they sat on. I’ve been cleaning my phone case, our door handles, and even my sunglasses after touching them while out. Am I simply being cautious, or have I crossed the line into compulsions?
For people with anxiety disorders, dealing with COVID-19 and anxiety during the pandemic puts them in a confusing position. People are being encouraged to be extra careful about handwashing and touching potentially dirty items. Events have been canceled and gatherings are recommended to be limited, making it easy to justify complete isolation due to anxiety. So when the behaviors that normally indicate a disorder are socially sanctioned, what do you do?
I can tell that going to the pharmacy triggered something, and where before I was simply careful, I’m now afraid of things in my own house because they came from outside, and I haven’t cleaned them. This alarms me because it’s exactly how I used to feel in the grips of contamination OCD. It’s overwhelming to suddenly feel like nothing around you is safe to touch.
This coronavirus could live on surfaces for two to three days, so maybe constant cleaning and disinfecting are completely warranted. I imagine many people are feeling this despite never experiencing feelings like it before. Nobody really knows how much is too much, and this is exactly why OCD is so tricky. In non-pandemic times, contamination-focused OCD is fed by a seed of doubt (indeed, every kind of OCD is fed by doubt). It can feel shameful because you know that your compulsions are irrational. Now, it’s unclear what rises to the level of irrationality. Maybe the compulsions I usually try to avoid are precisely what I should be doing.
There is no blueprint for handling COVID-19 and anxiety. I think it’s reasonable to increase your awareness of surfaces you might normally touch and to wash your hands more frequently. However, I know that for me, allowing myself to engage in my old compulsions is a slippery slope. It might be acceptable to do right now, but it will be harder to stop the longer I let it go on. It’s a balancing act, and I have to decide how much my anxiety is serving a purpose now versus how detrimental it is and could be in the future.
I’m certainly not going to tell anyone how to keep themselves safe. I am, however, going to tell myself to be cautious about being too cautious. As long as I can leave the compulsions behind again when life approaches normal, I’ll be okay.
3 thoughts on “COVID-19 and Anxiety: Caution vs Compulsion”
Excellent post, thank you 🙂
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It’s definitely not black and white, but a therapist friend of mine gave some good advice: “Do what you’re told, and watch it unfold.” For me, that means following WHO and CDC guidelines, but not doing anything beyond that unless the guidelines change.
Definitely good to defer to the experts.