Working through contamination OCD/health anxiety during COVID-19 pandemic

Not everyone with contamination OCD/health anxiety may be triggered by this pandemic. OCD has many different flavors. For some people, it's possible and normal for their brains to continue being obsessed with the same theme of contamination it was before the COVID-19 virus. However, this pandemic is likely testing most forms of contamination OCD/health anxiety.

Long before the start of this virus, your brain was sending you signals that you were unsafe. You identified that perhaps there was some truth to your fears, but the extent to which they were manipulating your life was no longer acceptable. Perhaps at that time, you entered therapy and followed Exposure and Response Prevention protocols. You challenged yourself to accept uncertainty, go into shared spaces, touch doorknobs, your face, and your 'sacred' belongings when contaminated. You may have limited the amount of reassurance-seeking you've done to ensure that you're "okay." You moved throughout your days aware of your initial attempt to avoid contamination, powering through to move towards a sense of 'normalcy." And now everything has changed. It's as if the rest of the world finally caught up to the intensity of fear you first experienced when your brain signaled that you may get sick or get others sick.

Perhaps you are wondering how you could possibly move forward with OCD contamination treatment if most of your compulsions are now recommendations? What do you tell yourself when your intrusive thoughts reinforce the idea of "I told you so! You're never safe!" How can you possibly navigate contamination OCD/health anxiety during this uncertain time?

Working through your contamination anxiety during a pandemic

Ultimately, the goal of OCD treatment does not change. The foundation is accepting uncertainty. You need to start inviting the risks and choose to live through the discomfort. You can still work on these skills while complying with the standards that will limit your exposure to the virus during this time.

First, I strongly encourage you to continue with therapy or contact a therapist knowledgeable about OCD to begin treatment. OCD brings uncertainty, but you do not have to be a slave to it.

Here are some of my suggestions to help you get through this time:

Become very clear on what are compulsions and what are life-affirming behaviors.

For example, choose to follow CDC's guideline for hand-washing. 20 seconds means 20 seconds. Challenge yourself to notice if you continue to wash until your hands 'feel' clean. Make sure to pay attention to the water temperature, how far up your arms you're washing, and how much soap you're using. Know your routine and challenge it to fit the standards that empirically support what is considered "safe."

Limit reassurance-seeking from others.

Seeking reassurance during such a turbulent time is healthy and an appropriate strategy for easing your mind. However, there is a clear line between connecting with others for support and engaging in a compulsion. Ask yourself how often you text, email, or call someone to feel reassured? Do you only reach out to people when you are feeling panicked and want to ease your anxiety? Instead of calling, consider keeping a reassurance log for whenever you have the compulsion to seek reassurance. You can also take this time to work on decreasing the number of times you call others for reassurance by setting a limit in advance and hold yourself accountable.

Limit seeking reassurance from yourself!

For example, if you're struggling with allergies at this time and your automatic thoughts suggest that you have COVID-19, telling yourself "I have allergies" repeatedly is a reassurance statement that falls in line with compulsive behavior. Another common one to watch out for is repeating, "I'm okay." Explore replacing those statements with more indefinite statements such as, "I'm not sure if I'm sick, and I'm going to continue living my life with that being a risk. I accept the possibility that I may become infected."

Limit checking updates online to learn about the virus.

Set a limit of when and how often you will check the news. For example, you can start by choosing one website to stick to and setting a time limit of five minutes to review the site. Then, work within those boundaries to help you be more in control of checking behaviors.

Practice mindful breathing exercises.

Regularly practice a four-count breath to help ease your nervous system. It's likely that your nervous system is dysregulated and would benefit from exercises that create a sense of ease. Use your breath as an anchor that can help you stay grounded during times of panic.

Stand outside for at least ten minutes a day.

Your body needs Vitamin D to help regulate your mood. If it's raining- use an umbrella or stand under an awning to still receive the benefits of fresh air while staying dry.

Know that you are not alone in this fight.

Uncertainty is very unpleasant, but it's possible to manage the anxiety that comes with it. Stick to your therapy routine. Stay consistent with appropriate exposures (Ask your therapist about imaginal exposures if applicable). Practice self-compassion and remember that this too shall pass!

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