Dubai: With this year’s World Mental Health Day (October 10) coming amid the pandemic, the debilitating mental impact that COVID-19 has had on some people has become a subject of much discussion. Among the many issues they handle, mental health specialists said they are seeing a higher number of cases of Obsessive Compulsive Disorder (OCD) these days.
Ghania Kabbara, clinical psychologist who treats patients for OCD at the Priory Wellbeing Centre, Dubai, said: “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 or out of their control, which is manifested with constant washing of hands and cleaning.”
As people have stringently adapted to the hygiene protocols of frequent hand washing, sanitisation and social distancing, there is a collective fear about many things. Chief among them are the fear of catching infection from food packets, fear of inert surfaces as well as fear of handshakes or accidental touch. People are constantly looking over their shoulder battling an invisible enemy that has brought dormant OCD symptoms to the surface.
Dr Padma Raju Varrey, head of the department of psychiatry at NMC Specialty Hospital, Abu Dhabi, said he is not only seeing a resurfacing of OCD symptoms in existing patients triggered by the pandemic, he is also getting ‘DeNovo’ or first time patients. “The fear of germs and the fear of being contaminated by them is at its peak,” he said.
Dr Varrey said while doctors have explained how the disease spreads, there is still this largely unexplained fear of community transmission. “Those with OCD now believe that the current pandemic even validates their behaviour. It’s likely to exacerbate symptoms in those already living with OCD and could be triggering an emergence of symptoms in others too.”
How OCD takes over
While many people with no OCD follow the protocol of washing hands once an hour for two minutes or using masks in public and hand sanitsers when washing facility is not available, in those with OCD, the action acquires anxiety and a repetitive pattern and also gets them to attach a certain amount of guilt with the action, said Dr Varrey. Symptoms such as excessive handwashing, cleaning and avoiding contamination are common among those with OCD. In the current situation, OCD patients intensify such rituals. Besides that, they begin to doubt the completion of their compulsive behaviour – a defining feature of OCD which is repetitive action that is out of the control of the patient.
For example, not only will many sufferers feel the need to wash and sanitise their hands more frequently and for a longer time period than usual, they will also doubt their technique and its effectiveness. Completion of the task will never be fully realised, which will encourage a never-ending cycle of handwashing.
Inflictng physical harm
There is the added worry that some may take this ritual a step further and use harmful cleaning solutions or abrasive materials in the belief this will help rid them of contamination. The breakdown of the skin’s natural oils can make handwashing painful and affect the skin’s ability to protect itself from infection.
Kabbara warned that if left unchecked, such behaviour can overtake every aspect of life. ”The fear of being affected by the pathogen can translate into an overwhelming obsession with hand hygiene, general cleanliness and an avoidance of situations which they might perceive to be high-risk. Combined, this behaviour can have a debilitating effect on the daily lives of those affected.”
It is therefore important to be aware of the triggers and control one’s panic, the psychologists said, adding that counselling with cognitive behavioural therapy is used to address the issue. In cases of extreme OCD, it is also possible to consult a psychiatrist and be prescribed medication which is found to be effective in treating the condition.
Key symptoms to look out for in OCD sufferers:
Coarse hands from over-washing and using harmful detergents which they may feel is the only way to reduce contamination.
Repetitive showering/washing on account of an over-riding focus to be constantly ‘clean’
Lack of sleep, due to over-worrying / anxiety.
Difficulty sticking to any kind of schedule, whether it’s work or school, due to an excessive amount of time being spent on washing/hygiene rituals.
Angry outbursts and general misbehaviour, especially if the person is not able to carry out desired rituals.
Dos and dont’s to prevent OCD in a post-COVID-19 world.
Trust official sources of information and not get influenced by hearsay.
Avoid social media forums on COVID-19. Limit access to news related to the pandemic. A constant barrage of news-related items even when just on in the background will leave OCD sufferers in a permanent and higher state of anxiety due to the constant barrage of information and statistics. But ensure you keep up to date with current advice, perhaps once a day.
Learn to relax. Use meditation apps, deep-breathing and mindfulness exercises can all help to focus and calm the mind.
It is important to wear appropriate protective gear and go out and meet people in ones and two at restaurant or the beach and not banish oneself into a self-imposed exile. Meeting people and trying to lead as normal a life as possible will help people get over the ‘agoraphobia’ or fear of people.
Reduce possible triggers/stressors, such as certain physical objects and situations. The more anxiety experienced, the more likely OCD symptoms will emerge.
Don’t be afraid to ask for help. Ensure a family member/partner/friend is aware of how you are struggling during these unprecedented times, to help offer regular reassurance and support.
Seek professional help where available online or by phone. Psychotherapy, cognitive-behavioural therapy and medications may be recommended depending on the severity of the symptoms.
Source: Dr Padma Raju Varrey and Ghania Kabbara