Why Coronavirus could be a defining moment for OCD sufferers

As football fixtures were postponed, European countries began to shutter their borders and the unpleasant phrase ‘herd immunity’ entered the common vernacular – a small room above a community centre in West London felt like the sanest space in the city. It is here where I, and others unfortunate enough to suffer obsessive compulsive disorder, meet every two weeks to discuss our relationship with a disorder the World Health Organization lists as one of the world’s 10 most debilitating.

“How is everyone coping with the coronavirus news?” said one participant in the London OCD support group. There was a relaxed hum. Somebody spoke. “I’m fine,” they said. “I prepare for catastrophe every day as it is.” It felt vaguely inappropriate to crack a smile, but people did anyway.

Few mental disorders are misunderstood like OCD. Our illness is routinely mocked on the popular crafts site Etsy (for £15, you too can own a quaintly offensive Obsessive Christmas Disorder T-shirt), in advertising (right at this very moment, Sky is advertising one of its new TV packages with the strap “obsessive compulsive viewing”) and on breakfast television (last week, within 30 minutes of rising and putting on the box, I heard three people use the phrase “I’m a bit OCD”, when “I like to keep things tidy” would have been more appropriate).

I wish I was tidy. I once became so lost in my obsessions that I spent a week lying in bed, the cover pulled over my head, crying, worried I’d murdered someone and forgotten about it. Another time, as a student, I woke up one day and decided I was HIV positive. I’d caught it when I’d got a tattoo, I decided. I rang the then active NHS Direct so many times they sighed when someone picked up the phone and realised it was me. I went for six AIDS tests in one year. I lost my mind.

Most people have some sort of understanding that OCD has something to do with handwashing. It’s the most common subset of the disorder, with 25 per cent of American sufferers saying the fear of contamination is what forms the basis of their obsessions and compulsions. The easiest way to explain what goes through an OCD person’s cognitive process during heightened states of anxiety – though I often think if you don’t know, you won’t know, and I dearly hope that you never ever have to know – is the idea that the sufferer must protect themselves from some unseen enemy. So much of OCD is about doubt – its front-line treatment, CBT and what’s known as exposure therapy (quite simply the process of living with thoughts rather than pushing them away and emboldening them, or looking for reassurance), is about learning to live with uncertainty and risk. OCD is self-perpetuating. Hand washing eases the doubt, but it prolongs and amplifies the suffering.

Which makes living with OCD in the age of coronavirus complicated. Many OCD people have spent decades resisting washing their hands too much. It’s
quite literally the recommended treatment – and now they’re supposed to do
the opposite? 

One OCD friend texted me yesterday to express their confusion. “I just don’t know where the line is,” she said. “How much hand washing is too much? I’m worried that if I start, I won’t stop.” At the height of her handwashing, my friend would wash her hands until her skin would crack and bleed. They, and I, am terrified they’ll return to days they’d rather forget… if OCD ever lets a person forget anything.

It’s likely that coronavirus will have a lasting impact on the evolution of OCD. I learned in therapy that my obsession with Aids – extremely common in Gen X types like myself – can be linked to the irresponsibility with which the illness was reported at an age when we were at our most vulnerable. A therapist once said to me, “Do you remember the iceberg?” and I instantly felt chills. They were referring to an early public information film aired on British television in the Eighties featuring an iceberg carved to spell the word “AIDS”, but which might as well have been advertising the end times. “Someone with OCD talks to me once a week about the iceberg,” said my therapist. It’s likely future generations of OCD sufferers will speak of coronavirus similarly.

My OCD group probably won’t meet this week. Getting so many people in such a small room at this point in time is logically a terrible idea. But we’ll be thinking of each other, hoping the best for each other, yearning for a better, less confusing and much less terrifying time.

James McMahon runs the blog, The OCD Chronicles, featuring testimonials of other sufferers