MHM Magazine

26 | MENTALHEALTHMATTERS | Issue 3 | 2021 MHM of OCD during this time or if there’s a diagnosis their symptoms may be exacerbated. The common subtypes of OCD that may be impacted during this pandemic are Contamination OCD, Harm OCD and/or Perfectionism OCD. However, any subtype of OCD can be exacerbated or present itself during times of heightened stress. If the individual is seeing a GP, psychiatrist or a therapist they should continue with their treatment provider(s). However, if someone isn’t getting treatment for their OCD symptoms it’s important they seek out treatment from a trained professional. The gold standard in treatment for OCD currently is a combination of medication in the form of a Selective Serotonin Reuptake Inhibitor (SSRI) and psychotherapy in the form of Cognitive Behavioural Therapy (CBT). The CBT the person receives should include Exposure and Response Prevention (ERP). ERP is where the person is gradually encouraged to face situations that cause them fear while at the same time refraining from engaging in compulsions. The therapy may also include components from Acceptance and Commitment Therapy (ACT), which includes accepting the uncomfortable feelings and thoughts a certain situation brings, while at the same time committing to behaviour that’s in line with the person’s values even if those behaviours bring about or increase their uncomfortable emotional feelings in the short-term. If the person can’t see a professional due to lockdown, or having been in contact with someone who tested positive for COVID-19 or they’re too afraid to go to a healthcare center then they should be guided and informed that they can make contact and continue with treatment via an online platform (e.g. Zoom consults). It should be noted that ERP can be complicated during the time of the pandemic so here are some guidelines that can be useful: • Struggling with contamination fears o Wash hands for 20 seconds with soap and water if they leave the house and are returning or if they’ve been in contact with someone from outside, but not for longer o If they don’t leave the house or have contact with someone from outside then only wash hands (as above) at certain times: § Before eating § After going to the toilet § After sneezing and blowing their nose o Only clean and disinfect surfaces that are regularly in contact with hands o Clean surfaces for a few minutes once a day. o If surfaces are not in contact with hands or the person has not left the house and nobody has entered the house then cleaning or disinfecting the surfaces should be avoided • Struggling with harm OCD o Be mindful that these thoughts can be exacerbated as the OCD can take the fears of COVID-19 and tell a person they might have infected someone or they are going to infect someone. o Accept that these thoughts occur to everyone during this pandemic and that they can only control what’s in their control, such as the health and safety guidelines. They can’t control doubt. They should view these intrusive thoughts and feelings and see them as fleeting. • Struggling with perfectionism o Remind them it may be impossible to protect themselves “perfectly” from COVID-19. It’s better to use common sense than to go to extremes of perfectionism. o It might be helpful to talk to a trusted friend, family member or mental health worker to help figure out what health and safety behaviours are appropriate with covid-19. o A therapist can help a person understand how to apply COVID-19 health guidelines in a way that meets the health standards but that won’t worsen their OCD symptoms. An individual suffering from OCD should also be encouraged to allow themselves to think about the coronavirus and any other intrusive thoughts they may have. Forcing themselves to not think of these thoughts can have the opposite affect and increase the frequency of these thoughts. The individual should dedicate a time in the day they call “worry time” (10 to 20 minutes) and purposefully think of these intrusive COVID-19 or any other intrusive thoughts during this time. Lastly if they feel their stress and general anxiety levels have increased due to lockdown they should also try to incorporate physical exercise, breathing and relaxation techniques into their daily routine. It’s also helpful to keep contact with family members and friends even via Zoom, Skype or phone. References available upon request