Keeping your OCD recovery on track

“I was doing really well, my hands weren’t even sore and then along came Corona! It’s got my OCD saying ‘I told you so’”.

FTB Service User

The above experience has been voiced by many of our young people struggling to manage their Obsessive-Compulsive Disorder (OCD) at this time. Their health fears alongside the fear of contamination have left many crippled with anxiety.

The World Health Organisation (WHO) ranks OCD in the top ten of the most disabling illnesses in terms of lost earnings and diminished quality of life. So, as if the constant OCD alert bulletin wasn’t already enough, we know that the daily and increasing focus on the pandemic in the news is beyond triggering.

However, it made a few of us here at FTB wonder. Could this still be an opportunity rather than a stumbling block? Is there still a chance to “boss back” OCD? Absolutely!

We don’t live in a perfect world and OCD is always going to tell you that you’d better keep up those extra rituals... just in case. So we’ve put together some advice to put OCD where it needs to be.

The following tips are useful whether you are at the beginning of your treatment journey or fearful of relapse during this triggering time and are designed to keep you, rather than OCD in charge of your life.

Choose your news

It’s tempting to constantly check news bulletins to see how the situation is developing. OCD might even tell you that you should be, “just in case”. But we know that constant checking only increases anxiety. However, we also acknowledge that it is difficult to ignore. It may therefore help to limit your news intake, turn off notifications and alerts or simply switch channels.

Top Tip: Remember - ‘panic sells papers’ so dismiss emotive headlines and stick with the science

Keep things ‘business as usual’

As far as possible, normalise your life. For travel advice take the government's advice and not your OCD's. Try to be guided by reason, responsibility and the rational. Make decisions will based on information released not on the extra “OCD alerts” and keep a note of the difference.

Top Tip: It might be helpful to observe a friend or family member without OCD and see how that person is making decisions and try to follow their lead.

Give yourself permission to follow health advice

If you are currently in treatment/recover , you may have already been making a sterling effort to reduce compulsive rituals to keep OCD in check. However, at this time we’d advise you to give yourself permission to follow World Health Organization (WHO) or U.K. Government guidelines. Remember, the WHO has the scientific knowledge to give good advice, that charlatan OCD does not.

Top Tip: Remember not to over-do it. You may find yourself questioning government advice as, for example, your own hand-washing routine may be longer than the advised 20 seconds. Make the recommended guidance your “cut off” and remember that official advice is enough.

Practice healthy strategies to regulate emotions and tolerate the uncertainty

The uncertainty of this time is still an opportunity to get OCD back in the box. Following recommendations is in itself an exposure and response prevention (ERP) exercise and repeated exposure helps you handle it.

The situation is undeniably scary and there is so much uncertainty. It might help to put together a coping plan (absent of increased rituals and compulsions) to help you manage the anxiety. But remember that the aim is to use your skills to tolerate uncertainty rather that work as hard as possible (ultimately failing) to create certainty.

Top Tip: Tolerate to regulate

Let family and friends know

Anxiety about COVID-19 is normal and you are certainly not alone. The situation has raised anxiety in even the most stalwart individual. If you are experiencing an increase in anxiety and distress and need extra support, there is no shame in asking for it.

Top Tip: Let others know you are struggling so they too can limit the discussion of news updates around you.

Cheerlead yourself

Remind yourself of your treatment goals and your motivation for recovery. Tell yourself you can do this because you can.

Top Tip: OCD may well be ‘dancing an anxious jig’ right now, but nothing has changed. It’s not the boss of you. You’ve got this!

Remember you are not alone

As well as sessions with your core worker there are a number of self-help guides and resources online. Remember our drop-in service, Pause, also has dedicated workers on hand to offer support and guidance.

OCD-UK has free discussion and support forums for people with OCD and family members. They are completely FREE to use and are fully moderated. Register at: https://www.ocdforums.org/

References and acknowledgements

OCD UK.

Reid Wilson, PhD, author of Stopping the Noise in Your Head: The New Way to Overcome Anxiety and Worry,

Kimberley Quinlan, LMFT, creator of ERP School,

Shala Nicely (2020)

“I was doing really well, my hands weren’t even sore and then along came Corona! It’s got my OCD saying ‘I told you so’”.

FTB Service User

The above experience has been voiced by many of our young people struggling to manage their Obsessive-Compulsive Disorder (OCD) at this time. Their health fears alongside the fear of contamination have left many crippled with anxiety.

The World Health Organisation (WHO) ranks OCD in the top ten of the most disabling illnesses in terms of lost earnings and diminished quality of life. So, as if the constant OCD alert bulletin wasn’t already enough, we know that the daily and increasing focus on the pandemic in the news is beyond triggering.

However, it made a few of us here at FTB wonder. Could this still be an opportunity rather than a stumbling block? Is there still a chance to “boss back” OCD? Absolutely!

We don’t live in a perfect world and OCD is always going to tell you that you’d better keep up those extra rituals... just in case. So we’ve put together some advice to put OCD where it needs to be.

The following tips are useful whether you are at the beginning of your treatment journey or fearful of relapse during this triggering time and are designed to keep you, rather than OCD in charge of your life.

Choose your news

It’s tempting to constantly check news bulletins to see how the situation is developing. OCD might even tell you that you should be, “just in case”. But we know that constant checking only increases anxiety. However, we also acknowledge that it is difficult to ignore. It may therefore help to limit your news intake, turn off notifications and alerts or simply switch channels.

Top Tip: Remember - ‘panic sells papers’ so dismiss emotive headlines and stick with the science.

Keep things ‘business as usual’

As far as possible, normalise your life. For travel advice take the government's advice and not your OCD. Try to be guided by reason, responsibility and rationale. Make decisions based on information released not on the extra “OCD alerts” and keep a note of the difference.

Top Tip: It might be helpful to observe a friend or family member without OCD and see how that person is making decisions and try to follow their lead.

Give yourself permission to follow health advice

If you are currently in treatment/recovery, you may have already been making a sterling effort to reduce compulsive rituals to keep OCD in check. However, at this time we’d advise you to permit yourself to follow World Health Organization (WHO) or U.K. Government guidelines. Remember, the WHO has the scientific knowledge to give good advice, that charlatan OCD does not.

Top Tip: Remember not to overdo it. You may find yourself questioning government advice as, for example, your hand-washing routine may be longer than the advised 20 seconds. Make the recommended guidance your “cut off” and remember that official advice is enough.

Practice healthy strategies to regulate emotions and tolerate the uncertainty

The uncertainty of this time is still an opportunity to get OCD back in the box. Following recommendations is in itself an exposure and response prevention (ERP) exercise and repeated exposure helps you handle it.

The situation is undeniably scary and there is so much uncertainty. It might help to put together a coping plan (absent of increased rituals and compulsions) to help you manage the anxiety. But remember that the aim is to use your skills to tolerate uncertainty rather that work as hard as possible (ultimately failing) to create certainty.

Top Tip: Tolerate to regulate

Let family and friends know

Anxiety about COVID-19 is normal and you are certainly not alone. The situation has raised anxiety in even the most stalwart individual. If you are experiencing an increase in anxiety and distress and need extra support, there is no shame in asking for it.

Top Tip: Let others know you are struggling so they too can limit the discussion of news updates around you.

Cheerlead yourself

Remind yourself of your treatment goals and your motivation for recovery. Tell yourself you can do this because you can.

Top Tip: OCD may well be ‘dancing an anxious jig’ right now, but nothing has changed. It’s not the boss of you. You’ve got this!

Read Becca's OCD patient story

Don't Stop Now - Becca's story written during the height of the COVID-19 pandemic

With everything that has been in the news recently, I have been questioning the logic and reasoning behind my decision to make this the year that I say goodbye to my OCD for good. With government advice in the last week advocating hand-washing for 20 seconds, avoidance of touching your face and hand shaking, I am sure that every OCD sufferer around the world has been wrestling the urge to return to, or increase safety behaviours to combat the anxiety brought on by the prospect of catching and spreading the coronavirus, COVID-19.

So right now, I am starting a blog. To hold myself accountable. To make sure that I exercise a measured practice of cleanliness as per government advice, and don't let the anxiety provoked by a potential pandemic push me back months in my recovery.

Last week I was describing to my housemate a breakthrough in my ability to resist my rituals. My hands were smooth and in-tact for the first time in a very long while. I had finally got over the compulsion to sterilise my hands after contact with any external object and was finding that actually, I can lie in for an extra half an hour in the morning when I don't perform an 11-step hand-washing routine around my breakfast!

And then the media got wind of the coronavirus epidemic and I found myself plunged back into a world of panic and anxiety. So I decided that instead of drowning in that pool of panic, I would take a pen and plot out the evidence I have to present to my OCD, to tell it to stay away for good. To tell it that the coronavirus is not a reason for it to creep back into my life and take a stronger hold than it already has.

So let's start with some personal reasons to stay away from the rituals and rules that have kept me 'safe' for so long. Firstly, I take AGES to leave the house. Washing my hands is the last thing I do, and honestly? It is a pain. Secondly, my hands hurt and they LOOK awful. If it isn't obvious to everyone else that I keep heading off to wash my hands, the lines across my wrists denoting my sleeve cuffs and the cracks over my knuckles are enough to give it away, it would be so nice to be able to use soap and not wince as I place my hands under the tap! Next I am imagining for myself a life where I can hold my boyfriend's hand, buckle a seatbelt in a taxi and use a cash machine. Simple day-to-day tasks that strike a fear in me. And, keeping it brief, just being able to use the fridge handle and the kettle would make a massive difference to my quality of life!

It is very easy for OCD to convince you that it is your guardian, sent to protect you from all the dangers in the world. The germs that can breach the natural barriers your body has evolved over millions of years to protect you. The skin is an effective layer covering the entire body to protect it from pathogens. It is covered by a healthy flora of benign bacteria which function to compete against pathogens and prevent their replication and it is waterproof, nothing can burrow through it into the blood stream, as obvious as that may sound. In fact, the breaching of the skin caused by the incessant washing and scrubbing of the hands leaves you more open to infection. So there we have it again, The protection offered by OCD leaving you open to more danger. Safety blanket or smothering blanket?

Now for health. I can break this down into mental and physical health. It is far easier to weigh the impacts of OCD on the mental health than the physical so I am going to start there.
Allowing OCD to be present in my life immediately sets me on the back foot. Anxious and calculating, I would follow my routines over spontaneity. I would find it far more important to complete a hand-washing compulsion than shake hands at a conference or hold hands with my boyfriend. In the moment that I complete this compulsion, I am relieved of anxiety, but this is momentary. In that moment of relief, I am reinforcing that OCD is there keeping me safe, staving away the fears that I grapple with and more importantly the physical dangers of the real world.


But is that momentary relief of anxiety worth the building angst that stays ever-present as the rituals expand and the opportunities lessen, the social life depletes and the mood dampens? Having just caught a glimpse of the possibility of a life without OCD, I would argue not. I do not expect that it will ever be completely gone, but in acting against it and not allowing it to run my life, unsurprisingly, there will be benefits globally. Friends won't have to sit through the washing and the panic, I will get to work on time and most importantly, instead of being ever-reinforced, the anxiety will pass! Eventually this will result in happiness, relative relaxation and more fulfilment from whatever I throw myself into. Because ultimately, I will be able to throw my whole self into it and not have that small segment of my mind distracted by the nagging chat of OCD.

The arguments around the effects of OCD on physical health are more difficult to battle. It is here that the OCD voice tells you it is protecting you. By washing your hands an excessive amount, you are protected against the germs you are exposed to on a daily basis. OCD assures us that this is the only reason we stay well. That our immune system is sub-par and if anything, depressed further by the lack of exposure to germs, it has done that fine a job of protecting us.

If I never test this wild claim made by the OCD voice in my head, I will never know the truth. Was I unlucky enough to be lumped with the failing immune system or has my crutch been lying to me all my life?

As for the coronavirus I think it is pertinent note that for people with OCD, our hands are never clean enough, we have never washed long enough or used enough soap and gel. So when the government released their coronavirus advice, the temptation is to go above and beyond the standard rituals that keep you ticking along. But it is important to remember, if the government advice is enough for the public, it is enough for me.

Sticking to the government advice as a set level of 'normal' is enough. There is nothing that makes me more special than the person sitting next to me on the train, and the likelihood is, that I wash my hands more thoroughly and for longer than advised anyway. And that, admittedly, is something I need to work on. Maybe setting the government advice as my exposure threshold will, in the long run help me beat this thing.

Becca x

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