This Is What It's Like Having OCD During the Coronavirus Outbreak
Everyone's anxious as coronavirus spreads. But for people with OCD, each day is an excruciating battle.
The moment it was reported that coronavirus had hit the U.S., I felt the familiar itch of anxiety. Worldwide, people have grown apprehensive, shooting threatening glares whenever someone coughs near them, struggling to open doors with their elbows, and stocking up on supplies in the event of being quarantined. But as someone with obsessive-compulsive disorder (OCD), each day feels like an excruciating battle to stay sane and uncontaminated.
Every time I board a subway car near my neighborhood in Brooklyn, I size up its passengers. Is anyone coughing? Does anyone appear to be having trouble breathing? I strategically position myself in a pocket of open space and pull a Clorox wipe from my bag. I grab onto the subway bar using the wipe as a barrier between my palm and the sullied steel.
I was officially diagnosed with OCD in 2016—and once I heard it, everything suddenly made sense (down to my tendency to rewrite a text message so that it would fit on a certain number of lines). The disorder is characterized by uncontrollable, recurring, unwanted thoughts (obsessions) and behaviors (compulsions) that one feels the urge to repeat. Those compulsions come in various forms, including counting, ritualistic behaviors, the need for symmetry or exactness, and constant checking, among others.
My OCD materializes most tangibly in avoiding doing anything in threes, disregarding half of the food on my plate due to "bad pieces," and having explicit rituals I follow in the morning, night, and while perusing Instagram, for example. Much of my obsessive thoughts and actions have become so second-nature I hardly notice when I'm acting out the compulsion or having an intrusive thought.
Anyone with OCD truly believes executing their compulsions or resisting certain behaviors will prevent their obsessive thoughts from materializing. For example, I wouldn't wear a shirt with a breast cancer awareness ribbon on it because my mind convinced me that my mother would get diagnosed with breast cancer as a result.
When I feel calm, my symptoms are less prevalent—sometimes absent—but they spike during times of high stress, like, let's say, a deadly pandemic. The stakes are higher, so you must tend to your compulsions more diligently lest you get infected. In the midst of the AIDS epidemic, Fred Penzel, PhD, wrote, "One of the main features of OCD is that sufferers have difficulty in determining just how risky certain things are. Sufferers often confuse possibility with probability: if something can happen, it will happen, no matter how unlikely." Many people with OCD believe fervently that their compulsions will save their life, so when there is a life-threatening virus, these compulsions can feel like a familiar life raft to settle into.
As you can imagine, a packed New York City subway car allows for very little personal space. On this particular day, my knees are touching those of an older woman who is seated in front of me as I stand gripping the bar above. As the train jerks into motion, she coughs without covering her mouth, and I envision each virus-infected air particle rolling in a germy gust that will ultimately hit me. I look at her with contempt and confusion. Has she not watched the news? Was she never taught manners? My anxiety comes to a rolling boil. My compulsions come to fruition. I move to get away from her, and in doing so, I bump my knee on hers. Now, I must bump my other knee on hers, or else. I do so surreptitiously as I move down a few inches.
For a fleeting moment, I am relieved because I feel like I have power over the situation. As OCD is intrinsically linked with the desire to gain control, it ramps up during times where you cannot possibly have that kind of power, like during an epidemic. To soothe existential stress, I try to control what I can, like how many times I blink in a minute or by making sure if one of my shoulders brushes against the doorway, I brush the other, too.
Suddenly, I can practically feel the germs crawling across my cheeks. I am overcome with the need to itch my face. I itch my left cheek, then my right to maintain symmetry. I itch my left again because I am not satisfied with the first time. I itch the right cheek again so as not to have itched an odd number of times.
Then I'm reminded that coronavirus can be transferred by touching your face if a contaminated particle has made its way onto your hand. I have just increased my chances four times over. If people generally touch their faces about 23 times per hour, I must touch my face at least 46 times per hour, doubling my chance of contracting coronavirus. My brain begins to battle itself, swearing that if I don't touch each side of my face four times more, I will die; but if I do touch my face multiple times, I could die from contagion, an ostensibly more real threat. This inner tug-of-war is constant in people with OCD—it becomes tiring rather quickly, your brain jumping from thought to thought unnaturally fast with no rest.
As the thoughts compete faster and faster, my breathing gets shorter and more strained, which my rational mind knows is a sign of an oncoming anxiety attack, yet the obsessive portion of my brain convinces me is a symptom of the virus.
There are two more stations before we reach my stop. I can't make it. I endure the excruciating seconds before the subway reaches the next station. I bolt out of the doors a stop early, pushing past impatient people shoving their way into the train car. I rush up the stairs and emerge above ground, sucking in tiny gulps of air to stop my lungs from short-circuiting.
For a fleeting moment, I wish I would contract the virus. My worst fear would be realized, and I would no longer worry about my fate—I would know it. If I have the disease, there is nothing to control anymore; it is out of my hands, and that relief sounds sweet. Then, I quickly scrub this thought out of the grooves of my brain.
I've been in this situation many times before—but never on the verge of a pandemic in one of the most populous cities on the planet. When there are three people in my Uber, for example, I can simply ask the driver to drop me off. But now, I can't escape, and I am struggling to discern how to maintain any sliver of sanity. While the U.S. surgeon general says not to be afraid, my brain screams, "Panic or you shall perish!" On the other hand, perhaps years of my brain telling me that every minor decision I make could be the nail in my coffin might make me uniquely qualified to contend with this virus.
It can be disconcerting for people with OCD to parse out what behavior is helpful versus harmful, especially during a pandemic. They might have been washing their hands or showering an exorbitant amount for the past 40 years in an effort to stave off germs and other diseases. With the CDC recommending that people wash their hands for a specified amount of time (20 seconds) and in certain situations (when dealing with food, when treating a cut, when using the toilet, when blowing their nose, when touching animals, etc.), that can conflate previous obsessive thoughts and compulsions for people with OCD, especially for those whose compulsions include counting.
After catching my breath an extra subway stop away from work, I start making my way to the office—a half mile away. I watch each step, ensuring my heel lands exactly at the edge of each crack in the sidewalk. I am vigilant so as not to step on any triangle-shaped slabs, because they are three-sided.
When I arrive at work, I must enter through the middle turnstyle because the left or right could be considered the third. After reaching my desk, I finally feel at ease knowing that I can fall into work, losing track of time and my outside anxieties. Worries sometimes sneak up and I have to type a three-letter word twice over so that it's technically six letters or I feel an overwhelming urge to pick up and put down my mouse discretely a couple of times.
As the coronavirus panic roars on in the U.S., those with mental illnesses are likely suffering like they never have before. When coronavirus eventually tapers off, society's anxiety will fizzle out, and everything will return to business as usual, except for those who experience OCD, who live in that heightened state of unease and apprehension 24 hours a day, 7 days a week, 365 days a year, pandemic or no pandemic.