Those with OCD better prepared mentally to handle the pandemic

What was once referred to as an irrational fear that plagued those suffering from an obsessive-compulsive disorder (OCD) —an invisible, airborne disease will infect us — is now a rational fear that we all are learning to address in real-time as we deal with the prolonged pandemic.

“Irrespective of whether you have OCD or not, we see so many people so fearful of coronavirus. (As coronavirus cases go up daily) We find people constantly checking the news every few minutes in order to be armed with the latest information,” said Radhika Bapat, a Pune-based clinical psychotherapist.

‘Better Prepared’
While COVID is no doubt a stressor for those already suffering from OCD (specifically those with compulsions related to hygiene), Bapat believes that those who have been undergoing therapy for their OCD are better prepared to handle the uncertainty and anxiety that comes with Covid-19 when compared to the general population.


“They already have the skill sets to manage their lack of control over their thoughts and worries about Covid,” she said. In fact, Bapat found that some patients were actually doing better than before the pandemic outbreak. “Those doing better have said to me that they finally feel the world will empathise and understand “how they feel” “all the time”,” she said.

General anxiety, not corona fears
The National Institute of Mental Health and Neuro Sciences (NIMHANS) Bengaluru, spoke to about 240 patients associated with their OCD clinic and found that most patients weren’t affected by corona fears.

“It looks like OCD patients are not majorly affected by the Covid-19 pandemic,” said Dr. YC Janardhan Reddy, a Professor of Psychiatry at NIMHANS. “They also don't seem to have a lot of obsessions and compulsions related to COVID-19 (fear of contracting the infection and excessive washing and cleaning because of the fear). (However) This is short-term data. We need to wait and see if there is any long-term effect,”

“Whether Covid-19 could influence new-onset OCD and the symptoms is hard to say. The new patients we have been seeing over Zoom or phone don't seem to be unduly worried about Covid-19. In fact, general Covid-19 related health anxiety (not OCD) was not more in our OCD sample compared to the general population.”

Obsession vs. Safety Precautions
“We expected them to be more vigilant and wash and clean and avoid public spaces and other potential contaminants more than a healthy population, but that has not happened at least in the short-term,” said Dr. Reddy. “About 8 per cent (out of 240 patients) of them showed a relapse of OCD, but this is no more than the relapse rate that occurs naturally over the course of illness. Most of these relapses were not related to Covid-19 fears.”

Going forward, Dr. Reddy believes that the biggest challenge will be helping patients understand the difference between normal safety measures and obsessive preoccupation. “Behaviour therapy for OCD includes deliberate and sustained exposure to the source of contamination (Exposure) and preventing from washing and cleaning (Response Prevention). Practising behaviour therapy may be a big challenge because of excessive preoccupation with measures to prevent contracting Covid,” he said.

Potential For Relapse
Asked if patients who had shown signs of recovery post the pandemic would relapse, Dr. Reddy said, “About 22% of the patients who had shown response to treatment pre-pandemic have relapsed during the pandemic, but only a few had Covid related symptoms (3 or 4). The relapse rate is no more than what happens during the natural course of illness. Therefore, it cannot be attributed to Covid-19.”

He also noted that the relapse was strongly associated with having impairments in various domains of life, that was brought about by the lockdown (such as work, home management, private & social leisure activities, etc.). “This seemed to have a much higher, negative impact on OCD, more than the fear of contracting Covid-19.”