It’s hard to believe, but for some people, Covid19 is not their greatest worry. Not catching it, not getting sick by it, not even dying from it.
‘I’ll be dead by the end of the month anyway” states Sarah.
Sarah isn’t really Sarah, but we’ll call her that for the sake of this article. Sarah is not ill, nor is she actually dying.
Sarah has something called Obsessive Compulsive Disorder, or OCD for short. You may have heard of the term before. It is estimated that 12 in every 1000 adults experience this mental disorder; and those are the just the ones that were willing to come forward for the survey. It’s also become something of a generalised statement for slightly quirkish behaviour (“Oh I am so OCD about my wardrobe”). For some it can be very mild, but for others, like Sarah, it can be severe and debilitating.
Sarah has had OCD since she was twelve. It manifested in those days through her belief that she either had meningitis or was going to catch it.
“Someone at school had it and they sent letters home with the symptoms to look out for. I don’t know what happened but I became convinced that I was going to get it. I spent hours checking my skin for rashes and seeing if the light affected my vision”.
Despite therapy, Sarah’s OCD continued to evolve as she got older. At the age of 18 she found a breast lump. It was thankfully found to be benign, but her thoughts and behaviours began to descend into worry and panic that she had Cancer somewhere in her body. Ritualistic checking and asking questions from loved ones became the only way she could cope. Within a few years, the OCD expanded into other areas of her life, like checking switches and believing twigs on the ground were discarded hypodermic needles that may infect her with HIV.
Despite Sarah becoming overwhelmed by OCD, she still managed to obtain a first class honours degree in Sport Science. Her dissertation was so good in fact, that it was published in a leading scientific journal and Sarah was offered a place on a Masters degree program. Her dream was to become a physical education teacher. Unfortunately, the OCD had left her housebound and reliant heavily on loved ones to do just the simplest of tasks.
I myself was diagnosed with OCD when I was 18 years-old. For me, it has always been the fear of germs and contamination. I would experience intrusive thoughts, just like Sarah, where my mind was telling me that if I touched a door handle I would most definitely be picking up all kinds of nasty bacteria that would make me ill. The compulsion would be to wash my hands repeatedly or use sanitising gel. My condition was manageable until my mid twenties when I got my first (fairly horrific) bout of food poisnoning. That was just the perfect fuel to my already burning OCD fire.
Sarah’s compulsion is to seek reassurance that she doesn’t have Cancer, or that the things she encounters in her life won’t make her sick. For the last year, Sarah had been having weekly sessions with a specialist clinical psychologist. Through these sessions, Sarah had begun to make significant progress to get her OCD under control.
“I used to ask so many questions from my family. Was this a lump? Did I have swelling? Was that bruise the sign of something. But working with my therapist, I had got to a point where I was asking maybe one or two questions a day. I was also going out more and partaking in things I had always struggled with”.
On March 23rd, the UK was placed on lockdown for Coronavirus.
For many with mental health problems, access to services were either cancelled or re-arranged. For Sarah, her therapy was moved to a weekly phone call instead of a face-to-face appointment.
When lockdown was announced and we were told by medical advisors to stay away from people and wash our hands regularly I laughed at the irony. I cannot tell you the number of days I’ve spent in therapy for hand washing. I used to go through litres of hand gel every week and had to be weaned off it by a therapist who would follow me round on trips into the city. It was probably one of the toughest things I’ve ever faced in my mental health journey. Now here I was, 6 years later, going out to buy gel and antibacterial wipes.
Initially I coped, as did Sarah.
The new normal felt more comfortable after the first week of lockdown. I spoke with her on week 2, where she was happily exercising in the garden and laughing at my jokes.
Last week, Sarah found something on her leg which made the panic flood back. All of those around her told it was maybe a small skin infection, but likely to resolve itself with a bit of warm water and Savlon. But her thoughts raged on with pace. ‘This is Cancer’ would play on loop in her mind.
“Normally I would be seeing my doctor who meets with me once a month for a review. I should be going next week but they’re not doing face-to-face appointments. Even talking to my therapist is difficult because it’s not the same on the phone”.
Sarah has been struggling with the thoughts that she has something sinister growing inside of her and no one is there to check. She knows her thoughts are not rational, but the intrusions that she’s going to die will not stop. In her reality, she feels like she is dying and no one is listening. She knows she shouldn’t feel this way with what is going on in the world. She knows there are people out there who are actually terminally ill. The guilt she feels is as real and raw as the swelling on her leg. The emotions she feels are forever conflicting and waging war inside.
She worries that people will judge her the thoughts she has no control over.
I can relate to all of this.
My thoughts around hand cleaning and hand gels have started to rise again in the last week. The compulsion to scrub my skin and to smother it with burning alcohol is so strong that it infiltrates my dreams. I worry about what will happen when covid eventually goes away. Will my thoughts settle? Or will I be back at square one again? All I know is that I’ve gone past the point of being sensible. I’m doing the secret hand cleaning because I’m ashamed for anyone to know what my brain is doing right now. Just earlier, I washed my hands clean and then the tip of my little finger brushed past a bag I’d worn outside.
“You could have covid on your finger!!”
I went back and started washing for a second time.
Then cleaned my bag with antibacterial wipes.
Then I washed my hands again.
Then I used gel.
Sarah & I are just two of many people who will be struggling with OCD through this crisis. I can guarantee that after all of this, there will be many more struggling to re-integrate when we are finally allowed. The brain is a complex engine. It will do and say what it wishes to keep you safe.
Even if it’s completely irrational.
Even if it seems completely barmy to the outside world.
But if you are out there, with OCD now, or in the future, just know that you’re not walking the path alone.