How to Manage OCD During COVID-19
September 11, 2020
Image courtesy of David Garrison for Pexels.
The lockdowns, quarantines, restrictions, and guidelines for cleaning and living in a pandemic such as COVID-19 are strenuous and traumatic for everyone. But the portion of the population living with mental illness is having a far tougher time dealing with the onslaught of this situation than many people realize.
Those with OCD are especially triggered, as the cleaning and routines recommended by organizations such as the Center for Disease Control or the World Health Organization can easily become obsessions or compulsions when fueled by fear-- or for some, familiarity.
It’s especially important during these times to focus on what you CAN do to manage OCD and its symptoms. We’ve got some suggestions we hope you find helpful regarding:
- Physical health
- Mental and emotional health
- TMS as a treatment for OCD
Physical health habits
One of the keys to good mental health-- regardless of the presence or lack of a diagnosis-- is developing good self-care habits and sticking to them. But what self-care habits look like might surprise you. It’s not all bubble baths and New Age music (although those have their place, too).
First of all, make sure that you’re eating good nutrition. We want to use the word “nutrition” here to avoid triggering anyone, and also to create a more positive relationship with the food we eat. Include proteins like nuts and lean meat like fish, chicken and turkey. Beans and eggs are also good sources of protein. This will satisfy hunger, and the manner in which they fuel your body is slow-release and balanced. Fewer hunger crashes sounds good to us!
Fruits and vegetables are integral (you saw that one coming, didn’t you?), as are whole grains, because they keep your blood sugar balanced and your digestive and excretory systems in top working order. Plus fruits and vegetables contain antioxidants, which boost every bodily function and provide the foundation for healthy body development (think good eyesight from beta carotene and vitamins C and E to prevent cell damage).
Steer clear of caffeine, or at least reduce your intake. Caffeine can jack up anxiety, which is not fun on anyone’s list. If you have simply can’t start your morning or get through the afternoon slump without it, try options that offer antioxidant benefits, such as yerba mate or green tea. If you’d like to start reducing caffeine but need something to refresh you, try herbal teas such as hibiscus, mint, or rose (they’re delicious hot or cold).
If you’ve had too much caffeine and need to calm down, try lavender and chamomile tea or another herbal blend that touts calming abilities. Drink lots of water-- a body working without hydration is like a car trying to work without coolant or gas.
Definitely stick to your prescriptions, and avoid alcohol and smoking. Not only can these have dangerous side effects when mixed with prescriptions, they can create anxiety. Maintain physical activity-- even during lockdown, most states allowed people to leave their homes to walk, job, run, bicycle and get physically active. Wear a mask, especially when around other people with whom you do not cohabitate. As a bonus, exercise keeps levels of cortisol-- the nasty stress hormone that causes anxiety-- in balance.
Sleep is equally important for managing OCD, stress, and just life in general. Your body performs specific repair functions when it’s sleeping that it can’t do when you’re awake. But OCD and anxiety can make it hard to “shut your brain off” and go to sleep. Try setting a sleep routine that still allows for some flexibility-- set aside 10 minutes to an hour before bedtime to clean up and get off social media and electronics. Use that time to read, listen to music, practice mindfulness techniques, do crossword puzzles, or some relaxing nighttime yoga.
Mental and emotional health habits
Your mental and emotional health habits also play a huge role in managing your OCD-- after all, these are the two areas that are affected the most by it. Maintaining as much balance as you can helps you to manage your symptoms more effectively. So how do you accomplish this seemingly enormous feat?
One small good habit at a time.
Start with mindfulness exercises. These can be easily incorporated into a sleep routine, throughout the day between chores or work tasks, and do not require much time. Check out Psych Central’s 1-Minute Exercises, or if you have some extra time, the Mayo Clinic’s mindfulness exercises can be adjusted from a few minutes to as long as necessary.
If you like exercising and have the ability to get out into the woods, try forest bathing. First, pick a spot like a nature preserve or state park. Apply sunscreen and bug repellent (make sure it repels ticks, too!) Then pick a spot or trail, and hike or walk there. Here’s the key-- leave the tech behind, or at least shut it off once you reach your spot. Fully immerse yourself in experiencing the forest-- place your palms against the tree bark, listen to how the quiet is not quiet at all, but rather full of birdsong and the wind in the trees. Breathe in slow and deep.
If you have access to a grassy area, you can also try grounding or earthing. Take off your socks and shoes, and stand barefoot or lie down on the ground. Some folks like water instead, and wading or floating in a body of water will accomplish the same goal.
You should also practice kindness towards yourself in the form of focusing on goals and celebrating victories, even small ones. Talk to your therapist about a good goal-tracking method-- you may need to try a few out before landing on one that works for you. Leave yourself nice notes, such as “I am proud of how I love myself” or “I am worthy and loved.”
Limit your media exposure. This may mean that you need to limit some social media as well, but practice watching the news only long enough to find out the major headlines and then turn it off. Walking away from the media is a powerful tool to managing obsessions and anxiety, especially during times when most headlines are triggering or negative.
And of course, seek support. Know who is safe for you to turn to if you’re having a bad mental health day. Keep regular appointments with your therapist and join an OCD support group or find a mental health coach that specializes in OCD patients. It is normal and okay to recognize when help is needed and to ask for it.
TMS and OCD during COVID-19
TMS can be of great help to OCD patients, especially during a pandemic, because it calms the part of the brain related to obsessions and compulsions. The manner in which TMS treats OCD is non-invasive, and has little to no side effects that would prevent the patient from safely traveling to and from the appointment independently.
All of these things make TMS an ideal way to help manage OCD symptoms. The equipment can be sterilized, masks and social distancing are possible, and the general lack of side effects means the patient has control over exposure risks during travel. The treatment itself boosts and redirects brain activity, which results in healthier brains with fewer OCD symptoms.
TMS also does not take very much time. Depending upon the diagnosis, treatments occur daily for a few weeks and then taper off and spread out over time. The treatment sessions can last anywhere from a few minutes to an hour, which makes it easy to fit into a schedule. It’s also about the average time-- or less-- of a good grocery store trip, so exposure risk may be somewhat controlled.
There are three different approaches to using TMS to treat OCD.
The first is by targeting the prefrontal cortex. This area controls cognitive skills, which is related to compulsions. More information is needed to decide if this method is successful, mostly due to the fact that early studies did not use a strong enough delivery and therefore had little effect. Recent studies using stronger waves have proven more effective than previously thought.
The second approach is to target the orbitofrontal cortex, which is the area of the brain generally most affected by OCD. This area tends to be overactive in OCD patients, so TMS calms this hyperactivity and symptoms improve for around a month (sometimes longer) at a time with only short treatments.
The third approach is to target the pre-supplementary motor area, which is consistently hyperactive in OCD patients. This last method has had the most effect on treating OCD. Patients generally report not only a reduction in symptoms, but also reduced anxiety and depression and an increase in functioning. It also lasts longer-- possibly three months or longer in most patients.
Again, using TMS to treat OCD is still experimental, but it’s highly promising and effective. The way in which TMS rewires the overactive parts of an OCD patient’s brain into slowing down and working more normally makes it a fantastic option for treatment-resistant patients.
Try these ideas and see what combination works for you. Talk to your therapist, and remember to focus on what you CAN do to manage your symptoms. We’re rooting for you!