man washing hand

The Reality of OCD During the COVID-19 Pandemic

Source link: https://www.thehindu.com/sci-tech/health/the-anxiety-and-reality-of-obsessive-compulsive-disorder-ocd-during-the-coronavirus-pandemic/article31832099.ece

Cover your face, scrub your hands, repeat. The pandemic has heightened anxieties of infection, even more so for people with obsessive compulsive disorder

Once in every 20 minutes, like clockwork, Sivakumar Bharati* washes his hands and checks if the window are shut. “I have not ‘relaxed’ in three months aside from my REM sleep,” he says. “There is the prevalent fear of germs and contamination which is why the pandemic has been particularly stressful.”

This is the reality of OCD or obsessive compulsive disorder.

“You don’t really take notice of it until someone else points it out — and a lot of people did,” says 59-year-old retiree Sivakumar . “And back in the 70s, mental health was not taken seriously. People back then just thought I was militant about being neat, some poked fun at it.”

Sivakumar’s home in Hyderabad is evident of his obsessive compulsive disorder: to want everything symmetrical, no clutter, even the presence of muted tones. There are moments of anger and frustration where if things are not lined up, there would be a meltdown, curable only by the correct positioning and considerable time to cool off.

Chennai-based Professor Dr Gauthamadas Udipi, specialist in neuro-behavioural medicine, who has worked with people with OCD for almost many years explains, “OCD may only be the behavioural marker of a more extensive systemic disorder. “After all, the mind is only an expression of the functioning of the brain, and the brain is only a part of the body. At one end of the OC spectrum is ‘normal’ obsessive thinking and ordered behaviour in daily life, which does not interfere significantly with daily functioning. At the other end is severe obsessive rumination and compulsive behaviour that does not allow daily function.”

Essentially, the underlying pathology is in the Salience Network (SalNet) or ‘worry-loop’ of the brain, which sees a person having uncontrollable, reoccurring thoughts and/or behaviours that they feel the urge to repeat over and over; it can be especially harrowing now, owing to the COVID-19 pandemic which invites uncertainty, rising tensions and innumerable risk factors. Often caused by severe psychological stresses, OCD manifests in different forms, from ritualistic obsessions to suicidal compulsions. Sivakumar is on the lower end of this spectrum, and it took a long time for him to realise what he had.

‘I’m OCD about that’

Sivakumar, during the late 2010s, was finally formally diagnosed by a neurologist in South Africa, who stated that OCD is a legitimate condition — and not one about which to be ashamed. “I remember him mentioning how popular culture had not even normalised but trivialised OCD. The parameters of what was ‘deemed’ OCD had shifted in a big way; people thought being tidy was OCD,” recalls Sivakumar.

And things have not been easy as the pandemic trudges on.

Dr Udipi affirms that the pandemic can be a heightener, explaining, it could “result in triggering underlying OC spectrum disorders in a genetically prone person, tilt the balance from ‘normal’ obsessions to a pathological OC pattern, or worsen an already existing OC disorder.”

The International OCD Foundation, Boston, sees the unique challenges for the OCD-afflicted and has offered numerous online resources, which are free-to-use and which help people run through their OCD anxiety with some ease while maintaining physical distancing. These options include WHO-approved tips on how to deal with contamination fears, video teletherapy, which helps those with OCD find a licensed teletherapy provider while retaining physical distancing, and printable coping cards. These cards, not a replacement for help from a medical professional, are written reminders and questions for the self to be mindful, breathe easy, take back control and understand that progress is better than perfection.

Dr Udipi adds that empathy from close friends and family is helpful. “[They] must understand that this is a disorder originating in brain circuits over which the person has little control, and advising the person that ‘it is all in the mind’, and ‘learn to control it’ is of no use, and that yoga, meditation, and other ‘self-therapies’ will not work in the case of a ‘pure obsessive thinking’ (which occurs in a very small percentage of people with SalNet disorder), as the person cannot bring the mind to focus on them due to pure circuit overdrive.” He emphasises that early identification and proper treatment by a qualified psychiatrist and team is the key.

Sivakumar agrees, concluding, “There are times you may not feel worthy because you feel like you are adding stress to home life or work life. But when you start humanising yourself with the help of a mindful and informed healthcare professional, it helps tremendously. It also helped that my family and I could find common ground with patience. But for other OCD folks out there, you have to want to accept it as a condition and not as an extension of the self. It’s emotionally taxing to go through it because your mind is telling you that this obsessive order of things is paramount.”

* Name changed to protect identity

Six Psychological Steps to Take in Corona

Source link: https://www.psychologytoday.com/intl/blog/get-out-your-mind/202004/six-psychological-steps-take-in-corona

Simple tools and techniques from Acceptance & Commitment Therapy

stairsThe Corona pandemic is putting us all in front of new challenges. There are economic challenges, because entire businesses can no longer operate, putting millions of people out of work. And there are health challenges – not only due to Corona itself, but because the pandemic strains the resources of our healthcare system, leading to the illness and death of people who otherwise would have received proper treatment.

And as if this wasn’t enough, we also face mental health challenges. Because of Corona, going outside is no longer “just going outside”. Instead, every trip to the supermarket is now a calculated risk, where we try to avoid contact with other people as much as possible. Meanwhile, we also need to make sure we do not accidentally touch our own face. Leaving the house thus means having to be constantly alert.

We not only fear getting infected ourselves, but that our loved ones get infected, and that we end up losing someone close to us. In fact, it is very realistic that we will experience some form of loss due to Corona, and it is important that we prepare ourselves for loss. The constant stress paired with the uncertainty of the future creates a harmful context, where psychological ailments thrive. For this reason, now more than before, we need to be attentive to our mental health. In the following, I’ve compiled six psychological steps you can do to effectively deal with the challenge of Corona. Let’s begin.

Step #1 Connect With Feelings

When we are entangled in difficult emotions like fear, sadness, or even panic, life becomes hard. Every little step becomes a chore, and our entire focus then revolves around stopping “bad” feelings. Meanwhile, we also stop doing things that would actually help us (e.g. like proper eating and exercise), and put our lives on hold.

In the middle of this pandemic, it’s important to not let our emotions run the show. This does not mean pushing bad emotions away – this has never worked well in my experience – but allowing ourselves to feel emotions, without having to act on them. Do not attempt to force “good” feelings, but try staying with your emotions in an open and compassionate manner. Hold them, like you would hold a small, anxious child. Be kind. Listen to your body. Then see if they actually contain information you can use in the next steps. For example, fear or sadness might be a good way to support connecting with others or taking steps to protect their safety.

#2 Connect With Focus

When the future is uncertain (as it is right now – more than before), our minds like to run wild. We imagine the wildest scenarios of what will happen, and how the pandemic is going to affect us. For instance, many people worry about supermarkets closing, and thus resorted to panic-buying products in bulk, like toilet paper, wine, and even condoms (yes, really). Incidentally, many of those same people are now realizing that this didn’t happen and some are even trying to get their purchases refunded (condoms, anyone?).

When your mind runs wild about all the ways of how things can go wrong, slow down and plant your feet in the now. Literally! Stand up, take a breath, and then notice your feet and how they hold you. Now that you are “grounded,” focus your attention here it matters. This is not about pushing unhelpful thoughts away. The thoughts are here, and that is alright. But instead of letting them take over, let unhelpful mental chatter pass, and focus on what is there to be done, here and now. There are many additional techniques for this, and they are worth checking out.

#3 Connect With Others

Social distancing is no fun. Due to Corona, we can no longer see our friends and families in the same way that we used to, which creates a big challenge. We are social animals after all, and the importance of physical touch for our well-being has been well documented. For the time being, we need to give up (or at least limit) touching others.

However, just because we limit contact, does not mean we need to give up connection. The New Zealand Minister of Health, Dr. David Clark, made an important distinction in a public address, where he emphasized the need for physical distancing, not social distancing. We need to maintain physical distance, while staying connected socially. Through the internet and telephones, we can do this more easily than ever before. Call your loved ones, make time to attend to them, while maintaining six feet of distance.

#4 Connect With Presence

It is astounding how much the world has changed over the past weeks and months. Just two months ago, everything still seemed like it has always been. And you might even find yourself longing for the days when you could mindlessly scratch your nose, and carelessly shake hands. Naturally this is no longer possible. And it is unclear how long this last, and how much longer we will need to continue to adapt to Corona.

Right now it’s easy to wander off with your mind – to romanticize the past, or to paint grim pictures of the future. And when you caught yourself wandering like this, make sure to gently guide yourself back. You are needed right here and right now. Life is happening right in front of you, and the better you can attend to your life right now, the better off you – and everyone you come in contact with – will be. Ground yourself in the presence, and gently guide yourself back whenever your mind has wandered off.

#5 Connect With Values

The Corona situation has forced us all to restructure our days. The morning coffee at McDonalds? No longer possible. The daily commute to work? Not a good idea with public transportation. In short, a big chunk of our lives is out of order, and many of our habits that once filled us with pleasure and meaning are suddenly no longer an option.

This creates a problem. Many people can no longer do what is truly important to them, and for some, it is like taking their purpose, their lifeblood. In this stressful time, it is crucial that we reconnect with our goals and values, and with whatever lies closest to our hearts. Again, there are many techniques to do this, my favorite you can find here.

#6 Connect With Action

Many people have now more free time than ever before, because they are working less, and spend less time visiting their friends and family. Naturally, this opens a big window to finally do the things we always wanted to do, but never quite found the time for. And yet, most people do not tackle their goals.

Instead, they resort to just functioning, going through the motions, and continue putting things off. There is no strict schedule that they would need to stick to, and no colleague or friend to hold them accountable. And so a day in pyjamas on the couch it is.

I get it. It’s hard. And this is exactly why we need to create accountability by choice and start taking action. Move towards your goals in tiny, small steps – bit by bit. This is not just about achieving a specific outcome, but merely taking steps with purpose can do wonders for our sense of competence and self-efficacy. Corona is posing a challenge to us all, and we can come out stronger than ever if we are willing to show up as whole human beings, connected to our feelings and to others, focused on the now and the possibilities it contains for values-based action, and then moving forward in a way that reflects who and how we want to be.

 

Psychological War — DSM (Defeating Stigma Mindfully)

Times have really changed during the last couple of months. Countries all over the world are battling a viral pandemic that is not only affecting the human body, but the mind as well. The virus is causing great damage to not only the elderly but young folks with no comorbidities. More hospitals in the U.S. and Italy are seeing younger people being admitted and even intubated! This virus is causing panic and skyrocketing anxiety levels; it has become a psychological war.

via Psychological War — DSM (Defeating Stigma Mindfully)