Living with OCD is never easy for anyone. Just the anxiety, the nervousness, and the frustration it can breed inside an individual are enough to drive him over the edge. Add to it the uncertainty of the current times, the perfection required for maintaining the spread of the virus, and the trauma of knowing how big the pandemic is, and you have the perfect recipe for a mental health fiasco.  

What is OCD? It can be identified by the presence of either obsessions or compulsions in an individual but mostly both. An obsession can be defined as an unwanted invasive thought, image, or urge that repeatedly flashes in the person’s mind. Compulsions can be defined as the repetitive behaviors or actions that the person feels mentally forced to perform. 

A compulsion can either be overt and observable by others, such as checking that a door is locked, or a covert mental act that cannot be observed, such as repeating a certain phrase in one’s mind. The symptoms can cause significant functional impairment and/or distress.

For an OCD patient, and those cohabiting with him, living with the simplistic compulsions during the normal day is stressful. For instance repetitive behavior such as checking appliances or locks, repeatedly washing hands because you never really feel clean enough or mental acts such as counting and re-counting something are the anxieties an OCD person struggles with. As a treatment, therapists advise OCD patients to try and break out of their compulsive habits consciously…for example if you get the urge to wash your hands, don’t do it immediately. But the dilemma during COVID is exactly the opposite…imagine doctors tell us to wash hands and that too frequently and the news saying that hygiene is of utmost importance right now! This just aggravates the misery of the OCD patient.

And if a health professional also has OCD, then it can be severely traumatic for him knowing that he is encountering patients who can be virus carriers and that he needs to keep himself clean to protect himself. This may result in common obsessional themes such as;

- Extreme and unrealistic concerns about contamination and the dire need for cleanliness: If the patient touched the desk, or whether the door-knob has been sanitized enough?
-Sense of guilt: the health care workers with OCD might feel that it is their responsibility to keep things clean and orderly because if things are contaminated or unclean they might be the reason for the spread of the virus. 

 - Repeated and excessive doubts

- Being disturbed if the things are not the way they want: Be it something as simple as keeping the bedsheets/ masks in a certain way or serving the food to the patients in a particular manner and with the COVID concern of the need to be perfectly sanitized, the OCD workers might never feel stress-free of relaxed enough. If the events don’t happen in the way they want them to, they might encounter intense distress or distractions that are unimaginable for a normal person. 

- Ignoring the thoughts/actions to avoid responsibility issues: Many times the people with OCD try and ignore the invasive thoughts, images, or impulses. They try to counteract or block the distressing and repetitive thoughts like for instance; if a healthcare worker has experienced or seen someone die of the virus they might try to ignore all the things that the person thought might be the reason for the patient’s death. They might even avoid going to the room or the bed the patient died in and associate anyone who took the bed to be struggling with the death due to the virus. Even though these thoughts seem unrealistic, those people cannot help but think or react to these images in the way they do.

- Finishing work within timelines: With the ceaseless flow of patients being admitted and the increasing number in the deaths due to the virus, the OCD suffering health care workers might feel that they have to finish their tasks within the informed timeline else they might develop anxiety and the feelings of not being in control of the situation. For instance; a 5-minute delay in having the lunch served or medicine check might make them feel distressed and kick in anxiety. 

- They want to be perfect and suffer from hyper responsibility: OCD sometimes might even make the health care professionals feel that they must always be perfect and do things perfectly, be it the smallest of interactions they might have with the patients. They also deal with hyper responsibility wherein, they feel that they are responsible to save the patients from the virus. They feel responsible to make others feel better even during the epidemic times. If things don’t happen that way they might feel worthless and agonized by their incapability to make things right.

- Decision making becomes difficult: Many times the health care professionals struggling with OCD might think that if they take any decision it might lead to a negative outcome. Hence, they might try and avoid making any decisions. And in serious conditions, this might also lead to delayed actions or incorrect actions for patients leading to serious consequences. In order to avoid these tortuous responses, they may be tempted to push the wheel to someone else, always.

With such excruciating situations occurring due to the virus outbreak, how does one manage the OCD in health care workers?

- Make a safety plan: Creating and managing a safety plan based on rational judgments might help the workers while carrying out their tasks. Maintaining stringent timetables of even the simplest things and pointers for e.g. how much sanitizing is enough to be perfectly sanitized, what is the time frame for checking the medication for the patients, how often do they need to check the patient’s during the day will help. Sticking to this time table and ticking it off for the completed tasks might make things easy for the healthcare workers.

- Seek help: It is better to accept the problem and seek help from a colleague or a therapist as soon as possible. They might be able to help you with rationalizing and sticking to this safety plant. Therapists might also give additional techniques to counter the OCD phase or anxiety whenever they occur. 

- Focus on self-care: OCD can be exhausting and following the safety, a plan might also feel extremely tiresome. This can be managed by carrying out enough breathing techniques, physical exercise, and taking medication if prescribed by the therapist to avoid hyper actions or panicky episodes at hospitals.

- Accept and open up: Accepting reality and opening up about it is the most difficult yet the best way to encountering the problem. Talking about it to someone who understands will. By seeking help one might also feel relaxed a bit and while telling about the unrealistic beliefs they might even realize the unnecessary burden they have taken upon themselves. The professionals might help in resolving the problem sooner as it would be needed in the pandemic circumstances.