OCD is a debilitating condition that affects around 3% of people in some form. Most stereotypically it is described as people checking doors and windows and repeatedly washing their hands. However, the condition is far more complicated and wide ranging than that, as anyone suffering from OCD will testify. In this article we look at how OCD differs from Generalised Anxiety Disorder, why it is likely to have been aggravated by the current ‘lockdown’ situation and ways that sufferers can take back some control over this often all-consuming condition.


Are your symptoms worse in lockdown?


OCD is one of many ways that humans respond to stress levels that are higher than they can cope with. Often the ritual behaviours or repetitive thoughts are a way to gain control over situations that feel out of control. This current period of social distancing and general uncertainty over Covid-19 is unprecedented. It is only natural that we should feel as if we have little or no control over what’s happening. And it is therefore not surprising that we should respond with activities that increase that sense of control. For people who already have existing OCD tendencies, it is likely to see an increase in those behaviours.

In addition to the current uncertainty, there is an obvious theme of germs and contagion. The constant news feed surrounding new infections is clearly going to raise stress levels around germs and cleanliness. In this climate, people who have cleaning obsessions are likely to see an increase in their compulsion to clean.

There is an additional aspect of lockdown which may not be as obvious a factor in aggravating OCD. One of the triggers that affects resurgence of OCD behaviours is our emotional needs not being met well in balance. Lack of social community and lack of privacy are just two needs that currently are likely to be poorly met. This can result in our emotional levels rising, anxiety, poor sleep and irrational thoughts and behaviours. And if you already suffer from OCD this is likely to make life very miserable indeed.



How does OCD differ from Generalised Anxiety Disorder?


For people suffering with Generalised Anxiety Disorder (GAD) the fears are very often based in rational thought, even if they are not highly probable. For example, what if I lose my job, what if I get ill, what if I’m in a car accident? Obsessions are very frequently quite irrational, and this is what makes it so difficult to cope with. The sufferer knows that these thoughts are not rational, but when triggered they are put into a trance state. And in the same way that we don’t question our dream scenarios when in the REM state, a sufferer in the trance state induced by the repetitive thoughts accepts the possibility of what would ordinarily be completely irrational thoughts. When not in that trance state it is frustrating to view those same thoughts and know that they are irrational.

Another aspect that differs from GAD is that the fears are often extremely specific and those fears garner excessive attention. But in other more general areas the sufferer may feel quite calm and rational.

But the most distinctive feature of OCD is having a compulsion to do something (or not do something). This may take the form of checking or cleaning, endlessly replaying conversations or reciting a mantra or special phrase. And these compulsions, whilst often causing anxiety, make OCD very different from generalised anxiety, and should be treated as such.



OCD caused by trauma


Sometimes there is trauma at the root cause of an OCD behaviour. For example when someone is unfortunate enough to be burgled, it can instigate checking routines like checking doors and windows. Sometimes these compulsions remain long after the initial trauma that caused them. This example makes sense and is an understandable reaction to the incident, even if it is extreme.

However, sometimes the connection between the compulsion and an initial trauma is less obvious. A mum may have a compulsion to keep remaking the bed so that her son doesn’t have an accident at school. Whilst this seems to bear no relation and is not a rational action, in her emotional brain there’s a link. A pattern will have been laid down in the amygdala, the part of the brain that keeps us safe. This pattern is made stronger by the repetition of the ritual which strengthens the connection each time it is done. If trauma is the cause of the behaviour it would be wise to get specialised help dealing with your OCD.

Dwelling on our thoughts

It should be said that not all OCD has a basis in trauma. Occasionally a fleeting thought can take hold in someone’s mind and they find it impossible to dismiss it. Dwelling on them and worrying about them inevitably makes them come to mind again and again. They become harder to ignore and eventually rituals can be generated as a means to compensate for the thoughts. Knowing that the ritual is irrational doesn’t in any way help to stop the sufferer needing to carry them out.



Why getting our needs met can help to get OCD tendencies under control


Most sufferers of OCD will be well aware that their symptoms tend to worsen at times of stress or anxiety. When we are stressed we are often not aware of what is at the root of it. We all have basic emotional needs that need to be met in healthy ways in order to be mentally well. Therefore, when several of these needs are somewhat compromised or even if one need is badly affected we will suffer. As a result emotional levels in the brain rise, our anxiety increases and sleep is likely to be affected. This means that we’ll be more likely to react to situations, and be less rational in our thoughts.

Test your emotional needs

Checking the health of your emotional needs is a handy way to assess how the current situation is affecting you. You can download an Emotional Needs Audit here and check out how life right now is meeting your needs.

If you find that control is scored low, then look for ways to consciously take back some control. This may be taking steps to combat financial worries, by contacting banks and mortgage companies and making arrangements to help. Perhaps take the opportunity to organise paperwork or storage. Doing these things consciously will help to calm the unconscious need to carry out cleaning or checking rituals.

If privacy or community needs are scored low, look for ways that you can increase them. You may need to explain to the people in your household that you (and they) need some time alone. This is not personal, but is a necessity for all of us. We also need to feel connected. So make sure that you call at least one friend or family member every day and have some social interaction.

Try to address your need for meaning and purpose by learning something new. This needn’t be something worthy or highbrow, just anything that interests you that you find absorbing. Our brains love to learn new information and reward us with uplifting endorphins when they do!


How can I help myself?


Checking out how you are doing emotionally is a great place to start. This helps you to see where your weak spots are. Don’t forget when our needs aren’t being met well our stress response increases and emotional levels rise. But in addition to this there are a few ways in which you can help yourself to reduce and control your OCD tendencies.

When we are stressed, our emotional brains are much more active than our rational brains. Imagine a pot that is being added to during the day and that at a certain point will boil over. So each time something triggers an emotional response that pot gets added to. Bearing that in mind, anything that can lower those levels during the day means that you have more chance of the pot not boiling over.


So, this first suggestion is a preventative rather than a cure. This is a simple breathing technique which lowers the emotional arousal levels in the brain (stopping the pot boiling over). The 7/11 breathing technique works on the basis that by breathing out for longer than you breathe in and concentrating only on the count, it stimulates our parasympathetic
nervous system which is our relax and calm response. This sends a message to our whole body and brain to calm down. See the full explanation here.


We all have an observing self as part of our natural resources. This is the part of us that is able to step back and look at a situation as if it were separate to us. With OCD it is helpful in being able to separate the compulsion to do something from ourselves. In other words, we can then recognise that the OCD is not part of who we are. It is something outside of us, separate, but affecting our life in the most unwelcome of ways. In this way it is easier to separate out an OCD thought from a normal thought. This is a vital part of recognising when the OCD is in charge and when our brain is functioning normally. Just having that conscious understanding is very helpful in sorting between rational and non-rational thoughts.


Ideally it would be good to stay in that observing self as much as possible. In this way you can observe the OCD and keep it separate and distant. When you become aware that OCD thoughts are intruding, it’s useful to have a distraction to pull you away from the thoughts and calm yourself down. A great tactic is to replace the problematic behaviour or ritual with less problematic ones. Prepare these in advance so that you can switch into them automatically when needed. These harmless rituals can be anything; aerobic activity (particularly good for getting us out of emotional brain); listening to music; calling a friend; Anything that you can immediately engage with as a distraction from carrying out the OCD ritual, and calm down.

As you learn to avoid or minimise carrying out the rituals, a feedback mechanism is set up from the environment. The emotional part of the brain ruled by the OCD is informed repeatedly that despite not carrying out the compulsions, the feared consequences are not happening. Once enough of this feedback is received the OCD thought can be switched off permanently.


Working with our brain and our resources


By understanding what area of our brain is controlling the OCD we can find ways to calm it down. Anything that stimulates our rational thinking brain will help you to switch out of that emotional headspace. Try the above breathing technique, or do some mental arithmetic. Use your natural resource of your observing self to view the OCD objectively. Consequently, once you are able to recognise the unwelcome, intrusive thoughts, you can distract yourself with new more beneficial rituals and begin to break the cycle of the compulsions.

I hope this has been helpful and as ever if you know someone who would benefit from understanding a little more about OCD then please share. And for more in-depth information head on over to our website.

With my very best wishes


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