My head was on my pillow, and my eyes were drifting closed. All of a sudden they snapped open again. Is the door locked? I pulled myself out of bed one more time and stumbled out of my bedroom and to the door of our dorm. The door looked locked. I touched the doorknob just in case. I turned around to go back to bed. I turned around again and checked the doorknob one more time, pulling it for good measure. I turned around. Sighed. And checked one more time.
It was in my second year as an RA in college that I realized I might have obsessive-compulsive disorder (OCD).
A lot of people think of OCD as obsessive hand-washing and meticulous cleanliness, and for some people it does manifest that way. For others, like me, our exterior lives are often a mess (my bedroom floor does not scream OCD!), and our personal lives may appear pulled together, while from a mental health standpoint we’re struggling with intrusive thoughts and compulsions.
Will a small choice on my part lead to terrible consequences? How can I possibly choose the right thing to do in so much uncertainty? These are questions a person with OCD wrestles with regularly.
As we navigate a global crisis, I’ve seen people dealing with these very questions, questions that I’m deeply familiar with because of my experience with OCD. While, of course, this time exacerbates my OCD in some respects (as any time of anxiety would), I’ve been surprised by how much my experience facing these questions about risk and uncertainty has helped me in the current crisis. And I’ve begun to think that my experience might be of use to others as well, whether they’re actively dealing with mental health issues or just trying to live a normal life amidst a pandemic.
For me, growing through OCD gave me a chance to think about my relationship with fear. Now that we find ourselves in a time that is full of fear for many people, I’ve looked at the world around me and seen people coping with fear in different ways. While some of these ways are very healthy, some of them remind me of my days deep in the throes of OCD.
As a note, if you’re actively struggling with OCD, or if you’ve never thought about it but what I’ve said so far speaks to you, consider whether this piece is a good read for you at this moment, or if it might be better to reach out to a mental health professional. I’m writing this piece as someone who struggled with OCD in the past, and I know that the details of my experience (especially naming specific intrusive thoughts) might introduce new problems for someone who is currently struggling with OCD symptoms. Don’t hesitate to seek out a trusted therapist and return to this piece later when you’re in a better mental place!
OCD for beginners
To understand why the COVID-19 pandemic has reminded me of my OCD journey, it’s important to briefly explain how OCD manifests itself.
Obsessive-compulsive disorder involves two basic components: obsessions and compulsions. The two symptoms are related, but different. An obsessive thought sometimes takes the form of a disturbing but irrational idea, like, “What if I ran someone over in the road without realizing it?”
While everyone’s brains experience similar thoughts at times, the OCD mind has a much harder time letting these thoughts go. Basically, a person with OCD is horrified by the presence of the thought and continues returning to the thought in an attempt to make it go away. Of course, that just intensifies the recurring thought—just like when someone tells you not to think about a pink elephant and all you can think about is a pink elephant. The obsessive thought comes back over and over again, often over a span of weeks, months, or years, and the extreme distress that it causes the person just serves to solidify the thought in her mind.
Compulsions go hand in hand with obsessive thoughts, but they’re actually a different symptom. A compulsion often, in fact usually, arises out of a fear that may or may not be an obsessive thought: in my case back in college, “What if my dorm gets broken into?” While these fears may begin on the surface, compulsions work their way deeper and deeper until they aren’t really a conscious choice. The way that they force the person with OCD to act is by giving her a sense that something overwhelmingly bad will happen if she doesn’t follow the compulsion, and they can feel really scary when they are particularly irrational. Of course I didn’t think it was really likely that my dorm would be broken into in that sleepy college town. But knowing that didn’t change the force of my compulsion. It’s not the kind of thing that you can just decide not to do; that’s the nature of the mental illness. You’re overwhelmed by the fear of what might happen if you don’t do the compulsion, even if rationally you know nothing is going to happen. It’s like a voice in your head: “DO THIS, OR YOU ARE DOOMED.”
From obsessive hand-washing to constantly checking whether the stove burners are on, OCD behaviors arise out of fear. For me, the fear was very specific: the fear that I would do something small—even have a bad thought—and it would have catastrophic effects. Having experienced trauma in my life, I felt sure that I must have done something wrong to cause this bad experience. I turned to my own life with a magnifying glass, trying to find where I had gone wrong, and the result was hyper-analyzing every action: if I forgot to turn off my straightener, my dorm might burn down. If I accidentally plagiarized, I might be expelled. If I didn’t lock the door, someone might come in and kill my friends. Having experienced one terrible event, I had lost all of my sense of proportion between my actions and the consequences—because it’s the inescapable truth that sometimes small mistakes do cause catastrophes.
Now think about the ways we’ve been cautioned about the spread of COVID-19. We’ve seen visual simulations about how one sneeze can travel through half a grocery store, how one person can spread the virus to many, many other people just by touching a door handle, and we’ve been reminded time and again that just because you don’t have symptoms doesn’t mean you’re not asymptomatic and unwittingly spreading the disease. There was even an Oregon ad campaign featuring the question “Did you accidentally kill someone today?” which, while no doubt coming from an earnest place, is unwittingly the epitome of the catastrophic thinking people with OCD suffer from every day. Not many people have genuinely asked themselves whether they accidentally killed someone today. I have, and I was not in a good place. Being told that one small mistake can cause catastrophic damage to another person, it’s no wonder many of us are afraid to take a step in the direction of “normal” life.
Before or even after diagnosis, OCD people have a feeling (or get advice) that they should just “snap out of it.” Knowing that their compulsions or obsessions don’t make sense, though, just serves to intensify the distress. It took time spent in therapy and dedication to exercise (yay endorphins!) to help me function in daily life in a normal way, and my case is fairly mild. Thankfully, with professional help and modern medicine, a normal life can be within reach for OCD patients, and one thing that is often helpful is cognitive behavioral therapy (CBT). The basic principle of CBT is becoming an observer of your own thoughts, able to distance yourself from your obsessions or compulsions.
Confronting our fears
The biggest realization I had in the struggle with OCD was a very simple one: there is no way to truly reduce risk to zero. As I observed the way that others that I knew and loved lived their lives, I realized that they didn’t live without any risk; they just didn’t let that risk take over their minds. To borrow the words of Bilbo Baggins, “It’s a dangerous business, Frodo, going out your door.” Every day we get on the freeway or eat food or even close the door behind us without double-checking that no lamp could fall over and set the house on fire, we’re living a life with some level of risk.
The big lie of OCD is that we have to minimize risk as much as humanly possible. But here’s the thing: minimizing risk as much as humanly possible looks like me checking the doorknob over and over. It looks like fitting the house out with bars over the windows and multiple locks on the doors. It looks like never really living, because if we’re honest, we could spend our entire lives in obsessive risk management and still never obliterate risk completely. Even if my house never burns down, I could get in a car accident. Even if I clean my house so industriously that my kids never get so much as the flu, one of them could die of cancer. And living a life ruled by fears means never really living life at all.
Another element of the journey out of OCD is the realization that we aren’t in control. I spent years trying to take control of my life and make sure nothing bad ever happened to me or anyone I loved, but what I learned was that when I try to minimize every possible risk, I can’t handle the pressure. While I know it’s healthy to let go of that control, it’s hard to do, because in my head I’ve become the only one keeping the world from chaos. But when I really step back from that mentality, I realize how warped it is. I’m not in charge, and I wouldn’t want to be! Instead, letting go of my OCD thoughts is giving that control back to a higher power.
As I’ve looked out at the world over the last few weeks, I’ve seen people facing the fears that I have been familiar with for years. The fear that something small we do could cause catastrophe for ourselves or those we love. The fear that we’re not doing enough to minimize risk. The fear that we’ll deal with guilt for the rest of our lives because we didn’t follow this or that compulsion toward total safety.
What I learned from OCD is that it’s not worth it to let your life be ruled by fear. When OCD was my daily reality, I let my fears take over my mind, and they crippled me. Now I’m living a meaningful and fulfilled life that involves a little bit of risk now and then, and striving daily to let my fears go and live confidently.
As we slowly phase back into something that looks more like normal life, it’s going to be scary. I know that I myself am struggling daily with letting my fears go, because it’s so hard to keep a level head in this time of crisis (and I’ve let my endorphin-boosting workouts slip!). But I’m trying to remember that a life lived in fear can’t be the answer. Instead, I am trying to find my way to a life lived in trust.
Of course, we all need to follow the guidelines that are offered for our protection, but for many of us, it’s weighing the prudential decisions—is it really safe to go out yet? What is really going to minimize risk for myself and my family? How will I know when it’s time to make a change?—that will be the real challenge. I don’t pretend to know how we can all answer these questions, but I know that it’s good to approach them from a position of peace and courage. Whether I’m the first person back at church or the last person back at the grocery store, I can still choose not to let my OCD mind take over. I can make choices by weighing truths, not my fears.
The fundamental lesson of these days is that none of us has, or can have, total control. But, thankfully, we're not in control. When you’re battling OCD, life often feels like a series of trust falls—trying to let go of your fears over and over again, sometimes succeeding, sometimes failing. And now in this time of crisis everyone’s having something of the same experience—one giant trust fall, trusting that we’re making informed decisions that are cautious while also allowing ourselves to enjoy the great adventure that is life.
Editor's Note: If you or someone you love is struggling with OCD, contact a licensed therapist, or visit the website of the International OCD Foundation.
Meredith Woods is a pseudonym.