Will coronavirus trigger a spike in Obsessive Compulsive Disorder?

As coronavirus continues, parents face the challenge of making sure children take protective actions, while also ensuring we don’t generate anxiety that causes long-term harm, writes Dr Judith Locke.

A reader sent in a request for me to write a little about Obsessive Compulsive Disorder

(OCD).

She was concerned that all of the talk about cleanliness and social isolation during

COVID-19 might make children more at risk of getting OCD.

It’s an important consideration. We have to make sure children continue to do protective actions, such as keeping sufficient distance from others and washing their hands regularly. But we also have to make sure we don’t generate enough anxiety in children that cause them to become preoccupied with avoiding germs.

OCD is an anxiety disorder that has two elements – obsessions and compulsions. Obsessions are intrusive and repetitive thoughts that generate anxiety in people on topics of safety, such as a fear of sickness or disaster. These thoughts are extreme, much greater than the situation demands, and often centring around fear of their actions causing themselves or other people harm.

These anxieties cause intense discomfort in them, to the point that they feel to need to do something to reduce that anxiety. This is where the compulsions come in.

We have to make sure children continue to keep sufficient distance from others and wash their hands, but we also have to make sure we don’t generate anxiety. Picture: Istock

When anxious thoughts overcome them, they will perform some type of ritual, such as washing their hands for two minutes or getting out of bed to check that the oven is turned off. These activities make them feel temporarily safer and better.

While this all doesn’t sound too terrible, the problem with OCD is that the relief from these rituals is very short-lived. The anxious thoughts might come back via new doubt, ‘Did I wash all of the germs off?’ or ‘Was the oven really off?’ This doubt makes the person perform the ritual repeatedly to the point where they are washing their hands 10 times an hour, or not using the oven for fear of leaving it on. Over time, OCD activity can easily take over their lives.

Sometimes the rituals aren’t really obviously related to the fear, a little like a sportsperson’s belief that wearing a lucky pair of socks will help them win the game.

Some children with OCD will become convinced that perfect order in their bedroom or turning off the light and only walking three steps to bed will make everyone in their house safe.

the problem with OCD is that the relief from these rituals is very short-lived, says Dr Judith Locke. Picture: Jamie Hanson

The key element is that the rituals themselves are not necessarily pleasant. So, your child wanting to eat four chocolate biscuits for dessert each night would not be an OCD ritual, but them having to thoroughly tidy their room every day to the point they don’t want to do

pleasant things such as playing games, would be considered potentially OCD.

It is easy to get a little obsessive or compulsive when stressed or nervous. Preparation for a job interview might involve fixation with relatively unimportant elements such as styling one’s hair exactly right or purchasing a new ‘perfect’ suit. Minor things like this are not really a problem, indeed it is likely that right now readers might be adding a few new routines to their day to feel in control of the current situation.

The key element in a diagnosis of OCD is that although the obsessions and compulsions interfere with the quality of a person’s life, they keep doing them regardless. They might excessively seek reassurance from others, by asking the same question (e.g. child asking parents if they will get sick) over and over. Or they may do essentially helpful activities but much more often than needed, to the point where it’s overkill and potentially harmful.

The key element of OCD is that although the obsessions and compulsions interfere with the quality of a person’s life, they keep doing them regardless. Picture: iStock

The good news is there’s effective treatment for OCD. Cognitive Behavioural Therapy (CBT), delivered by a psychologist, can turn around your child’s behaviours. Find qualified help at the Australian Psychological Society’s Find a Psychologist service.

OCD is a terrible burden: don’t leave it too late to get them the help they need. The takeaway for parents is that we want children to be alert but not alarmed. Here are some ideas.

 When discussing safety behaviours, make sure you don’t invoke extreme warnings, such as possible death if they don’t do it properly.

 Keep the routines as simple as possible – such as only 20 seconds of handwashing as soon as they get home.

 Try not to be too perfectionistic with them. For example, insisting they use very neat handwriting to turn in flawless work will imply that mistakes and mess can be catastrophic.

 Allow them to experience the joys of dirt – even now. Playing in the backyard, gardening, splashing in puddles, and sandpit play are all good ways for them to be less obsessed with remaining clean.

Dr Judith Locke is a parenting expert and columnist.

Originally published as Will coronavirus trigger a spike in Obsessive Compulsive Disorder?