At the start of the pandemic, I first dismissed my increasing concern for hygiene and order as a regular, healthy response to the heightened risk of disease. However, with time, the symptoms reached beyond handwashing and started to include excessive counting, organizing, other ritualistic behaviors and intrusive thoughts. As someone who struggled with mild Obsessive Compulsive Disorder (OCD) in the past and thought my condition was gone for good, seeing my habits re-emerge during the pandemic feels like a significant setback.

In the past few months, many people have become more cautious and thorough when it comes to the cleanliness of their hands and the surfaces around them. During a pandemic, this is a perfectly normal and even prudent response, especially since such behaviors do actually help prevent the coronavirus from entering the body. As a result, some people who usually do not think twice about how clean their hands are, at any given moment, are experiencing a certain hypersensitivity.

“I wash my hands so often now, I’m so OCD,” some may state. Such remarks only add to the trivialization of the already stigmatized and often misinterpreted condition. OCD is something one has and not is, and it is definitely not something one qualifies for by simply following hygiene recommendations during a global pandemic.

OCD is a disorder characterized by intrusive, often recurring thoughts — obsessions — and compulsions, often used to diminish the anxiety the obsessions bring about. A higher level of awareness of hand hygiene, sometimes accompanied by the feeling that one’s hands are nearly always dirty, is a common symptom of OCD patients. According to researchers from the German Society for Obsessive-Compulsive Disorders, people who previously struggled with compulsive hand washing have experienced a worsening in symptoms or a return of habits they had previously overcome.

However, this is only one side of the struggle, a set of symptoms not shared by all those with the disorder. How has the pandemic affected other potentially less commonly known manifestations of OCD?

The obsessive part of the disorder consists of intrusive thoughts about an array of topics, a common one being the fear of losing control and harming oneself or others. Usually, the process consists of a thought or other trigger, followed by anxiety and some kind of reaction - a compulsion.

With the pandemic in full swing, such thoughts are not limited to the fear of one’s own infection, but can also be manifested as intense concern about other people and loved ones, thereby leading to nervously checking on them every hour. Being far away from my family has been a source of distress since I feel like I cannot control their health and well being. However, I have learned to reduce my urge to constantly ask them how they are doing. For many people with less mild symptoms, doing so is extremely difficult. Sometimes, however, alternative rituals are also created, completely unrelated to the person one hopes to keep safe.

Numbers are important when performing rituals. Although it may appear bizarre and incomprehensible, a common belief in people with this specific manifestation of OCD is that things must be done and said a specific number of times. For example, one type of the family check-in ritual may include doing so a specific number of times every day, maybe even at the very same time. It is key to remember that these compulsions become insufferable because one time is never enough — a ritual brings ease from anxiety for a short period of time, after which thoughts usually return to torment the individual with other obscene or harrowing scenarios.

Between compulsive hygiene or the development of new obsessive rituals, the pandemic can be a huge burden to individuals with OCD, exacerbating symptoms which are often debilitating to begin with. Some compulsions may not make sense to many people, but they help those affected by OCD feel temporarily better. For people not struggling with OCD, it is important to remember that saying “take it easy” or “washing your hands once was enough!” does not cure those who are struggling with it. Gradual progress and distancing from unhealthy coping mechanisms is essential to OCD recovery, but it does not happen overnight. To all those affected — a setback is not something to be ashamed of, especially in these circumstances.