One of the hallmarks of obsessive-compulsive disorder is contamination fears and excessive hand-washing. Years ago, a patient with severe OCD came to my office wearing gloves and a mask and refused to sit on any of the “contaminated” chairs. Now, these same behaviors are accepted and even encouraged to keep everyone healthy.


Only a few months ago, this type of behavior would have been considered excessive and certainly not healthy.


So, where do doctors draw the line between vigilance to avoid being infected with the coronavirus and obsessive-compulsive disorder that can be harmful?


This is an important question that I, a psychiatrist, and my co-author, a wellness and parenting coach, often hear.


Adaptation or internet addiction?


During the pandemic, however, society has quickly adapted online opportunities. Whenever possible, people are working from home, attending school online and socializing through online book clubs. Even certain health care needs are increasingly being met remotely through telehealth and telemedicine.


Is it obsessive-compulsive or protective?


While COVID-19-era behaviors may look like clinical OCD, there are key distinctions between protective behaviors in the face of a clear and present danger like a pandemic and a clinical diagnosis of OCD.


The repetitive, ritualistic thoughts, ideas and behaviors seen in clinical OCD are very time-consuming for people dealing with them, and they significantly interfere with several important areas of the person’s life, including work, school and social interactions.


Some people have obsessive-compulsive traits that are less severe. These traits are often observed in high-achieving people. Such “keep the eye on the prize” behaviors are recognized in nearly 20% of the population. A talented chef who is very attentive to detail may be referred to as “obsessive-compulsive.” So may a detail-oriented engineer building a bridge or an accountant examining files from many different angles.


The critical difference is that the persistent, repetitive, ritualistic thoughts, ideas and behaviors seen in those suffering from clinical OCD often take over the person’s life.


A person with OCD never gets the “all clear” signal. It is not uncommon for a person with OCD to spend several hours per day washing their hands to the point their skin becomes cracked and bleeds. Some people with OCD have checking rituals that prevent them from ever leaving their home.


OCD triggers have become harder to avoid


For those who struggle with compulsive use of the internet and social media, the new, increased demands to use digital platforms for work, school, grocery shopping and extracurricular activities can open the black hole even further.


People with pre-pandemic contamination fears find trigger situations that were once avoidable have now become even more ubiquitous.


As new behavioral norms evolve due to the changing social conditions, the way that certain behaviors are identified and described may also evolve. Expressions such as being “so OCD” or “addicted to the internet” may take on different meanings as frequent hand-washing and online communication become common.


For those of us adapting to our new normal, it is important to recognize that it is healthy to follow new guidelines for social distancing, washing hands and wearing masks, and that it is OK to spend extra time on the internet or other social media with the new limits on personal interactions. However, if internet use or hand-washing becomes uncontrollable or “compulsive,” or if intrusive “obsessive” thoughts about cleanliness and infection become problematic, it’s time to seek help from a mental health professional.