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.

强迫症的特征之一是对脏东西的恐惧和过度的洗手。几年前，一位严重的强迫症患者戴着手套和口罩来我的办公室，并且拒绝坐在任何“脏”椅子上。现在，人们接受甚至鼓励这种行为，为了让每个人都保持健康。


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

就在几个月前，这种行为还会被认为是过度的，当然也是不健康的。

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

那么，医生如何在为避免感染冠状病毒而保持的警戒和可能有害的强迫症之间划清界限呢？

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

这是我（一个精神病学家）和我的合著者（一个健康和育儿教练）经常听到的一个重要问题。

Adaptation or internet addiction?

（适应还是网瘾？）



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.

然而，在疫情期间，社会迅速适应了在线上做各种事。只要有可能，人们就在家办公、在线上学、通过线上读书俱乐部进行社交活动，甚至某些保健需求也越来越多地通过远程医疗得到远程满足。


Is it obsessive-compulsive or protective?

（强迫症还是保护性行为）

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.

虽然COVID-19时代的行为可能看起来像临床强迫症，但在面对像疫情这样明确而现实的危险时采取的保护性行为与临床诊断出的强迫症之间还是存在关键区别的。

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.

临床强迫症患者重复的、仪式化的想法和行为非常耗费时间，而且会严重影响患者个人生活的几个重要方面，包括工作、上学和社会交往。

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.

有些人有不那么严重的强迫性特征，这些特征通常在成功人士身上观察到，近20%的人有种“盯着细节”的行为。一个非常注重细节的天才厨师可能会被称为“强迫症”。一个注重细节的桥梁建造工程师，或者一个从许多不同的角度检查文件的会计，也可能被称为“强迫症”。

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.

关键的区别在于，临床强迫症患者身上出现的持续的、重复的、仪式化的想法和行为往往会掌控患者的生活。


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.

强迫症患者每天花几个小时洗手，直到皮肤破裂出血。有些强迫症患者有检查的习惯，这使他们无法离开家。

OCD triggers have become harder to avoid

（强迫症的诱因越来越难以避免）



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.

对于那些强迫性使用互联网和社交媒体的人来说，在工作、上学、购物和业余活动中使用数字平台的新需求增加，可能会进一步打开这个黑洞。

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

对疫情发生前的脏东西感到恐惧的人，发现曾经可以避免的诱因现在变得更加无处不在。

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.

由于社会条件的变化，新的行为规范不断发展，确定和描述某些行为的方式也在不断发展。随着频繁洗手和网络交流的普及，“强迫症”或“上网成瘾”等表达可能会有不同的含义。

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.

对于我们这些正在适应新常态的人来说，重要的是要认识到：遵循关于社交距离、洗手和戴口罩的新指南是有益健康的；在对人们相互交流的新限制下，可以多花点时间在网络或其他社交媒体上。然而，如果上网或洗手变得无法控制或是“强迫性”的，或者可能对清洁和感染有侵入性的“强迫性”想法，那就是时候向心理健康专家寻求帮助了。