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Obsession Or Just Good Hygiene? Keeping The Coronavirus And OCD At Bay

Keith Negley for NPR

When I was 8 years old, just about all I could think of was how I was going to die that day.

No, I didn't grow up in the middle of a war zone, though many others on the other side of the world were living through that kind of nightmare in 1996.

I was born and raised in a safe, small town in Idaho where murder was a rarity. It wouldn't be a gun, a child predator, or a car accident that killed me, I figured.

Instead, because I had a significant form of anxiety that neither I nor my parents recognized at the time — obsessive compulsive disorder — I was convinced that some kind of microscopic creature would be absorbed through my hands and infect every living cell in my body. Maybe it would be bacteria, I thought, or parasites. Or a virus.

That pencil I borrowed from my second-grade classmate? It had to be totally infested. The handle on the drinking fountain? Crawling with germs.

When I took out the trash or cleaned our cat's litter box, my mind raced to strategize which hand I would use to turn on every light switch, open and close each door and carefully lift the lid on the garbage can to minimize my exposure to any kind of contamination.

I got good at using my feet, elbows and any other part of my body that lacked opposable thumbs to avoid touching what I deemed to be the life-threatening surfaces of everyday objects.

Now, 23 years later, those skills that only the most generous would have called "eccentric" in pre-pandemic times are actually useful as I try to keep myself and my immunocompromised housemate — my girlfriend — safe.

I worry that, to my girlfriend, I look like a frazzled conspiracy theorist — as though I'm tracking links and clues on a corkboard filled with pins and ribbons, meticulously tracing every step.

But those skills come at a cost as I try to balance the need to frequently sanitize our home with the need to keep anxiety-driven compulsion at bay.

One in 40 adults and 1 in 100 children in the United States cope with OCD on a daily basis, according to the National Institutes of Mental Health

There are different flavors of OCD with different degrees and different types of obsessions and compulsions, including what people may have seen on the A&E TV show Hoarders. Those who militantly organize their surroundings also might have a touch of it.

One of my symptoms has always been an extreme and focused aversion to contamination, a characteristic I share with an estimated 40% of those who develop OCD, according to Dr. Elias Aboujaoude, a psychiatrist and director of Stanford University's OCD clinic.

As a child, touching anything I thought was covered with germs canceled out the use of that hand until I had a chance to scour it with soap and water. Until then I would hold my hand as far as possible from my torso.

If I didn't perfectly perform these draconian mental gymnastics, I knew — without a doubt — I was going to die. Maybe not immediately, but probably within a day or two, I thought.

Logic, which seems like it would be the panacea for irrational fears, is actually cruelly twisted back at you with OCD. No matter how much you reassure yourself that the hellscape you dreamed up in your head isn't real, the condition amplifies your fears until you perform whatever fantastic ritual you've created for yourself to alleviate the anxiety.

By the time I turned 9 — with cognitive behavioral therapy, persistent practice, as well as a lot of patience and support from my parents — I learned to accept the invasive, persistent thoughts for what they were. Just thoughts. Medication also helps cut my base-level anxiety, and it limits the scope of an occasional panic attack.

Today, my OCD is classified as mild to moderate, which means I'm not crippled by anxiety, at least most of the time.

I haven't had a major contamination relapse since 2008 when I was in college. I was convinced for months back then that I needed to always keep whatever food I ate or drank within sight, because I thought it would magically be dosed with LSD. Let's be real, no one would be that generous with their stash.

(That episode ended after I finally got the help of a new therapist after not having seen one for more than a decade).

It's not uncommon for people with well-controlled OCD to experience a small lapse in compulsive behaviors when under great pressureor stress, psychiatrists find, though for many people, full-blown relapses are, as in my case, rare after successful treatment.

Still, the pandemic has been challenging for a lot of us.

Cases of COVID-19 began to spring up in Idaho, where I live, in mid-March. Since then, thousands more cases have appeared.

As we learned the details of how some patients died — alone, gasping for air, choking on fluid that fills their lungs like a lock system in a dam — I could feel my anxiety rise.

I've been lucky enough to be able to work from home. But I'm suddenly finding my cleaning regimen taking up a not-so-insignificant part of my day.

In the home I share with my girlfriend, I take every precaution I can to maintain a contamination-free zone in the house, just as CDC guidelines recommend, though sometimes I go a little overboard.

High-touch objects such as door knobs, light switches, remotes, faucets and countertops are all disinfected multiple times per day. When a package gets delivered, I handle it like a live grenade. It, too, must be zapped of any trace of this disease that could sneak into our house.

I know where every object in this house has been, whether I've touched it with a finger that has grazed a doorknob that was nicked by the grocery bags that were left on our doorstep, and whether I've recently doused that surface with rubbing alcohol to kill any possible trace of the coronavirus that might have crept in while I wasn't paying attention.

If the gallon and a half of hand soap doesn't run out first, the hand lotion will.

I worry that, to my girlfriend, I look like a frazzled conspiracy theorist — as though I'm tracking links and clues on a corkboard filled with pins and ribbons, meticulously tracing every step.

That's not how she sees me, she says. But for her own mental health, she has been leaving the cleaning up to me.

It's stressful for her, too. She knows I don't trust her to decontaminate any delivery or package we receive (and I feel guilty admitting that's true).

While her mind is consumed with concern over the rising global death toll and whether there's any end in sight, my mind is also managing dozens of little internal clocks ticking down the hours, minutes and seconds until every microbe will die on the mail pile or on the cloth seat in my car.

There's a thin line between being hypervigilant and succumbing to my deeper obsessions and compulsions — so far I've managed to stay on the right side of that line.

My therapist, who will tell me if I've crossed it, is still accessible by video call, thankfully. I've taken up exercising on our back porch to burn off some of my anxious energy, and that helps.

I've planted my garden full of lettuce, spinach, arugula, fancy purple carrots and radishes. Smelling the rich soil and seeing the vibrant colors of my vegetables transports me away from the day's news and body count.

Heading back inside, I'll think about how delicious all these things I've grown will be to eat in a month or two. But sometimes another thought breaks through, with a slight sense of dread: "Did I wash my hands?"

James Dawson is writer and reporter for Boise Public Radio.

Copyright 2020 Boise State Public Radio News

James Dawson joined Boise State Public Radio as the organization's News Director in 2017. He oversees the station's award-winning news department. Most recently, he covered state politics and government for Delaware Public Media since the station first began broadcasting in 2012 as the country's newest NPR affiliate. Those reports spanned two governors, three sessions of the Delaware General Assembly, and three consequential elections. His work has been featured on All Things Considered and NPR's newscast division. An Idaho native from north of the time zone bridge, James previously served as the public affairs reporter and interim news director for the commercial radio network Inland Northwest Broadcasting. His reporting experience included state and local government, arts and culture, crime, and agriculture. He's a proud University of Idaho graduate with a bachelor's degree in Broadcasting and Digital Media. When he's not in the office, you can find James fly fishing, buffing up on his photography or watching the Seattle Mariners' latest rebuilding season.