Concerns Versus Compulsions
Published July 2021
The COVID-19 pandemic brought cleanliness and hygiene to the forefront of everyday life. But as you continue to acclimate to a post-vaccine reality, you might begin thinking about which pandemic-time habits you will keep practicing. Even more, you might wonder, "Are these habits healthy?"
In looking at germ- or pandemic-related behavior, it can be helpful to understand immunity and how your body interacts with its environment.
"Immunity is your body's ability to recognize germs and prevent them from causing illness," explains Deeba Masood, MD, an allergy and immunology physician at Northwestern Medicine.
There are two types of immunity:
- Innate immunity is the immune system you are born with. An innate immune response is immediate.
- Adaptive immunity is the protection your body builds over the longer term when it meets and remembers antigens, which are germs and other foreign substances.
"Then there are two types of adaptive immunity," adds Dr. Masood. The first type, active immunity, is when antibodies develop in your immune system after you are exposed to an antigen via a disease or an immunization. This type of immunity lasts for a long time and potentially for life.
Passive immunity is the second type of adaptive immunity. This is when you are given antibodies to a disease instead of producing the antibodies yourself. An example of this is when a mother shares antibodies with their child through breast milk after birth.
Together, these immunities comprise the job of the immune system to help identify and eliminate dangerous germs before they can cause disease or damage in the body.
Crossing the Line
Within the context of immunity, we can understand why the SARS-CoV-2 virus has posed such a threat. As a novel, or new, coronavirus, SARS-CoV-2 was a new antigen to human immune systems. Outside of physical distancing, isolation and rigorous sanitization protocols, we did not have a way to fight it. Not until we had vaccines, that is.
Concern about infection is still valid — we know that the COVID-19 vaccines are not 100% effective, although they are shown to be extremely effective in reducing infection and spread of the disease. However, there is a clear and important distinction between infection concern and obsessive-compulsive behavior related to the fear of germs. It all comes down to time, life interference and distress.
"If a person's behaviors are time-consuming and cause significant distress and life interference, we would say these behaviors are more than a general concern," says Tina L. Boisseau, PhD, a psychologist at Northwestern Medicine. She notes that, typically, "time-consuming" behaviors take up more than one hour in a day.
Along with the pandemic came an expectation for everyone to wash their hands more and adopt other sanitization measures. However, if the safety measures you take are excessive or obsessive given the context of your situation — such as spending hours decontaminating your house — you should talk with your physician.
Treating the Cause
Obsessive-compulsive disorder (OCD) and other anxiety disorders affect many people. If you are struggling with behavioral symptoms related to hygiene, know that you are not alone. There are options for treatment.
"There are very well-established, effective treatments for anxiety and OCD," says Dr. Boisseau. Cognitive behavioral therapy, with a focus on exposure and ritual prevention, and medication are treatments that can be explored together or separately.
If you want to find out which option might be the best for you, discuss your symptoms with your physician.