Relearning Normalcy
In A Tale of Two Cities, Charles Dickens had a very poignant message, “It was the best of times, it was the worst of times…” over the past 10 months most of us probably believe this has just been the worst of times. He went on to write, “…it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of light, it was the season of darkness, it was the spring of hope, it was the winter of despair.” — I suppose if we take a few minutes we can see that we too are living in a parallel universe. One where life still is happening, sometimes faster than we may like, but everything just seems shrouded in doubt. We laugh and enjoy while also struggling to remember what we used to feel as normal. Some tell us that this will truly be the winter of despair, but will it?
I’m going to take you back, and get a little bit vulnerable, but I think it’s important to try and find some pieces we may be missing. After the birth of my first son I went into the abyss a little, well maybe a lot. I have several theories on why it happened to me, but none of those really matter today. Perhaps for another story in the future; but I found myself plunging head first into worry and despair. It almost cost me my marriage, and more than that, my sanity. I felt as if everything around me was unclean, and I needed to create a safe space for the baby to be protected. I would wash my hands constantly and I made everyone who was going to touch the baby do the same. This spiral continued until it was clear I was a victim of Obsessive Compulsive Disorder(OCD).
I ended up having two types: checking and contamination OCD. It started out with contamination and it moved into checking. Obsessive Compulsive Disorder is characterized by the overwhelming and constant feeling that if you don’t do everything right, the way your mind tells you, you will be the cause of great suffering, either your own or that of another. I created, what I believed to be a quite sterile environment for my son and my family. I had to make sure, even in the face of the chaos that is having a newborn, that my kitchen and bathrooms were clean at all times. If I touched something that was what I considered contaminated I would *obsess* over it until it was unbearable in my thoughts, and then to release to pain of those intrusive thoughts I would *compulse* by washing my hands, or cleaning my son’s hands, or giving him a bath. In the beginning most of it was just in my mind, but as it progressed, it was hard to hide. The checking came into play as well, this was a secondary obsession and compulsion and happened closer to when I returned to work. I would check and recheck things like if the stove was off, or if I had locked the door.
It usually went something like this: lock door to the garage, get into the car, strap in baby, open garage and then the thoughts would come creeping in, “did I lock the door?” Get out of the car check the door handle, yep locked, “but did I check the stove and make sure it wasn’t on?” — Go back to car, grab the baby, unlock the door, go again check if the stove was off, then the cycle would repeat all over again. I can’t tell you how many times I would tell myself that I had shut the garage door and would drive a quarter mile away and I couldn’t shake the feeling and obsess that I had left it open, then I would compulse and return home several times to make sure. This caused me a lot of problems because it made me late to everything. Not to mention it made me feel like I was going insane. The compulsive hand washing also took it’s toll. My hands were constantly red, cracked, often bleeding, and in pain.
All of this made life very complicated. My husband tried to understand but it was difficult for him. He looked to groups and support from outside and thought he could help me that way. My mother was very supportive, she knew I was doing it but she would stay positive and eventually would help me greatly to climb slowly out of the hole. The more stress I would have, the more obsession and compulsions would happen. Eventually to calm the crazy I learned that if I would designate safe places I would maintain some semblance of normalcy. So I became a bit agoraphobic. I had designated in my head that my mom’s house and my house were safe and clean. Going to other places was always hard, so I avoided them. I wouldn’t use public restrooms, and I avoided too much social interaction when I didn’t have to.
I knew all along that this was in my head, the trouble was I couldn’t figure out how to get out. The more stressed I would become the worse the obsessive feelings would be, and it would force me to compulsively do the thing that would make the obsession go away, even if only momentarily. It was a vicious cycle. My husband had spoken to professionals about me, this made me angry, because I felt like he was looking to fix me, and I really didn’t believe I was broken, just kinked. So I found solace in reading books on how to get out of the hole I had found myself in. My husband and I had a conversation about a therapist who thought I could be put on some medication to help me get out of this mess, but when you have OCD, you don’t trust a lot of people. If they haven’t been designated as “safe” then you stay away from them because they cause more stress, which leads to more obsessions, and eventually more compulsions. This never ends.
So instead of relying on therapists who I didn’t trust, I read, and read, and read. Not long after my husband had suggested I get on medication, I found a passage in a book I had been reading which said some words that really were the key to me climbing out of the abyss. It read something like this, “psychiatric meds for OCD are like water wings, they can only hold you up, they don’t teach you how to swim,” and it was then that I realized the only way out of this dark place was to relearn how to live. The idea behind the thought was “immersion therapy.” You had to let the obsessions creep in and then wait longer and longer periods of time before you compulsed. Eventually you would learn that the bad thing you thought would happen wouldn’t, and you would relearn how normal people think and behave. This was no easy feat. I said earlier that my mother played an integral role in my healing and she very much did, she was always very patient with me, and unlike so many others in my friend cohort and family who easily exhausted of my issues, she would patiently answer any questions I had. The following was a typical exchange:
ME: “Mom do you think it’s ok that I just touched this?”
MOM: “Yes you will be fine, it’s ok.”
ME: “Are you sure, maybe I should wash my hands and clean his hands because (insert item) might be dirty.”
MOM: “No you will be ok, just try and not think about it.”
This would go on ad nauseum for several minutes. I would ask her questions about food safety, that would be seen as irrational to most, but she would calmly answer that it would be ok, and this reduced my stress and allowed me to relearn normal facets of life. It was almost as if I needed actual permission to do things people generally just do. Writing about it now seems almost silly, but at the time it was the most important thing imaginable. I literally had to relearn how to do the most simple tasks to avoid obsessing over them. I had to push myself. “yes you closed the garage, just keep driving.” Over time everything changed and I settled back into normalcy. I learned to better manage my stress, I took lots of supplements to help my adrenals be less overactive, and I eventually retaught myself how to live.
Now, what exactly does that have to do with present day? Well, unless you have lived in a cave over the last ten months you are probably in the throws of some of the biggest stressful moments of your life dealing with the current pandemic. I read an article a back in September from the Washington Post that put a fine point on what was happening to people during this pandemic. The article was titled, “My extreme anti-covid routines: Sterilizing my eyelids and soaping my nostrils.” I couldn’t believe the title so I had to dive in. It left me sad, yet understanding. This poor women had fallen deep into the throes of the obsessive. I felt angry that Washington Post appeared to be using her to normalize and aggrandize this behavior. Being so obsessive that the virus was coming for you that you would have a routine of sterilizing your eyelids and soaping your nostrils was absurd on it’s face, but I knew it all too well.
This article should have been framed as a cautionary tale of how one shouldn’t act during this pandemic. We are all faced with knowledge and data that shows us just how unnecessary it is to have extreme worry, if we choose to look. Reading and learning was always helpful to me as I was relearning normalcy. I was shocked earlier in the pandemic when a medical doctor had a video that went viral showing people how to sanitize their groceries before taking them into their homes. Certainly we had come to a point where we were creating an entire society that is so afraid that they have forgotten to how to live, and I knew why. The WaPo article starts out somewhat innocent:
One could say that this was maybe just due diligence. Perhaps if it had stopped there it would have been not much to think about; a woman worried about an illness so she checks for signs. I personally think it’s not really necessary for a daily routine, but if it made her feel better then we could maybe see where it’s not really life disrupting, but it didn’t stop there. The sub-headline for this article is, “These measures may seem gratuitous. But they are my means of self-preservation,” which for me as a past sufferer of OCD knew what those words really meant. She had to do these things, because it helped her to maintain her sanity. Sound familiar? It does to me. Another passage from the article had me even more concerned. She was showing just how stressed she was by having to manage so many negative thoughts:
She not only is concerned with her clothing being contaminated but she also has learned to fear that the hand sanitizer which she feels safe using might also combust and cause a fire. This is very obsessive. While certainly it could possibly be a concern, it’s likely not a very big risk. She also obsessively makes sure to sanitize all touchable surfaces in her car. The science has been pretty clear over these months that fomites (objects or materials which are likely to carry viral particles, such as clothes, utensils, and furniture) do not play any significant role in infection rates. Emanuel Goldman, PhD., a professor of the Department of Microbiology, Biochemistry and Molecular Genetics at Rutgers School of Medicine in New Jersey wrote a piece about “exaggerated risk of fomites” in the Lancet back in July.
He wrote: “In my opinion, the chance of transmission through inanimate surfaces is very small, and only in instances where an infected person coughs or sneezes on the surface, and someone else touches that surface soon after. He goes on to say, “I do not disagree with erring on the side of caution, but this can go to extremes not justified by the data. Although periodically disinfecting surfaces and use of gloves are reasonable precautions especially in hospitals, I believe that fomites that have not been in contact with an infected carrier for many hours do not pose a measurable risk of transmission in non-hospital settings. A more balanced perspective is needed to curb excesses that become counterproductive.”
She would be the only one in her car coughing and sneezing and so it makes little sense to sanitize her entire car daily in order to avoid her own germs. Her automobile is not a hospital setting. This could be viewed as a serious obsession and her cleaning habits quite compulsive. It appears to me that the article framed this as a good thing, not a concerning one. I question the motives of Washington Post with having a perspective article like this without also allowing for a competing opinion. The next excerpt I found particularly concerning:
She has a “friend at Pfizer” that happened to tell her that she should stick soap in her nose and then dab alcohol up there with a Q-Tip. I have to say this may be one of the worst things she could possibly do, and I don’t know this “friend’s” credentials but this is not a good idea. First of all, it’s unlikely that she even comes into much contact with the virus and the use of soap and then isopropyl alcohol in the nose is a very foolish action as both are very drying. “Your sinuses will dry out,” says family medicine physician Daniel Allan, MD. in an article written for the Cleveland Clinic website, he continues, “the mucus that normally should be gooey and thick and can trap infection gets drier. So you’re more likely to get a cold because your mucus is not as able to catch things that you breathe in.” One reason in the winter we are more susceptible to viruses is because the cold air, and often dry climate outside, compounded by indoor heaters, dry out our mucus membranes. These are our first line of defense in preventing illness. This can only serve to hasten such conditions. I fear people could read this, emulate her, and make themselves more likely to contract an illness, that’s not helpful.
Then we get to deeper issues in her thinking about things. She appears to be quite concerned for her own well-being, but also she lays bare her need to have some normal in her life. She tells us all of the things she personally does to maintain her own “self-preservation” then goes on to tell us how she used other people in certain ways to help this process:
So, she pays service people extra money to come to her home, I start to see some serious ‘ivory tower’ thinking come over me as I read that passage. People, even those who worry about themselves, seem to have the ability to overlook the obsessions when it comes to needing a service provider to perform what they deem essential, which I get, but I have a hard time understanding how it is ok to send the dogs to the groomers who will be touching them, but she has to sanitize her car for a ride home. How does she sanitize the dogs? I’m am harkened back to my stent deep in the throws of Obsessive Compulsive Disorder and how I was able to designate safe spaces to lessen my stress and the need to compulse. She goes on to explain what her other “cautious” friends do, and makes an interesting comment about them:
She admits she is “paranoid” and that her friends are less so. She allowed certain friends who had convinced her of their “safety” over for some pizza, but at the end lauds them for assuming the virus “takes off” when they do these things she doesn’t really deem as fully safe. I will say this is a win, half the battle is admitting you have a problem. Though, it appears she spends a lot of time deciding just how ritualistic she needs to be. As a former agoraphobic with OCD, I know she has designated these people and actions as safe, but she misses how this may really be a greater problem.
She goes on to say she has started swimming and doing breathing exercises. This is a very good thing. Exercise is very helpful in reducing stress. The Mayo Clinic has a good article on why exercise can help to reduce your stress and everyone who feels like their world is falling apart right now would do well to get in some exercise. I found out as the years passed that I was also very deficient in vitamin D. Eventually I read several research papers on the role vitamin D deficiency can play in neuropsychiatric disorders like OCD, even in children. Vitamin D is an important neurosteroid hormone and immunomodulatory agent. Research continues to find a positive correlation in maintaining adequate vitamin D levels and health; from cancer, and immune health, to protecting the brain from imbalance.
With the current issues facing us we need to understand that sequestering ourselves and our families indoors for extended periods can be detrimental to our levels of necessary nutrients like vitamin D. Seasonal Affective Disorder, can be caused by low vitamin D levels and leave people feeling alone and lost. This is often a product of diminished sun exposure of people living in more northern latitudes, being indoors so much now leaves more of us vulnerable. I am particularly concerned with the children who are feeling this loneliness more than all of us because they are forced to remain apart from their friends and cohort in school. It’s leaving many of them feeling angry and depressed. In another more recent Washington Post article, authors Hannah Natanson, and Laura Meckler describe these children as “losing interest in food. They are complaining of back pain and burning eyes,” and describe a young man from a private school in NYC as being mandated to put on his uniform as he “sits down on his bed, where he will spend the next six hours attending an almost unbroken string of Zoom classes” — They speak of a little girl and how this affects her as well:
I’m glad to see that reporting in some instances by major media outlets is finally lessening their need to post the most absurd and hyperbolic and is starting to discuss the way these last 10 months is taking a toll on our most vulnerable in society. There’s no way to sugar coat it, we are ultimately likely causing more harm than we are preventing. Donna L. Farber and Thomas Connors wrote a piece in the New York Times recently that spoke to the importance of immune challenges in children as their immune system matures throughout childhood and affords them lifelong protections.
Dr. Donna L. Farber, a professor of immunology and surgery at Columbia University Vagelos College of Physicians and Surgeons, expresses her concerns of what we may be doing to children’s immune systems by keeping them from their normal social interactions. Will this cause other long-term issues with our children as they grow? The authors write that, “the long term effects of removing the social system that brings children in contact with other people, places and things remains uncharted territory.” As a parent of two boys this is a major concern of mine.
We also know that lack of enough sun, that children often get at school through PE, or playing and walking outside, can also lead to issues regarding the immune system. Vitamin D is very important for immune and also neuropsychiatric health. Research is mounting of the important role that Vitamin D plays in prevent severe illness as well. A recent article in Scientific Reports of the Nature Research Journal spoke to vitamin D deficiency among two groups of patients. Those in group A with confirmed asymptomatic illness were significantly less Vitamin D deficient than group B with confirmed illness, those in group B had severe cases and ended up in the ICU or worse:
Ultimately, I am seeing so many people doing extreme actions to avoid getting sick. Much of it that isn’t supported by the science. I still have friends who have not left their homes since March. They have all groceries delivered or designate a single person in the home to shop and then disinfect all of the groceries and items that come inside. They still sanitize all of their surfaces relentlessly, even when their common sense should tell them the virus is likely not present. As a former sufferer of Obsessive Compulsive Disorder and an agoraphobic who had to relearn normalcy, I know the painstaking steps it takes, I fear for my fellow humans because I see the signs. I’m not perfect today, when my stress levels soar, it’s a fight to not fall back into obsession. I sometimes will ask my mother and others a couple of extra times if something is ok, and I then have to put that back into my memory bank as “normal” and relearn. I don’t like it that my fellow citizens look at their neighbors no longer as humans, but as viral vectors they should fear. If we look around there is so much data and science that shows us we don’t really have to be afraid. Cautious and aware, absolutely; but please, don’t use this current situation as a reason to retreat and forget what normal is. A “new normal” to me is not acceptable. I worked too hard, and for too long, to relearn normalcy. I don’t wish that fate on anyone.
