​The CDC recommends frequent hand washing, avoiding close contact with others, and routine disinfecting to help us fight the spread of COVID-19. We should all be following these guidelines, but for those with contamination-related OCD, these behaviors are all too familiar. How can you tell if your behaviors are an appropriate reaction to COVID-19 or are veering into OCD?
 
Right now, washing our hands and disinfecting surfaces is expected, but ask yourself if what you are doing is above and beyond what is recommended or what most people you know are doing. Are you engaged in healthy protective behaviors or unhealthy coping strategies to deal with your anxiety about COVID-19?  The CDC recommends washing your hands for 20 seconds with soap before eating, after going to the bathroom, after coughing or sneezing, and anytime you reenter your home after being outside or in public. Many people are being “extra cautious” and find themselves washing and cleaning more than ever before. However, are you washing your hands for a few minutes, dozens of times a day, or even when you haven’t gone anywhere? Are you wiping down the same surfaces repeatedly? Are you frequently asking others if you cleaned enough or if you did it properly? Are you constantly ruminating over whether you or your home are contaminated? Are these behaviors in themselves having a significant negative impact on your life? If so, these may be signs that your abundance of caution has crossed the line into OCD.
 
It is normal to feel anxious about COVID-19 and feel you are spending a lot of time and energy in both worrying about it and protecting yourself from it. However, if you feel you are struggling with the stress, or are veering into OCD behaviors, mental health professionals are available for guidance, support, and assistance in helping you learning more appropriate and healthy coping strategies.

COVID-19 has disrupted our daily lives. These changes have impacts on youths’ development and functioning. Dr. Dena Rabinowitz recently completed a Q & A to help explain the challenges children and adolescents are facing during COVID-19.  Watch now to learn more.  

With each passing day, we are faced with more changes to our daily lives due to COVID-19. Most schools have closed and workplaces are urging employees to work remotely. Parents and their children are home together for days on end. It’s a far cry from normal and we are all struggling with this new reality. Being a parent during these times is particularly challenging, as we try to navigate this uncharted territory.
 
Here are some tips to help you support your children through the COVID-19 crisis.
 
Validate and Normalize
Kids may express a whole range of responses to learning about COVID-19. It’s important to normalize their reactions, whatever they may be. Some kids may act out, seem irritable, or become sad or anxious, while others may be excited to be home from school.  Find a time when your kids are not preoccupied with another activity, and ask them how they are feeling. Reassure them that their emotions are valid and that they will be okay without denying the reality of the situation. And remember, be aware of how you are talking about Covid-19, your kids are always listening and absorbing information
 
Share information appropriately
We want to give information that is accurate and age appropriate. Be factual but brief. Leave room for questions and tell your children that the conversation is always open. Be mindful about how often and how much detail you share about COVID-19 while your children are around. They are listening and often can misinterpret what is being said. Limit consumption of the news and social media in front of your kids. While it is completely understandable for parents to feel anxious right now, kids feed off of your anxiety and are absorbing what you share. For more suggestions visit the CDC child information website. 

Maintain a daily structure
Virus or no virus, establishing and maintaining routines and structure plays an important role in helping children thrive. Kids might equate having time off from school with being on vacation, so gently explain to them the difference. Create a schedule with your children to help them feel a sense of control. Offer reminders before switching to a new activity to help them transition between tasks. Sample schedules can be found online and aim for a balance between academic and play time. They also suggest consistent times for waking up in the morning, bathing, eating, and going to sleep. Make sure you also include exercise, which is particularly important for children’s physical and mental health.
 
Find opportunities to try new activities
Staying at home with your family for days on end can make anyone want some distance. It is absolutely normal to find it difficult to be in each other’s space all the time. While trying to carve out personal space and time for yourself, which can feel especially difficult, find ways to connect with your loved ones at home by trying new activities you always wanted to do but somehow fell by the wayside. Do art projects, bake and decorate cookies, learn a new game, throw a family dance party, or watch a family movie.
 
Help kids stay connected
Being social is a key part of regulating how we feel. To help kids stay connected with their friends while stuck at home, we recommend they video chat with their friends and relatives with apps like FaceTime and Skype. Get creative! Create a group video session with your extended family. Have kids do an activity together in their respective homes while connected through a video app. Rediscover snail-mail and have kids write letters to family and friend or send them individualized cards with drawings.
 
Take care of yourself
As parents, we always want to make sure our children are okay. To do that, we also need to make sure we are taking care of ourselves as well. We’re not effective when we don’t attend to our own needs. Take turns with your significant other so you each get a break and some time for self-care. Also, remember there is no such thing as the perfect parent and we’re all working to adapt to this new reality.
 
 
Click here for a list of some more online sites and activities for your children.

Anxiety is the disorder of “what ifs.” It makes it difficult to tolerate uncertainty and the unknown. When we are anxious, we catastrophize, and look for the worst-case scenario. We tend to exaggerate the sense of risk which makes bad situations feel worse. Without the ability to predict the future, anxiety makes us overestimate the likelihood of bad things happening.
 
Then we’re stuck with fear and emotional discomfort. Anxiety makes you desperate for a solution, so you can feel better. Anxiety makes you overthink, over-plan, and engage in activities that aren’t actually helpful, just so you can feel back in control. We excessively worry, engage in compulsive behaviors and avoid anything that triggers our anxiety, all to feel better.  In the short term, it feels like this helps, but ultimately, we are locked in a repetitive cycle of feeling anxious and trying to escape it.
 
Now enters the Covid-19 pandemic. Life as we know it has been turned upside down and it feels impossible to predict what is to come. As we stop going to work, school, or engaging in our daily routines, the structure of normal life is disrupted and we lose our sense of control. This is the perfect environment for our anxiety to grow. You may have more anxious thoughts: “When will this end? How long will I be home? Do I have the virus? Will I give it to someone else?” You may also engage in anxious behaviors like frequently checking the news, repeatedly checking your temperature, or buying food in unreasonable amounts.
 
We want to emphasize that it is completely natural to feel worried and scared. After all, anxiety is a survival instinct and can be healthy when it is proportional to the situation. COVID-19 is a threat to our physical, emotional and economic health and we want to be appropriately cautious and responsive. Without a little anxiety, we likely wouldn’t be taking the appropriate steps to combat this virus! That being said, we want to make it appropriate to the situation. Excessive worrying might feel productive, but it is actually harming your emotional well-being, and can interfere with your ability to think clearly and act responsibly during this crisis.
 
So, what do we do in response to anxiety felt about COVID-19?

1. Get your information from reliable sources. ​Information is power, but only if it’s accurate. Follow the guidelines outlined by the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO). 
2. Limit the amount of your exposure to news and media. Repeated exposure to the same information does not make you more prepared and only heightens the sense of fear. Inaccurate information and speculation make anxiety worse. Try setting specific times of day when you will check the news, and, outside of those times, do not check it.
3. Set a daily structure. COVID-19 has robbed us of our daily routines and sense of normalcy. But we need structure and a rhythm to the day. Have a plan for each day with specified times to get up, bathe, get dressed, prepare and eat meals, engage in school or work activities, and time for leisure activities.
4. Exercise. Inactivity breeds lethargy, boredom and depression. Get moving! Plan some physical activity every day and stick with it. If your local situation allows, go outside, get some fresh air and go for a walk. If your stuck inside, try an online exercise or yoga class.
5. Stay connected. You may not be able to see or spend time with friends and family but the internet is your ally here. Phone or video chat with friends and family regularly and use each other for social support
6. Take care of yourself. It’s okay to prioritize yourself for part of the day. Engage in self-care activities. Take some time to do something relaxing and calming: take a bath, watch a movie with your family, do some meditation. Allow yourself the time to have fun. And be kind to yourself and set realistic expectations about what you can accomplish during this difficult time.  

If you are feeling overwhelmed by your anxiety, seek out support from family, friends, and coworkers. If you feel that any anxiety or sadness is becoming the predominant feeling in your life or is causing distress and interfering with your ability to function, it is important to seek professional support. We, and many other practices, are offering telehealth to meet your needs. Feel free to reach out to us on our website, by email (info@cbpny.com) or call us at 212-873-0163

Dr. Dena Rabinowitz will be teaching two days of the CBT training institute at Adelphi University this July. Her workshops, “An Introduction of CBT Skills for Psychodynamic Professionals” and “CBT and Anxiety Disorders” will provide information on the fundamentals of CBT including case conceptualization and treatment for anxiety disorders. For more information on the summer institute, please click here. If you are interested in having Dr. Rabinowitz present or develop a lecture or workshop on any of the areas of specialization at CBPNY, please contact us at info@cbpny.com or call us at 212-873-0163.

Dr. Dena Rabinowitz,clinical director and founder of Cognitive Behavioral Psychology of NY, sat down with Business Insider to talk about trichotillomania. To learn about signs and treatment, watch Dr. Rabinowitz here!