Over the past week or two, the Ebola outbreak in West Africa has been receiving considerable media attention. The news that two healthcare providers with the virus were being transported back to the United States was met with a mixed reaction. Some people were concerned that their travel to the U.S. could trigger an Ebola outbreak here. One may ask: how much concern about Ebola contamination is reasonable and prudent? When exactly do we cross the line into excessive?
Many Americans are quite comfortable knowing that there are Ebola infected people receiving treatment in the U.S. — they trust the healthcare system to isolate them appropriately. At the other end of the spectrum are people who have begun washing their hands many times daily and taking other steps that most would deem unreasonable. Wearing rubber gloves, completely avoiding contact with others, and constant use of Purell may reduce anxiety about the likelihood of Ebola contamination, but these steps are not necessary. If you or a loved one is engaging in similar steps, he or she may be suffering from obsessive-compulsive disorder (OCD).
OCD often involves a vicious cycle of 1) a concern about potential contamination, followed by 2) an impulse to address this concern (often by avoiding, cleaning or washing), followed by 3) avoiding, cleaning or washing. This third step is considered a compulsion, and its function is to reduce anxiety. Very often with this type of OCD the cleaning or washing doesn’t meaningfully correspond to the contamination risk. For example, people with OCD sometimes feel the need to wash their hands a certain number of times. However, there is no reason to believe that any number greater than one meaningfully reduces risk.
Ebola symptoms and compulsive behavior
Initial Ebola symptoms include fever, intense weakness, and muscle pain. Someone with contamination OCD may pay very close attention to any sign of these potential Ebola symptoms. Any feeling of increased warmth or any minor ache becomes the first step in the above-described three-step cycle of OCD. By being “on the lookout” for any such symptoms, we paradoxically become more likely to notice them. What this means for someone with OCD is that the more carefully they watch for any possible Ebola symptoms, the more likely they are to end up engaging in excessive hand washing, cleaning, or even visiting the emergency room. Fortunately, OCD sufferers can find effective short-term treatments like Exposure and Response Prevention to address their OCD symptoms, often with great success.