Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Fear of Ebola

By Rex Perkins, LICSW, MSW

Aug 26, 20226 minute read

Reviewed byPatrick Carey

Contamination OCD is one of the most common subtypes of obsessive-compulsive disorder. OCD is a mental health condition which typically features a pattern of unwanted thoughts and fears (obsessions) that lead people to do repetitive behaviors or mental acts (compulsions). These obsessions and compulsions interfere with daily activities and cause significant distress. Contamination OCD causes a person to have obsessive thoughts and fears about being “contaminated” with dirt, germs, or pathogens, which causes them to develop various compulsive behaviors in order to cope with their fear and anxiety. One common theme within Contamination OCD involves fears surrounding Ebola.

Contamination OCD about Ebola involves fears about contracting the Ebola virus. This fear becomes an obsession, usually involving intrusive thoughts or feelings about contracting or spreading Ebola. Obsessions create a strong urge to engage in compulsive behavior in order to relieve distress and fear. Compulsions may involve repetitive cleaning, washing hands, researching, and avoiding things perceived as “dirty” or having germs.

Fear of Ebola can result in obsessions and compulsions that may cause severe distress and disruption of normal activities. People may develop fears of leaving their home, engaging in social activities, or managing daily living responsibilities. Individuals may also experience cyclical and extreme doubt and uncertainty regarding the Ebola virus.

This causes individuals with OCD to worry that they may unknowingly have the virus or spread it to others, especially if they have not been tested for it. Even those who have been tested and have received a negative result may still have fears that they do have it, typically caused by intrusive thoughts involving “what if” thinking about test results and accuracy. Doubt and uncertainty are powerful tools that OCD uses to maintain control over someone.

Ebola OCD – Common Obsessions

People with fear of Ebola can have very similar obsessions to other categories of Contamination OCD includes:

  • An extreme fear of becoming “contaminated” by touching certain types of substances or items
  • Obsessive fears about sticky residues, grease, or dirt on body or clothing
  • Obsessive fears about blood, bodily fluids, feces, or urine
  • Extreme fear of being coughed or sneezed on
  • Fear of wearing clothes that have come in contact with contaminants or someone who has been contaminated
  • Fears of spreading contaminants around the house, car, personal belongings, or bedroom
  • Fears about public health emergencies

Common Triggers

OCD can come in waves, with periods when your OCD thoughts or behaviors become more intense or frequent. People with OCD may have episodes where their symptoms are less significant and other times when their symptoms are more severe. It’s important to remember that everyone experiences OCD differently, so what may be considered an episode for one person may not be for another.

Triggers, or circumstances which commonly bring about obsessive thoughts, fears, and worries, can be divided into four main categories:

  • Environmental triggers
  • Emotional triggers
  • Interpersonal triggers
  • Situational triggers

People with OCD fear of Ebola may be triggered by situations including:

  • Coming into contact with bodily fluids
  • Being around people who contracted Ebola or who are believed to have contracted it
  • Being in places that they perceive as dirty or contaminated, such as public toilet or a shower 
  • Learning about new Ebola outbreaks
  • Coming into physical contact with people they fear have been exposed to Ebola
  • Reading, viewing, or listening to media about communicable disease

OCD survives by creating strong feelings of doubt and uncertainty, as well as intrusive thoughts about something considered important and valuable to the sufferer. It may even create intrusive thoughts that make the individual question the validity of their thoughts. Common thoughts include “What if that person had Ebola?” or “How do I know this is OCD and not a valid concern about Ebola?” 

OCD obsessions are not real, but it can be very difficult to accept this; they often feel as real as anything else. Some people dealing with fear of Ebola may spend large amounts of time seeking concrete answers through compulsive testing, symptom checking, and reassurance. They may begin to talk to others about their thoughts; in a sense this can be to gain reassurance from others regarding what they experience. 

It is also common for people with Contamination OCD over Ebola to spend large amounts of time researching and looking for answers, or to regularly schedule doctor appointments for infectious disease testing. Typically, they are seeking a specific answer to satisfy the uncertainty that OCD creates. However, regardless of how much time they spend looking for “the perfect answer,” they can never find it, because 100% certainty about contaminants and disease doesn’t exist. There is no cure-all, “lightbulb” moment of understanding that can allow a person with OCD to fully let it go. These behaviors only reinforce OCD over time.

Common Compulsions

When people with OCD fears of Ebola experience intrusive thoughts, images, feelings, or urges that cause distress, they may engage in compulsions, or repetitive behaviors that they feel a strong urge to perform. These can be physical or mental acts meant to reduce the anxiety produced by their obsessions or prevent something bad from happening. However, engaging in compulsions brings no long-term resolution, offering only a temporary relief from anxiety.

Common compulsions performed mentally or physically by people with Ebola OCD fears include:

  • Repeatedly washing and cleaning oneself (washing hands, disinfecting, showering, or bathing)
  • Excessive and ritualized bathing that may consume large portions of one’s time
  • Avoiding public spaces
  • Avoiding touching other people
  • Changing clothes frequently or discarding clothes and other items that have become “contaminated”
  • Seeking reassurance that they, or others, have not been “contaminated”
  • Repetitively researching Ebola symptoms, signs, trends, or stories

How to treat fear of Ebola

OCD fear of Ebola can be debilitating for people who struggle with it, but it is highly treatable. By doing exposure and response prevention (ERP) therapy with an OCD specialist, people suffering from Ebola themes in Contamination OCD can learn to identify, think about, and respond to OCD in a completely different way. OCD creates fear, anxiety, and discomfort: things that we naturally try to avoid, fight, or resist. However, in OCD, these fears to not correspond with actual risks or danger, so by responding to OCD in this way—engaging in compulsions—people receive only temporary relief from distress. Furthermore, by allowing a person to feel as if they avoided a real risk or danger, compulsions also reinforce OCD in the long term.

ERP’s primary goal is to break the cycle of obsessions and compulsions. This is done by deliberately exposing a person to situations that produce the same feelings of distress they feel due to OCD, and then teaching them to resist the urge to engage in compulsions. They are taught to recognize the obsession, feel the urge to respond, and observe the distress they feel, but not actually engage in compulsions. Since compulsions are the main thing that reinforces OCD, the focus of ERP is on changing a person’s response by habituating them to the discomfort they feel. By gradually facing their fears until they pass, a person gains confidence that a) their obsessions do eventually pass b) fears are often exaggerated or misplaced, and c) feared outcomes don’t occur when they don’t engage in compulsions. In a nutshell, the only way out of OCD is to go through it, which is accomplished in ERP therapy.

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