Do I Have Mysophobia (Germophobia) or OCD?

It’s normal to experience a bit of an “ick” about less-than-clean environments, but people with mysophobia—aka germophobia, sometimes spelled germaphobia—feel something more extreme: usually significant distress and anxiety when they come into contact with (or even just think about) dirt, germs, and bacteria. In fact, the fear of dirt and germs can rule their daily lives, as they go out of their way to avoid becoming contaminated.

For Yina Shan, 28, a content creator on TikTok, mysophobia involves a list of self-imposed rules—including frequent cleaning schedules, spraying the couch to disinfect it when guests leave, and running her robot vacuum cleaner at least once a day. “If a rule is not followed I’ll feel very uncomfortable and will make sure it gets done,” Shan shared on the platform.

“Without treatment, people do not typically know that they are acting irrationally,” says Tracie Zinman- Ibrahim, a licensed therapist at NOCD. “Sometimes, they just really believe that things are dirty or disgusting.”

Keep reading to learn more about mysophobia, what’s behind the fear, and expert advice on how to live free from the obsession. 

What is germophobia (aka mysophobia)? 

Mysophobia—the clinical term for germophobia/germaphobia—is an intense fear of germs, bacteria, and contamination. The condition goes by other names, including bacillophobia, bacteriophobia, and verminophobia, and is classified in The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a specific phobia. This means it falls under the umbrella category of anxiety disorders. Phobias involve a marked fear or anxiety about a specific object, situation, or activity. Interestingly, germophobia is most commonly associated with obsessive-compulsive disorder (OCD).

What are the signs and symptoms of germaphobia? 

The symptoms of germophobia start with your thoughts and emotions—but they don’t end there. Often, people with germophobia go to great lengths to avoid their triggers. Here are some of the signs:

Emotions and thoughts associated with germophobia:

• Thinking intensely anxious thoughts about being near germs
• Fear that your exposure to germs may cause you or someone else to get sick 
• Feeling overwhelmed when feel you’re in the presence of someone else’s germs—like a coughing seatmate on a plane

Behaviors associated with germophobia:

• Avoiding people’s bodily fluids  
• Avoiding things you deem “dirty,” such as soil, dirt, dust, mold, and sand
• Limiting time in public places that you can’t control the cleanliness of 
• Using hand sanitizer everytime you touch something “dirty”

Mysophobia, like all phobias, can also lead to physical symptoms commonly associated with anxiety. For instance, you may feel a racy heart or palpitations when out in public, or experience shaking, sweating, or lightheadedness when exposed to your triggers.

What are the causes of germophobia? 

It’s impossible to pinpoint one singular cause of germophobia, however genetics and environmental factors can raise your risk.

Certain types of phobias are more likely to occur in people who have a close relative with that type of phobia. Likewise, if a family member has an anxiety disorder or OCD, you may have an elevated risk.

As for the element of learned behaviors, if you were exposed to people with extreme hygiene patterns or fear of germs as a child, that may contribute to the development of germophobia.

Trauma can also play a role. A 2014 study published by ASEAN Journal of Psychiatry, found that women who had experienced trauma were more likely to develop mysophobia. 

How is mysophobia diagnosed? 

Currently, there are no tests to diagnose mysophobia. However, a mental health professional can determine a diagnosis based on asking you about your symptoms and patterns in your behaviors.

Here are some of the questions they may ask:

• Describe your fear thoughts and how they make you feel.
• Is fear of germs limiting your social life or getting in the way of your relationships with others?
• How much time do you spend each day thinking about germs or illness, or trying to avoid becoming contaminated? 
• Can you recall any trauma in your life that was related to germs or illness?
• Does anyone in your family struggle with an anxiety disorder or OCD?

What’s the connection between germophobia and OCD?

Being a germophobe is an idea that most people can embrace. They may even make self-deprecating jokes about how “neurotic” they are about cleanliness. But what many don’t realize is that an obsession with cleanliness, germs, and contamination is also a common OCD symptom. 

OCD is a chronic mental health condition characterized by two key symptoms: obsessions and compulsions. Obsessions are intrusive and distressing thoughts that cause a lot of distress. Compulsions are repetitive behaviors or rituals you engage in to relieve the anxiety or discomfort that obsessions cause. There are many manifestations of OCD, and Contamination OCD is one subtype that is centered around obsessions and compulsions surrounding germs, dirt, and uncleanliness. 

Contamination OCD obsessions include: 

• “If I touch that doorknob, I will never be clean again.”
• “I feel dirty and disgusting even though I showered.” 
• “Could this food be contaminated?”
• “Someone just coughed; what if I get sick and die?”
• “What if I spread an illness to someone and they die?”
• “What if I get contaminated by negative traits if I make eye contact with someone whose energy is bad?” 

Contamination OCD compulsions include:

• Excessive hand washing, showering, and cleaning 
• Throwing away contaminated items
• Repeatedly changing out of clothes several times a day
• Using harsh cleaners on your skin 
• Doing excessive research on germs, illnesses, and ailments 
• Sanitizing or using gloves 
• Seeking reassurance—like asking if you’re contaminated
• Engaging in rituals like praying, counting, knocking, repeating, or thinking specific thoughts.
• Avoiding using public bathrooms 

Do all germophobes have OCD?

Not everyone who is a germophobe has OCD, says Melanie Dideriksen, a licensed therapist at NOCD. But if you meet the following criteria, it’s worth being evaluated by an OCD specialist:

• You have both obsessions and compulsions surrounding germs, dirt, and contamination.
• Your obsessions/compulsions take up a lot of time (more than an hour per day). 
• Your obsessions or compulsions cause significant distress and affect your daily life. 

What does treatment look like? 

The good news is that whether you’re dealing with a case of mysophobia or actually receive a diagnosis for Contamination OCD, your symptoms should respond to the same type of therapy. 

The optimal treatment is a type of behavior therapy known as Exposure and Response Prevention (ERP). With the guidance of an ERP specialist, you’ll begin exposing yourself to the things that make you feel dirty or contaminated while learning “response prevention techniques”—meaning ways to respond without using avoidance behaviors or compulsions. 

What might ERP look like? Well, suppose you developed a debilitating fear of germs after the COVID-19 pandemic began, and you compulsively avoid having any guests enter your home. To start, you might work with your therapist to bring an object from another location into your living room, without sanitizing it first. Then you gradually build up to more challenging exposures, until you can finally have, for instance, loved ones over to visit. 

Over time, ERP helps you realize that your intrusive thoughts about germs and contamination never posed the threat you believed that they were—which takes the power away from your thoughts. “My confidence grew every time I felt my anxiety drop,” NOCD member Ashley Marie Berry says of her ERP journey for Contamination OCD. “Thoughts that once took over my life were now drifting behind me.”