People with germaphobia or germophobia have a pathological fear of germs. Psychologists may also use the term mysophobia, a fear of germs and contamination. The latter term covers more than just germs, encompassing anything the individual believes is unclean. Those with germaphobia often go to extreme lengths to avoid contamination, which can take a significant toll on their health.

Psychological Symptoms

Germaphobia has symptoms similar to those of other phobias. These symptoms usually manifest whenever a person fears exposure to germs, though they can also appear when one is simply thinking about germs. It is common for people with the condition to experience anxiety, fear, and nervousness. They may also have obsessive thoughts about contracting illnesses. Many individuals describe feeling powerless to combat their fears, despite recognizing them as extreme or irrational.

Behavioral Symptoms

In addition to emotional and psychological effects, germaphobia can also affect a person’s behavior. A vast majority of people with the condition begin washing their hands excessively, sometimes to the point of abrasions and dry, cracked skin. They find it difficult to spend time outside their houses, and even at home, they may clean unnecessarily or spend large amounts of time preparing for situations involving germs.

Physical Symptoms

Though germaphobia is a psychological condition, it can have physical effects. Many of the physical symptoms of germaphobia resemble those of anxiety disorders, resulting in ruminating on germs even when in a clean environment. They include

• Shaking
• Shortness of breath
• Chest pain or tightness
• Nausea
• Headache
• Rapid heartbeat
• Tense muscles
• Lightheadedness
• Sweating

While experiencing these symptoms, an individual may be restless or nervous and have difficulty relaxing, which can affect sleep.

Lifestyle Impacts

Germaphobia often has a lasting impact, forcing people to go to extreme lengths to avoid contact with germs. Individuals may become socially reclusive and avoid leaving their homes. Germaphobia can also harm relationships, as many people fear germs from intimate activities such as kissing and sex. Even in an environment with which they are familiar, people with germaphobia may frequently shower, wash their hands, or clean the areas around them.

Possible Causes

Psychologists do not state a single cause for germaphobia. Instead, they believe it developed due to a range of psychological and genetic factors and life experiences. Some people have a sensitivity to threats, making them more prone to developing germaphobia. A family history of obsessive-compulsive or anxiety disorders also increases the possibility a person will develop germaphobia. Some people have an increased sense of personal responsibility for avoiding harm, which raises the chance of developing germaphobia or another phobia.

Similar Disorders

Many experts explore the similarities between obsessive-compulsive disorder (OCD) and germaphobia. Around one-third of people in the U.S. with OCD have a fear of contamination. They often practice decontamination rituals such as excessive handwashing. However, those with OCD typically have a larger variety of triggers, including newsprint, bodily fluids, sticky fluids, chemicals, or even moral impurity. This shows that while the two conditions are similar, and it is possible to have both, they are distinct and separate disorders.

Possible Basis

Some people cite that germaphobia is logical, because it is so easy to contract an infection or other illness. However, the immune system needs some germs to operate effectively. Children need exposure to germs early in their lives to develop strong and resilient immune systems. While taking moderate and reasonable measures to avoid illness is healthy, excessive and unnecessary cleaning could cause more issues.

Diagnosing Germaphobia

There is no diagnostic laboratory test for phobias, but that doesn’t prevent experts from recognizing the condition. Because germaphobia appears in the Diagnostic and Statistical Manual of Mental Disorders, the American Psychiatric Association has laid out diagnostic criteria for the disorder. Generally, for diagnosis, an expert must conduct an interview that covers current symptoms as well as medical and family histories. He may also ask questions about how the client’s fears affect daily life. An important part of diagnosing a phobia is eliminating similar disorders. For germaphobia, clinicians aim to rule out OCD.

Behavioral Treatments

One of the most effective treatments for germaphobia is cognitive-behavioral therapy (CBT), which helps the client develop a set of practical coping skills that can provide stability in situations of extreme fear. Counselors will often pair CBT with exposure therapy. The goal of exposure is to reduce the anxiety and fear that results from contact with germs by repeatedly showing that interaction does not have a negative result. After successful treatment, a person with germaphobia can control and manage their thoughts about and reactions to germs.

Other Treatments

Occasionally, symptoms inhibit an individual’s ability to undergo behavior and exposure treatments. Because of this, some doctors prescribe medications to manage symptoms of anxiety in the short term. Alternatively, they may prescribe beta-blockers, antihistamines, and sedatives to ease symptoms in specific situations.