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Mysophobia

What Is It, Causes, Symptoms, and More

Author: Lily Guo

Editors: Alyssa Haag, Ian Mannarino, MD

Illustrator: Jessica Reynolds, MS

Copyeditor: David G. Walker

What is mysophobia?

Mysophobia refers to the intense and irrational fear of germs, dirt, or contamination. It is a type of specific phobia, which is a fear that is pervasive and interferes with daily functioning. An individual with mysophobia has an obsessive worry about contracting an illness from various sources, including bodily fluids and bacteria. It is one of the most prevalent types of obsessive-compulsive disorder (OCD), a psychiatric diagnosis characterized by excessive thoughts (obsessions) that lead to repetitive behaviors (compulsions). Repetitive behaviors associated with mysophobia may include excessive hand washing or bathing. Individuals with mysophobia may also feel an intense urge to avoid situations where they feel they can become contaminated, or they may go to extreme efforts to remove sources of contamination.

What can cause mysophobia?

Mysophobia may be caused by various factors, including an increasing awareness of germs and bacteria in recent years. The use of antibacterial products has become increasingly common and some mental health professionals believe that this increased awareness of germs has increased the frequency with which people develop mysophobia. 

Specific phobias are frequently associated with anxiety disorders, which may be caused by a history of negative experiences; for example, the individual contracted an illness in the past and is now worried that it may reoccur. Phobias may also be attributed to learned experiences from parents or caregivers as well as genetics in some cases. Lastly, variations and changes in brain function, such as an overactive amygdala, the center of the brain that controls fear, can result in a propensity to develop mysophobia. 

What are the signs and symptoms of mysophobia?

The main signs and symptoms of mysophobia include an intense fear of germs or contamination, accompanied with obsessive hand washing, avoidance of places perceived to be full of germs or contamination, fixation on cleanliness, and overuse of sanitizing products. An individual may also have the fear that their own child is contaminated and may thus disallow visitors to interact with the child. Those with mysophobia may be unable to think about anything else other than germs and are oftentimes worried that the germs will lead to illness. They may be aware that the fear is excessive or unwarranted, but they are unable to stop or control it. 

Germs and contamination pose some danger to humans, and thus, a reasonable fear of germs should be differentiated from mysophobia. A fear of germs becomes a phobia when it is unreasonable and interferes with normal activities. A person who frequently washes their hands may be unreasonably cautious; however, if hand washing does not interfere with the individual’s life or cause them discomfort or stress, then the frequent hand washing should not be identified as mysophobia.

How is mysophobia diagnosed?

Mysophobia can be diagnosed by a licensed mental health professional according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). The DSM-V is a tool used by professionals to help diagnose psychiatric conditions. The symptoms meet the criteria for diagnosis if the individual suffers from a persistent fear of germs and contamination that is unreasonable or excessive, exposure to germs results in an anxiety response, they realize that their fear is disproportionate to the perceived threat or danger, they take extensive steps to avoid dirt or contamination, and the phobic reaction interferes with the individual’s normal routine and relationships or causes significant distress. Additionally, the phobia must be present for a period of time, usually six months or longer, and cannot be attributed to another condition.

How do you overcome mysophobia?

Since mysophobia is related to OCD, therapy designed to treat OCD can also help people overcome mysophobia. This includes exposure therapy, which is a type of psychotherapy in which someone with a phobia is gradually and repeatedly introduced to the thing they fear until it no longer triggers a fear response. The exposure can be real or imagined, with virtual reality being a part of the treatment process. Cognitive behavioral therapy can be used as well, where a licensed practitioner teaches individuals relaxation techniques, such as breathing control and mindfulness. Some people suffering from mysophobia may also benefit from medications that help reduce anxiety and treat OCD, such as beta-blockers (e.g., propranolol), benzodiazepines (e.g., diazepam), and selective-serotonin release inhibitors (e.g., sertraline). 

What are the most important facts to know about mysophobia?

Mysophobia is the intense and debilitating fear of contamination from dirt and germs. It is associated with OCD, and those with mysophobia are constantly worried about contracting illnesses from various sources in their environment. While it is common to be cautious of germs, the disorder becomes a pathological fear when it interferes with the person’s activities of daily living and the fear is all they can think about. Common reactions for those with mysophobia include excessive hand washing, refusal to enter any places that could potentially be contaminated, and overusing hand sanitizers. Causes of mysophobia range from environmental (i.e., product of one’s experiences) to genetic (e.g., parents had similar phobia or were highly anxious). Treatment can include exposure therapy; cognitive behavioral therapy; and medications, if needed.

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