All About Germaphobia

We all have fears, but phobias tend to be viewed as unreasonable or excessive compared to standard fears.

The distress and anxiety caused by a germ phobia are out of proportion to the damage that germs are likely to cause. Someone who has germaphobia might go to extreme lengths to avoid contamination.

The symptoms of germaphobia are the same as the symptoms of other specific phobias. In this case, they apply to thoughts and situations that involve germs.

The emotional and psychological symptoms of germaphobia include:

• intense terror or fear of germs
• anxiety, worries, or nervousness related to exposure to germs
• thoughts of germ exposure resulting in an illnesses or other negative consequence
• thoughts of being overcome with fear in situations when germs are present
• trying to distract yourself from thoughts about germs or situations that involve germs
• feeling powerless to control a fear of germs that you recognize as unreasonable or extreme

The behavioral symptoms of germaphobia include:

• avoiding or leaving situations perceived to result in germ exposure
• spending an excessive amount of time thinking about, preparing for, or putting off situations that might involve germs
• seeking help to cope with the fear or situations that cause fear
• difficulty functioning at home, work, or school because of fear of germs (for example, the need to excessively wash your hands may limit your productivity in places where you perceive there to be many germs)

The physical symptoms of germaphobia are similar to those of other anxiety disorders and can occur during both thoughts of germs and situations that involve germs. They include:

• rapid heartbeat
• sweating or chills
• shortness of breath
• chest tightness or pain
• light-headedness
• tingling
• shaking or tremors
• muscle tension
• restlessness
• nausea or vomiting
• headache
• difficulty relaxing

Children who have a fear of germs can also experience the symptoms listed above. Depending on their age, they may experience additional symptoms, such as:

• tantrums, crying, or screaming
• clinging to or refusing to leave parents
• difficulty sleeping
• nervous movements
• self-esteem issues

Sometimes a fear of germs can lead to obsessive-compulsive disorder. Learn more about how to determine if your child has this condition.

With germaphobia, the fear of germs is persistent enough to impact your day-to-day life. People with this fear might go to great lengths to avoid actions that could result in contamination, such as eating out at a restaurant or having sex.

They might also avoid places where germs are plentiful, such as public bathrooms, restaurants, or buses. Some places are harder to avoid, such as school or work. In these places, actions like touching a doorknob or shaking hands with someone can lead to significant anxiety.

Sometimes, this anxiety leads to compulsive behaviors. Someone with germaphobia might frequently wash their hands, shower, or wipe surfaces clean.

While these repeated actions might actually reduce the risk of contamination, they can be all-consuming, making it difficult to focus on anything else.

Passing concern about germs or illnesses isn’t necessarily a sign of obsessive-compulsive disorder (OCD).

With OCD, recurring and persistent obsessions result in significant anxiety and distress. These feelings result in compulsive and repetitive behaviors that provide some relief. Cleaning is a common compulsion among people who have OCD.

It’s possible to have germaphobia without OCD, and vice versa. Some people have both germaphobia and OCD.

The key difference is that people with germaphobia clean in an effort to reduce germs, while people with OCD clean (aka engage in the ritual behavior) to reduce their anxiety.

Like other phobias, germaphobia often begins between childhood and young adulthood. Several factors are believed to contribute to the development of a phobia. These include:

• Negative experiences in childhood. Many people with germaphobia can recall a specific event or traumatic experience that led to germ-related fears.
• Family history. Phobias can have a genetic link. Having a close family member with a phobia or another anxiety disorder can increase your risk. However, they might not have the same phobia as you.
• Environmental factors. Beliefs and practices about cleanliness or hygiene that you’re exposed to as a young person may influence the development of germaphobia.
• Brain factors. Certain changes in brain chemistry and function are thought to play a role in the development of phobias.

Triggers are objects, places, or situations that aggravate phobia symptoms. Germaphobia triggers that cause symptoms can include:

• bodily fluids such as mucus, saliva, or semen
• unclean objects and surfaces, such as doorknobs, computer keyboards, or unwashed clothes
• places where germs are known to collect, such as airplanes or hospitals
• unhygienic practices or people

Germaphobia falls under the category of specific phobias in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

To diagnose a phobia, a clinician will conduct an interview. The interview might include questions about your current symptoms, as well as your medical, psychiatric, and family history.

The DSM-5 includes a list of criteria used to diagnose phobias. In addition to experiencing certain symptoms, a phobia typically causes significant distress, impacts your ability to function, and lasts for a period of six months or more.

During the diagnosis process, your clinician may also ask questions to identify whether your fear of germs is caused by OCD.

Most people take precautions to avoid common illnesses, such as colds and the flu. We should all be somewhat concerned about germs during flu season, for example.

In fact, it’s a good idea to take certain steps to lower your risk of contracting a contagious illness and potentially passing it on to others. It’s important to get a seasonal flu shot and wash your hands on a regular basis to avoid getting sick with the flu.

Concern for germs becomes unhealthy when the amount of distress it causes outweighs the distress it prevents. There is only so much you can do to avoid germs.

There may be signs that your fear of germs is harmful to you. For instance:

• If your worries about germs put significant limitations on what you do, where you go, and who you see, there may be reason for concern.
• If you’re aware that your fear of germs is irrational, but feel powerless to stop it, you may need help.
• If the routines and rituals you feel compelled to carry out to avoid contamination leave you feeling ashamed or mentally unwell, your fears may have crossed the line into a more serious phobia.

Seek help from a doctor or therapist. There is treatment available for germaphobia.

The goal of germaphobia treatment is to help you become more comfortable with germs, thereby improving your quality of life. Germaphobia is treated with therapy, medication, and self-help measures.

Therapy

Therapy, also known as psychotherapy or counselling, can help you face your fear of germs. The most successful treatments for phobias are exposure therapy and cognitive behavioral therapy (CBT).

Exposure therapy or desensitization involves gradual exposure to germaphobia triggers. The goal is to reduce anxiety and fear caused by germs. Over time, you regain control of your thoughts about germs.

CBT is usually used in combination with exposure therapy. It includes a series of coping skills that you can apply in situations when your fear of germs becomes overwhelming.

Medication

Therapy is usually enough to treat a phobia. In some cases, medications are used to relieve symptoms of anxiety associated with exposure to germs in the short term. These medications include:

• selective serotonin reuptake inhibitors (SSRIs)
• serotonin-norepinephrine reuptake inhibitors (SNRIs)

Medication is also available to address symptoms of anxiety during specific situations. These include:

• beta blockers
• antihistamines
• sedatives

Self-help

Certain lifestyle changes and home remedies might help relieve your fear of germs. These include:

• practicing mindfulness or meditation to target anxiety
• applying other relaxation techniques, such as deep breathing or yoga
• staying active
• getting enough sleep
• eating healthy
• seeking a support group
• confronting feared situations when possible
• reducing caffeine or other stimulant consumption

It’s normal to feel concerned about germs. But germ worries might be a sign of something more serious when they start to interfere with your ability to work, study, or socialize.

Make an appointment with a doctor or therapist if you feel like your anxieties surrounding germs are limiting your quality of life. There are numerous treatment methods that can help you.