Germaphobia, Symptoms, Impact on Lifestyle, Causes & Treatment Options
What is Germaphobia?
Germaphobia (also sometimes spelled germophobia) is the fear of germs. In this case, “germs” refers broadly to any microorganism that causes disease — for instance, bacteria, viruses, or parasites.
Other names that may refer to germaphobia include:
Symptoms of Germaphobia
We all have fears, but phobias tend to be viewed as unreasonable or excessive compared to common fears. The distress and anxiety caused by 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 illness or other adverse consequence
- Thoughts of being overcome with fear in situations when germs are present
- Trying to distract yourself from thoughts about germs or conditions 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 of situations that cause fear
- Difficulty functioning at home, work, or school because of fear of germs (for example, the need to excessively washing 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
- Shaking or tremors
- Muscle tension
- Nausea or vomiting
- Difficulty relaxing
Impact on Lifestyle
With germaphobia, the fear of germs is persistent enough to impact your day-to-day life. As a result, 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. However, some places are harder to avoid, such as work. Actions like touching a doorknob or shaking hands with someone can lead to significant anxiety in these places.
Sometimes, this anxiety leads to compulsive behaviors. For example, someone with germaphobia might frequently wash their hands, shower, or wipe surfaces clean.
While these repeated actions might reduce the risk of contamination, they can be all-consuming, making it difficult to focus on anything else.
Relation to Obsessive-Compulsive Disorder
Passing concern about germs or illnesses isn’t necessarily a sign of obsessive-compulsive disorder (OCD). With OCD, recurring and obsessions result in significant anxiety and distress. These feelings result in compulsive and repetitive behaviors that provide some relief. For example, cleaning is a common compulsion among people who have OCD. It’s possible to have germaphobia without OCD and vice versa. But, conversely, some people have both germaphobia and OCD.
The critical difference is that people with germaphobia clean to reduce germs, while people with OCD clean (aka engaging in ritual behavior) to reduce their anxiety.
Causes of Germaphobia
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: Specific changes in brain chemistry and function are thought to play a role in developing 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
How Germaphobia is Diagnosed
Germaphobia falls under 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 specific symptoms, a phobia typically causes significant distress, impacts your ability to function, and lasts for six months or more.
During the diagnosis process, your clinician may also ask questions to identify whether OCD causes your fear of germs.
Treatment for Germaphobia
Germaphobia treatment aims to help you become more comfortable with germs, improving your quality of life. Germaphobia is treated with therapy, medication, and self-help measures.
- Therapy: Therapy, also known as psychotherapy or counseling, can help you face your fear of germs. Exposure and cognitive-behavioral therapy (CBT) are the most successful treatments for phobias are exposure 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:
- Self-help: Specific 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
Frequently Asked Questions (FAQs)
How does germaphobia manifest itself?
Germaphobes will typically have washing and cleaning compulsions and will avoid potential contaminants. Unfortunately, decontamination compulsions can consume the life of affected individuals. Excessive and time-consuming cleaning, ritualized showering and bathing to remove perceived dirt and germs, excessive tooth brushing, grooming or toilet routines, and constantly focusing attention on assessing the threat of infection all take their toll on sufferers’ quality of life. Constant washing can result in red, dry, cracked, or irritated skin, discomfort, wrinkles, and even skin lesions prone to bleeding and infection.
Avoidance can include the excessive use of hand sanitizers and antibacterial creams, avoiding handshaking or specific aisles of the supermarket where chemicals are stored, using one’s sleeve or tissue to open a door, wearing gloves, shunning social events to avoid people who might be ill, pushing the heel of one shoe down with the other so as not to touch their shoes, shopping online so as not to have to touch money, and evasion of hospitals, doctors or public toilets which can have an enormously detrimental effect on one’s health, social and work life.
Given germs can make us ill, is there a logical basis for the condition?
There are “good” and “bad” germs that need to co-exist for our immune system to work effectively. We also need to be exposed to “bad germs” from our early years to develop a strong immune system. The human immune system is therefore resilient against germs.
That said, there are reasonable steps we need to take to maintain good health personally and as a community. While there are times and places when we need to be more attuned to keeping practices healthy concerning the infection (such as when handling food, in a hospital, or during specific outbreaks such as flu season), it is a balancing act. We should not be alarmed or overly fearful, nor should we go overboard with preventative and reactive measures.
Has it increased in prevalence in recent years?
It’s hard to know whether germaphobia has increased over the years. We know that it has peaked at various times, such as when there has been widespread reporting of AIDS, Bird Flu, Ebola, and Zika virus outbreaks. Once these outbreaks subside, so does the reporting of germaphobia.
Are there common causes that can trigger it?
A range of genetic and psychological factors, as well as life experiences, influence its onset. A predisposition to be sensitive to threats increases the chances of developing germaphobia. A family history of OCD or anxiety disorders or an upbringing overly focused on germs and washing/cleaning, or a history of health problems also increases the chances. Overestimating the probability of danger and the likely severity of dangerous outcomes eventuating, preserving the need for perfection and one’s intolerance for uncertainty, as well as having an overinflated sense of personal responsibility for preventing harm will all increase a person’s propensity for germaphobia.
Do you think the promotion of antibacterial products can exacerbate the incidence of germaphobia?
Yes. There are instances where antibacterial products are required, such as in hospitals and food management, and their reasonable use can be advantageous. But scare campaigns that encourage the overuse of such products detriment individuals and the community. For instance, the increased prevalence of allergies and asthma has been linked to parents’ widespread use of antibacterial products.
Is it still possible to be a germaphobe and be filthy?
With human nature, everything is possible. So, yes, it is possible to be germaphobic and live in unkempt surroundings, especially in cases where people are highly avoidant. I have seen several instances of people who live in squalid conditions, presenting with Hoarding Disorder and OCD characterized by contamination fears.
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 Severity measures for specific phobia—adult. (2013).
 Mayo Clinic Staff. (2016). Specific phobias.
 Mayo Clinic – mayoclinic.org/diseases-conditions/specific-phobias/diagnosis-treatment/drc-20355162
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