YANA Mental Health

Contamination OCD and the Fear of Germs: Symptoms & More

Obsessive compulsive disorder, or OCD, is one of a few different types of anxiety disorders that’s commonly present throughout the United States. It’s estimated that about 1 in 100 adults currently have diagnosable OCD.

OCD is a mental health disorder marked by obsessions and compulsions. Obsessions are unwanted and intrusive thoughts that trigger intensely distressing feelings. Compulsions are behaviors that you may engage in to attempt to get rid of the obsessions and decrease stress.

People can experience OCD in relation to many different things. Common examples are obsessions related to perfectionism, where a person may become concerned about unevenness or exactness. There are also obsessions related to losing control, where someone may become distressed about harming others or bringing harm onto themselves.

But perhaps the most common subtype is contamination OCD, in which a person obsesses over and deeply fears contracting an illness or spreading germs. 

Let’s take a look at everything you need to know about this type of OCD.

What is Contamination OCD?

Especially during the COVID-19 pandemic, everyone has begun taking some extra precautions to protect themselves and others when it comes to the spread of germs. Wiping down surfaces, wearing face coverings, and abiding by public health guidance does not mean you have contamination OCD, mainly because these actions are rational and expected during a pandemic.

Contamination OCD is the most common subtype of OCD that is marked by fear of getting sick or spreading illness. It also includes the fear of catching a terminal illness such as cancer, and a fear that you or the people around you will die from germs.

However, contamination isn’t limited to just dirt and germs. Common obsessions include:

  • Bodily excretions and fluids
  • Pets
  • Household chemicals
  • Garbage
  • Spoiled food

While it is normal for many people to be wary of many of these substances and stimuli, people with contamination OCD are not usually guided by logic when it comes to their obsessions and compulsions. For example, an individual may see a speck of dirt on the floor and incorrectly believe that it will spread to the walls and floors around them.

Emotional Contamination OCD

There is a less understood type of contamination OCD known as mental, or emotional, contamination OCD. This is less focused on physical contamination on surfaces and more focused on mental interactions with others. 

People with emotional contamination OCD may feel that certain people or locations are “contaminated” in a metaphorical sense, and must therefore be avoided at all costs.

For example, an individual with emotional contamination OCD may have had a negative experience with a server at a restaurant. They may then believe that this person will “rub off” these unfavorable characteristics onto them. These feelings can even be related to the restaurant itself. Therefore, the person will never go back to the restaurant again and will do everything to never come into contact with that server.

Common Contamination OCD Compulsions

People with OCD exhibit repetitive behaviors in response to their obsessive thoughts. These compulsions, while irrational, serve to alleviate the anxiety and stress that obsessive thinking often causes. 

If you notice that you or someone you know is frequently engaging in the following behaviors, they may have contamination OCD:

  • Protection: Wearing gloves or using other objects like towels or shirts to prevent direct contact between the skin and a surface.
  • Excessive Washing: Repeated hand washing to the point of raw, dry, or bleeding hands. One may take extremely long showers and wash singular body parts multiple times. Some may also use heavy-duty cleaners on their skin.
  • Avoidance: An individual may avoid places, objects, or people that they fear might threaten their safety.
  • Excessive Health Testing: Repeatedly seeking medical assistance for diseases just to be certain that you have not contracted an illness.
  • Excessive Research: Someone with contamination OCD is likely to conduct excessive research into germs, illnesses, symptoms, and ailments.

It’s also likely that someone with contamination OCD will seek reassurance from those around them. For instance, they may ask family members to confirm that something has been cleaned properly, or they might repeatedly ask a family member to feel if they have a fever.

What Causes Contamination OCD?

The exact cause of OCD is not entirely understood. However, one theory suggests that your biology can play a large role. 

Some research suggests that it involves communication problems between the front part of the brain and deeper structures of the brain, such as the thalamus or basal ganglia.

Also, family history of OCD may put you at a higher risk for developing it at some point in life. However, it appears that genes are only partly responsible, and the other causes are unknown.

A traumatic life event may also trigger OCD symptoms. For example, if you experience the loss of a loved one due to a viral disease, it might cause obsessions revolving around disinfecting to ensure that something similar does not happen to you or those around you.

The Effects of Contamination OCD on Daily Life

Many people often say that they have OCD just because they like it when things are clean and tidy. This is a harmful misconception, as it fails to address several of the key elements that denote OCD as a chronic disorder rather than a personality trait.

OCD is a chronic disorder of the brain, not a reflection of your character. But with that said, it can cause a great deal of stress and anxiety if left untreated.

People with severe contamination OCD may miss out on important life events, such as graduations or birthday parties, due to the fear of catching or spreading disease in a public setting. Additionally, individuals might be unable to use public restrooms or other facilities, which can cause inconvenience and embarrassment.

Also, certain compulsions can have negative physical consequences. Excessive hand-washing can lead to blisters, rashes, and scars. Similarly, using harsh disinfectants on the skin’s surface can be extremely irritating to the body and lead to injury.

The Role of Family and Friends

As much as OCD can affect the life of the person who struggles with it, it can equally cause stress for those around them. Frequent reliance on confirmation, persistence on cleaning the house, and other compulsions can cause family members and loved ones to become overwhelmed and inundated.

It is important to establish limits with loved ones, while also being cognizant of mood and personal boundaries. Talk with them to see how much reassurance they are comfortable receiving, how much time you spend discussing their disorder, and how much their compulsions are having an effect on other people’s lives.

Additionally, going to a family or group therapy session can be extremely helpful in allowing everyone to understand each other through a professional and moderated point of view.

How To Treat Contamination OCD

As with most anxiety disorders, OCD can be successfully managed by undergoing professional treatment. 

Exposure and Response Prevention (ERP) is a form of Cognitive Behavioral Therapy (CBT) that is highly effective at treating OCD.

During ERP, you are exposed to the thoughts, images, objects, and situations that make you feel anxious and cause your compulsions. In the case of contamination OCD, you may be asked to make a list of things that you’re afraid of and rank them based on how anxious they make you feel.

Then, you’ll do some exposure exercises starting with relatively low-level tasks. For instance, you might be asked to practice showering for less than 10 minutes. Gradually, your tasks will become more challenging. You might eventually be tasked with holding your hand on various bathroom surfaces without washing your hands after.

During your next session, your clinician will debrief with you to review your progress and talk about how these activities made you feel. The goal is to eliminate compulsions and gradually work your way up to feel comfort in increasingly distressing situations.

In Summary

Contamination OCD is a subtype of obsessive compulsive disorder that is marked by a fear of contracting and spreading germs or diseases. There is also emotional contamination OCD, which is the fear of being emotionally contaminated by a person or place.

People with contamination OCD will have obsessive thoughts related to dirt, germs, viruses, and diseases. These result in compulsive behaviors such as avoidance and protection. An individual with contamination OCD has difficulty engaging in normal daily behaviors because of a preoccupation with their obsessions.

Thankfully, it can be successfully managed through a form of therapy called Exposure and Response Prevention, where gradual exposure to fearful stimuli can build up tolerance over time.

If you or someone you know is struggling with OCD of any kind, help is always available. YANA is a virtual mental health clinic that matches you with a licensed medical doctor to provide you with a personalized treatment plan that will get you what you need, quickly and discreetly.

If contamination OCD is affecting your daily life, you are not alone. Click here to schedule your first consultation with a medical doctor and get started on your path to recovery.


Who Gets OCD?  – International OCD Foundation

What is OCD? – International OCD Foundation

OCD and Emotional Contamination – American Addiction Centers

What Causes OCD? – International OCD Foundation

Exposure and response prevention for obsessive-compulsive disorder: A review and new directions – NCBI

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