Phobia of Germs (Mysophobia): Symptoms, Diagnosis, Treatment

Phobia of germs, also called mysophobia or germaphobia, is an intense fear of dirt and/or contamination. 

People with mysophobia feel extreme distress and anxiety if they encounter or even think about dirt, germs, and bacteria. They may go to extremes to avoid being “contaminated,” often in ways that disrupt their everyday life.

Learn more about mysophobia in this article, including symptoms, diagnosis, causes, treatment options, and coping methods.

Definition

Mysophobia refers to an intense, persistent fear of dirt and contamination. It is not a specific disorder in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Instead, a phobia of germs is typically understood as a specific phobia within the broader DSM-5 category of anxiety disorders. 

A specific phobia is a type of anxiety disorder that involves an overwhelming, marked fear or anxiety about a certain object or situation.

People with specific phobias often go to excessive lengths to avoid the source of their fear or experience extreme distress when they are confronted with it. They may be aware that their fear is irrational but feel powerless to control it. 

Examples of other common specific phobias include claustrophobia (fear of tight spaces), acrophobia (fear of heights), and ophidiophobia (fear of snakes). 

Meanwhile, some people experience an intense fear of germs as an aspect of obsessive-compulsive disorder (OCD). Some people may have both OCD and a specific phobia of germs.

OCD is a mental health condition that involves both obsessions and compulsions: 

• Obsessions refer to persistent, unwanted thoughts about a particular theme that causes someone distress. 
• Compulsions refer to repetitive rituals or actions that someone performs in order to relieve that distress. 

For example, someone whose fear of germs is a symptom of OCD may compulsively wash their hands or clean household surfaces to reduce anxiety or try to prevent some dreaded event related to germs.

Symptoms

When they encounter or think about germs or dirt, people with mysophobia experience symptoms of anxiety and panic, such as:

• Excessive sweating
• Trembling
• Shortness of breath
• Rapid heart rate
• Dizziness
• Chest pain
• Disorientation
• Nausea
• Numbness or prickling sensations
• Feelings of extreme dread
• Crying
• Irritability
• Panic attacks

In the face of their fear or anxiety, someone with a phobia of germs may:

• Use hand sanitizer excessively
• Repetitively wash their hands
• Clean household items or surfaces constantly
• Avoid handshakes and other forms of personal contact
• Avoid crowds and social situations
• Use antibiotics unnecessarily
• Refuse to touch doorknobs 
• Refuse to use public bathrooms

If left untreated, the symptoms of mysophobia can have a negative impact on someone’s daily functioning. 

For example, someone with an extreme phobia of germs may wash their hands or use hand sanitizer so frequently that their skin becomes cracked and irritated. Others may avoid social events, schools, workplaces, and/or outdoor environments because they’re afraid of catching a virus or coming into contact with dirt.

Diagnosis

If you think you may have mysophobia, your healthcare provider can refer you to a psychiatrist or other mental health specialist. They can diagnose you with a specific phobia or other mental health condition, such as OCD, using the criteria in the DSM-5.

To meet the criteria for a specific phobia in the DSM-5, your phobia of germs must:

• Last for six months or more
• Cause an unreasonable or disproportionate level of anxiety
• Disrupt at least one major area of your life, such as relationships or work performance
• Not be caused by another mental health condition

How Common Are Specific Phobias?

According to the National Institute of Mental Health (NIMH), specific phobias are very common among American adults. Recent estimates suggest that about 12.5% of U.S. adults experience a specific phobia at some point during their lifetime.

Causes

Researchers have identified several possible causes for mysophobia and other specific phobias. These may include:

• Family history: In some cases, phobias are passed down in families. This may be due to genetic factors as well as the environment and learned behavior.
• Brain structure: Research indicates that there is a link between specific phobias and certain differences in brain structure and function, such as hyperactivity in the amygdala—a part of the brain that processes emotions like anxiety.
• Trauma: Some people develop specific phobias due to a history of trauma related to the source of their fear. For example, someone with a phobia of germs may have experienced a severe childhood illness, leading them to fear bacteria and contamination.
• Comorbid mental health conditions: Around 61% of people with a specific phobia also have at least one other mental disorder. Many people with specific phobias also have major depressive disorder (MDD), mood disorders, and/or other anxiety disorders, such as generalized anxiety disorder (GAD).

Treatment

The following treatments have been found to be effective in treating mysophobia and other specific phobias:

• Exposure therapy: The first-line treatment for specific phobias is a type of psychotherapy called exposure therapy. Exposure therapy involves gradually confronting the source of your fear to “unlearn” the connection between that object, activity, or situation and your emotional distress.
• Medication: Some studies have shown that taking certain medications, such as glucocorticoids and Seromycin (D-cycloserine), may increase the effectiveness of exposure therapy among certain people with specific phobias. Some antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), have also been found to sometimes help manage phobia-related symptoms.

Coping

In addition to mental health treatment, here are some ways you can cope with your phobia of germs:

• Find support: There are many online and in-person peer self-help groups dedicated to particular phobias and fears. In support groups, you can find valuable advice, resources, and community.
• Practice mindfulness: Mindfulness meditation techniques can help prevent and manage anxiety symptoms.
• Use relaxation exercises: Deep breathing exercises, progressive muscle relaxation, and other stress relief techniques can keep you calm and grounded when you start to experience phobia-related anxiety symptoms.
• Manage stress: Keeping your overall stress levels low by establishing healthy daily routines, getting enough sleep, and exercising regularly can help you reduce anxiety.

Seek Help

If you or a loved one are struggling with mysophobia or another mental health condition, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Summary

Phobia of germs (mysophobia) is an overwhelming, persistent fear of dirt and/or contamination. People with mysophobia feel extreme distress when they think about or encounter dirt or bacteria. They often go out of their way to avoid potential contamination in ways that interfere with daily life.

Mysophobia is a specific phobia, which is under the category of anxiety disorders. People with a specific phobia experience overwhelming distress, anxiety, and/or panic about a certain object, situation, or activity. Some people experience mysophobia as an aspect of obsessive-compulsive disorder (OCD). 

Specific phobias such as germaphobia have many possible causes, including genetics, environmental factors, brain function, learned behavior, trauma, and comorbid mental health conditions. Treatment for mysophobia typically involves psychotherapy, especially exposure therapy, and/or medication.

A Word From Verywell

Many people with germaphobia and other specific phobias feel ashamed or embarrassed of their symptoms. But there’s no reason to feel alone—phobias are extremely common. Your healthcare provider can help you find treatment options to reduce your anxiety and improve your quality of life.