What is Mysophobia? (An Overview)

Mysophobia

In this blog we will discuss the symptoms, causes and treatment for Mysophobia. 

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An intense fear of germs is called as Mysophobia. It is a type of specific phobia, part of anxiety disorders in the DMS-5. One feels extremely anxious when comes in contact with germs.  

People suffering from Mysophobia (or what is also called as Germophobia) will avoid any possible exposure with germs. They do so by the repetitive action of washing and cleaning, to remove any germs the object/place has in addition to lower their anxiety. These people, if assume that they contracted germs can experience extremely high levels of anxiety, followed by full-blow panic attacks. 

Mysophobia is said to be linked with Obsessive-compulsive Disorder (OCD). This is because, in both cases people fear contracting germs. The repeated acts of avoidance, which include washing/cleaning objects/things are the same in both Mysophobia and OCD. However, in OCD the person does these rituals in order to lower the unpleasant feelings caused by the incompletion of these acts. In Mysophobia, one does this to actually get rid of germs. 

The DSM-5 suggests that the anxiety or acts of avoidance produced in Mysophobia affect one’s social and occupational functioning. For example, if one is fearful of contracting germs, they are very likely not to go outside the house because of the fear of getting them from the outside. They might even avoid physical contact with people, such as hugging or hand shaking due to the fear that they might contain pathogens. 

They avoid going to parties, hanging out with friends or family or even eating food from restaurants. They socially distance themselves from others. One may not go to school or work because of the chances of them getting germs.  This affects their careers and academic life. 

In the current COVID-19 pandemic Mysophobia has been observed to be on the rise globally. There are people who now have instantly developed it after the pandemic.

The sufferer isolates himself, which can result in him developing depression in the future. 

Mysophobia can also lead to the development of social phobia, in which people avoid coming in contact with others. Which later can turn into Agoraphobia, people avoid going outside their house or in a social setting. 

The DSM-5 also claims that for someone to be diagnosed with Mysophobia, they should experience anxiety lasting for at least 6-months. 

Mysophobia, known by numerous names including Germophobia/Bacillophobia is the irrational fear of germs and getting contaminated. It is a type of specific phobia. The name of the phobia was coined by William A. Hammond in 1897, while researching on OCD (repeated acts of washing). 

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Symptoms of Mysophobia

Germs are contagious, potentially harmful to one’s health and should be protected from. But, someone with Mysophobia takes this potential threat to a higher level. They feel traumatized when in contact with germs (or when they think they contracted germs). In extreme cases, one suffers from high levels of anxiety by just thinking about germs. 

Their fear is not wholly irrational however, the exaggerated sense of threat and anxiety is what makes the sufferer unable to think logically or rationalize their thoughts and actions. The anxiety can be so extreme that one has panic attacks. 

In Mysophobia, the sufferer goes into flight or fight mode because of an adrenaline rush. In this state, the body’s physiological responses help one make decisions when in fear causing situations. They either decide to escape the situation (flight)-faint/experience panic attacks or stay and combat their fear (fight)- control their anxiety in a more counterproductive way.

Physiological symptoms that one undergoes in Mysophobia are: 

  • Extreme anxiety when allegedly in contact with germs 
  • Extreme anxiety when thinking about contracting germs 
  • Frequent handwashing 
  • Frequently washing objects that you assume contain germs 
  • Frequent use of hand sanitizers 
  • Frequently taking baths 
  • Inability to control anxiety 
  • Full-blow panic attacks 
  • Avoiding going out of the house (in fear of contracting germs) 
  • Indulging in time consuming activities to protect/prepare for germ contamination 
  • Increased heartbeat 
  • Breathlessness 
  • Muscle tension 
  • Tremors 
  • Sweating 
  • Hot/cold flashes when in a flight or fight mode (A hot flash refers to the temporary heating up of the body when in a state of fear. And a cold flash means when the body suddenly starts to shiver or cool down, when encountered by a fear stimulus).
  • Nausea 
  • Headache 
  • Feeling of restlessness 

In order for someone to diagnosed with Mysophobia, one must experience at least 3-5 of these symptoms, including anxiety. 
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Causes of Mysophobia

Mysophobia, like all other specific phobias has no known cause. These types of phobias can be a result of a number of factors such as biological (genetics) and or environmental (past experiences or social learning). 

Genetics refers to the genes and neurotransmitters in our body. Someone with a family history of a phobia/mental disorder has a higher chance of having the same or different disorder in the future. This is because the genes of the parents are transferred to their children, thus any alteration in the genes of ones’ parents is inherited by the child.

This genetic tendency to develop a mental disorder/specific phobia can also be referred to as a Diathesis-stress relationship. According to this, one with a genetic predisposition will not develop symptoms of Mysophobia until and unless there is some trigger event, instigating anxiety or fear of germs.

As mentioned earlier, one can develop Mysophobia as a result of OCD. Thus, someone who is already diagnosed with this disorder is more likely to have this irrational fear of germs. 

An environmental trigger event can be for example, a traumatic childhood experience with germs. Someone who developed a health problem by contracting germs from somewhere might fear them for the rest of their life. Their fear intensified may be because they had a near death experience due to their illness. 

May be they heard someone else, in their family or outside, who suffered an illness because they were infected by germs. A child might’ve lived in an area with hygiene issues, therefore, they are more likely to be afraid of going through the same problems they did earlier in life because of germs. 

Mysophobia can also develop due to the way media reports news about people dying by suffering from diseases caused by pathogens. The official stats of the ever rising mortality rates (because of pathogens) are also a major cause for one to fear germs. 

Thus, Mysophobia is caused by both a genetic predisposition and environmental trigger events. 

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Treatment of Mysophobia

Mysophobia, like all other specific phobias has no exclusive type of treatment that is specifically designed to treat it. Like all the other specific phobias, Mysophobia is treated by a number of different therapies including, Exposure Therapy, Cognitive-behavioral Therapy (CBT) and or medications that lower downs the anxiety or other physical symptoms. 

• Cognitive-Behavioral Therapy (CBT) 

It is one of the most frequently used treatment for patients with almost all kinds of mental disorders. Mysophobia is defined as the irrational fear of germs. Thus, the therapist helps the patient in replacing these irrational thoughts with more rational ones. 

The patients are helped out in analyzing and justifying the way they feel about contracting a germ. Therapists assist them in uncovering the reasons behind their fear and later they provide them with alternate, pleasant thoughts. 

The patient is told to maintain a thought diary (with ABCD column) which provides them a replacement for every irrational thought they have, when thinking about a particular situation. The ABCD stands for: 

i. A (antecedents) a situation or triggering event.

ii. B (belief) the thought that comes to one’s mind when in that triggering situation.

iii. C (consequences) the symptoms/feelings caused by that event/thought 

iv. D (dispute) alternate, rational thoughts provided by the therapist in an attempt to        dispute/challenge those irrational beliefs.

This last section of the thought diary is what really plays a role in helping the person feel good/less anxious.  

• Exposure Therapy 

It is one of the most frequently used ways of treating patients with Mysophobia (or any other kind of specific phobia). In this therapy, the patient is exposed to the source of his fear over a certain span of time. To begin with the therapy, the therapist exposes the patient to the least triggering stimuli, a picture of a germ or a possible germ source.  

As the therapy progresses and the patient is able to control his anxious feelings, imagery can be used to take the treatment a step further. In this part of the treatment the patient is asked to visualize/imagine a situation in which he is touching an object he feels contains the most germs. During this process of imagery, one actually feels being in that particular situation or place, experiencing various senses.

 Once the person successfully, without feeling anxious clears this step of the therapy, he is then exposed to a dirty surface or the object he feels has the most germs.  

While the patient is being exposed to different intensities of stimuli during the various stages of therapy, the therapist simultaneously teaches them coping exercises. These include, breathing techniques or muscle relaxation methods to lower their anxiety, when in an actual fear/anxiety causing situation. This teaches them how to remain calm when exposed to the fear stimuli.

Before actually starting the exposure therapy, the therapist needs to figure out the intensity of the patients fear, as to deduce whether they will be able to undergo this treatment, without any physical or psychological harm caused to them during the exposure processes. 

However, these steps desensitize one to their fear of germs, by exposing them to that stimuli repeatedly, until they learn to undergo the situation without anxiety/panic attacks.

• Mindfulness-Based Stress Reduction (MBSR) 

MBSR is a meditation therapy, is used to manage stress or anxiety. It is an 8-week program which includes group sessions. Mindfulness meditation and Hatha yoga are practiced in these sessions. Lectures and group discussions are also done to talk about mental health and increase interactivity.

In mindfulness meditation the person is told to, for example to focus on the sensations felt while breathing or the rhythm of the chest rising and falling during the process. This distracts the person’s attention from something stressful to something which is neutral and soothing. 

For quick and effective treatment, patients are also given a set of home works, for example 45 minutes of yoga and meditation sessions for 6 days a week and to record their results/feelings in a book or diary for 15 minutes a day.

• Dialectical Behavior Therapy (DBT) 

This is another effective therapy used to treat Mysophobia. It is more commonly used with people suffering from personality disorders, but is also useful with patients suffering from this type of specific phobias. Coping skills are taught in the DBT group which lasts for about 6-months and can have a number of people (depending on how many join the group). 

            i. Half-smiling is the first module of DBT. It is a technique that is used with patients who are distressed because of their irrational thoughts. The technique is known as ‘Half-smiling’ because the person is first advised to think about the stimuli that fears or upsets them, and while doing so they are told to lift the corners of their mouths by subtly smiling. Smiling is not that will help one get rid of these unpleasant thoughts, it is the person’s ability to constrain itself from thinking about those thoughts while half smiling.

          ii. Mindfulness, the second module, is another technique used in DBT groups which helps the individual in getting rid of those negative thoughts. Individuals are told to focus on the present and be attentive to what is going on around them at the moment. This helps in breaking the link between their mind and any negative thought that might come to them then.  

         iii. The third technique or module of the DBT is distress tolerance skills. This module teaches people to calm themselves down in healthy ways when they are distressed or emotionally overwhelmed. Individuals are allowed to make wise, rational decisions and take immediate action, rather than being captured by emotionally destructive thoughts that might make the situation worse. Reality acceptance skills are also learnt under this model so that people fully accept reality and later make plans on how to address the problem.

• Yoga/Meditation 

They are not just one of the many treatment therapies used for Mysophobia, instead they are one of the most common ways of relaxation used by many people. Yoga tends to stimulate the meditative state of one’s mind while the person is in a particular yoga posture. Through yoga/meditation the mind is diverted towards something more productive and calm, allowing the person to escape the negative, distress causing thoughts.

Out of a number of yoga types, one can benefit from any yoga type/pose they like. Hatha yoga is one of the different types of yoga. The breathing techniques or the imagery one creates while in a yoga posture are the real factors that makes the person feel less anxious and diverts their mind, away from the thoughts about germs.

• Drug Therapy 

Drugs are used to reduce the physical symptoms caused by Mysophobia. Drugs are very quick in effectiveness, as they start showing progress in the patients’ health at least 2 weeks after the medicine is taken. 

This type of biological treatment is usually more effective if the cause of the phobia is only genetic. However, these drugs/medicines are not to be taken without a doctor’s prescription or consultation. 

Two types of drugs are used in the treatment of this phobia:

                       i. Anti-anxiety Drugs

Medicines like Klonopin are anti-anxiety drugs. They are most commonly used with patients who experience panic attacks and also lowers their anxiety by binding to receptor cells of the brain that cause these unpleasant symptoms. 

                      ii.  Antidepressant Drugs

These drugs, as the name suggest don’t only treat depression but are also very effective in treating phobias. Medicines like Paxil reduce the anxious feelings of a person and makes him feel calm. They need to be taken on a daily basis but not without a doctor’s advice.

Whether the cause of Mysophobia, or any other type of specific phobia is genetics, environmental or both, the best and the most effective way of treating them is by using a combination of both biological treatments (drugs) with cognitive treatment (for example CBT/exposure therapy).

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Titles to read 

  • I Can Do That: Soothing fears of germs and illnesses.

by Karen Disher Stremke

  • OCD in Children and Adolescents: A Cognitive-Behavioral Treatment Manual

by John S. March and Karen Mulle Friesen

  • The Anxiety Journal: Exercises to Soothe Stress and Eliminate Anxiety Wherever You Are: A Guided Journal

by Corinne Sweet

  • 5-Minute Stress Relief: 75 Exercises to Quiet Your Mind and Calm Your Body

by Elena Welsh PhD

  • The Little Book of Mindfulness: 10 minutes a day to less stress, more peace

by Patrizia Collard

Frequently Asked Questions 

Q1) Is Germaphobia (Mysophobia) a mental illness? 

It is a specific phobia which comes under the category of anxiety disorders in the DSM-5. It is linked with Obsessive-compulsive disorder because individuals repeatedly avoid coming in contact with germs as this instigates anxiety. Therefore, yes it can be regarded as a mental illness/disorder. 

Q2) What makes a person a Germaphobe? 

Germaphobes are obsessed with cleaning and washing in an attempt to get rid of any possible germs the objects might contain. This is the name suggested for people who do these obsessive rituals to lower anxiety and avoid germs. 

Q3) Do I have Germaphobia/Mysophobia? 

The symptoms of Mysophobia are extreme anxiety when thinking about germs, repeatedly cleaning and washing objects that might contain germs, spending a considerable amount of time daily in order to prepare for any contact with germs. Physiological symptoms include, nausea, hyperventilation etc. 

Q4) How do you treat Germaphobia? 

It is treated by a number of cognitive therapies which include exposure therapy, CBT, mindfulness and or medication. 

Citations 

  • https://psychtimes.com/mysophobia-fear-of-germs/
  • https://www.verywellmind.com/all-about-msyophobia-fear-of-germs-2671871
  • https://www.healthline.com/health/germaphobia#causes
  • https://www.psycom.net/mysophobia-germophobia

What is Mysophobia? (An Overview)

Juanita Agboola

Juanita Agboola is the editor in chief of HFNE and an expert in mental health online. She has been writing about online behaviour, mental health and psychology issues since 2012. All Guides are reviewed by our editorial team which constitutes various clinical psychologists, PhD and PsyD colleagues.

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