Mysophobia vs OCD: Understanding the Key Differences
You constantly feel the need to wash your hands. Why? Because thoughts of germs or contracting some illness or disease from harmful bacteria run through your mind night and day. You just want it to stop, but the only thing that stops the upsetting and unrelenting thoughts and urges is to do something. What do you do? You clean. You wash your hands with soap, sanitizer, alcohol, or whatever disinfectant that you can find. You clean until your hands dry out, crack, blister, or bleed.
You clean because it is the only way you can calm your stress and anxiety. But are you washing your hands to specifically rid your body of germs and illness-causing bacteria or are you ritualistically washing your hands? In other words, is your handwashing linked to the actual germs and bacteria, or is it used as a stress reliever not necessarily related to the germs and bacteria? Do you feel better once you remove the germs and bacteria (because they are gone) by washing your hands?
Or do your angst, thoughts, urges, visions, and compulsions persist after washing your hands to the point where you are washing them excessively and never fully receiving relief? Does washing your hands after touching a doorknob or something of the like provide you with satisfaction and relief at times, but do nothing to quell your stress, angst, intrusive thoughts, and unrelenting urges at other times? Does your fear of germs, bacteria, and contamination feel like an obsession?
These questions are important because they help determine if you may be experiencing mysophobia, OCD, or both. Although similar in many ways, there are key differences between mysophobia and OCD. It is important to understand these key differences, so you can get the proper treatment for your condition. In this article, we will explore the similarities and differences between mysophobia and OCD.
OCD? What’s That?
Obsessive-compulsive disorder, also referred to simply as “OCD,” is a neurobehavioral, anxiety disorder that involves non-stop, upsetting, and repetitive thoughts, visions, urges, fears, emotions (obsessions), and rituals or routines (compulsions). While it is common to experience both obsessions and compulsions, there are times when only one is present (obsessions OR compulsions). OCD is a common mental health condition with millions of people developing it at some point in their lives. Surprisingly, there are many different types of OCD, ranging from relationship OCD to hoarding OCD. OCD is a real, life-altering condition, especially when left untreated. Yet, it is often misunderstood, mislabeled, stigmatized, and mocked. In other words, some people toss the term “OCD” around like a catchphrase for someone who is a type A personality, or use it as a butt of a joke. It is no joke. It can damage or destroy various aspects of a person’s life, causing failed relationships, broken friendships, low self-esteem and self-confidence, and missed opportunities.
One common type of OCD that has recently risen in popularity, due to the COVID pandemic, is contamination OCD, or a fear of becoming contaminated or ill from germs and harmful bacteria. The hysteria of this formerly unknown virus hit people with OCD especially hard due to the uncertainty of how it was transferred and how to treat it. Being sequestered at home due to furloughs and lay-offs also did not help the situation.
Being socially isolated from others with nothing to do but ponder and ruminate about becoming ill and possibly dying from COVID only heightened contamination-related OCD symptoms like stress, anxiety, and excessive hand-washing and avoidance behaviors. For these individuals, the main cause of the worsening OCD symptoms was the loss of control – a loss of order, rather than the virus itself.
Handwashing, in this case, served as a “stabilizer.” It was a way to temporarily remove the fear that the person was not doing enough to prevent themselves from contracting the virus and passing it on to others. For example, they weren’t clean enough, they weren’t safe enough, etc. So, they cleaned (hands included) until they felt they had cleaned enough. The goal of this compulsion was to regain control of the situation – through rituals or routines.
OCD is an energy-zapper and time-stealer. What that means is that it can and often does consume most of your time and drain you of your physical, mental, and emotional energy. As mentioned above, the obsessions are uncontrollable, upsetting, and persistent, and the compulsions are ritualistic and repetitive.
But OCD is treatable.
The first line of treatment for OCD, including contamination OCD, is psychotherapy (i.e., cognitive-behavioral therapy (CBT) or exposure-response and prevention (ERP) therapy). Other therapies that may be added to an OCD sufferer’s treatment plan may be family therapy, substance abuse counseling, couples counseling, individual counseling, or trauma therapies (i.e., eye movement desensitization and reprocessing (EMDR) therapy).
Neurofeedback, deep brain stimulation techniques, and electroconvulsive therapy (ECT) may also be prescribed when treatment-resistant OCD is present. When psychotherapy is ineffective alone, medications may be added to the treatment plan. The first line of medication is SSRI antidepressants, however, if these medications do not work, other OCD medications like tricyclic antidepressants, antipsychotics, etc., may be tried.
Many OCD sufferers have also turned to natural remedies, holistic treatments, and self-help tools like hypnosis, art therapy, crystals, marijuana, service dogs, OCD support groups and podcasts, and online OCD treatment programs like Impulse Therapy.
What is a Phobia?
Approximately 70% of people who have phobias have more than one of them. A phobia is an anxiety disorder that involves an extreme, excessive, or unusual thought or behavior that is hard to control or manage. It is an overreaction to a perceived dangerous or uncomfortable person, object, or situation (trigger). People tend to avoid the dreaded trigger, but if that is not possible, then they tend to experience significant emotional and physical distress.
What is Mysophobia?
Mysophobia, also known as bacillophobia, bacteriophobia, germophobia, or verminophobia is an extreme fear or phobia of germs, bacteria, and contamination. Similar to OCD, people who have this condition become obsessed with being contaminated by germs or bacteria.
People who have mysophobia tend to go to an extreme effort to avoid contact with bodily fluids (i.e., salvia, feces, urine, etc.) of other people, soil, dust, mold, sand, and other “germy” substances, spoiled, “touched,” or contaminated foods, and objects and surfaces that appear to be dirty.
People with mysophobia may also avoid interacting with children for fear of “catching something” from them. Moreover, these individuals are more likely than those who do not have the condition to over-use cleaning products and hand sanitizers.
Mysophobia is considered a “specific phobia,” which means that it is limited to one” specific” fear, phobia, or situation (a fear of being contaminated by germs). In other words, it is directly associated with germs, bacteria, and contamination. The phobia or fear does not transfer to other situations or items. It is situational. For example, a person with this condition would only excessively wash their hands after touching a doorknob at a specific store or public restroom sink – because it looks “dirty.”
If the person is able to avoid the doorknob or sink, or if they can wash their hands and “remove the germs,” they will feel relieved. It would not necessarily become a ritual or routine, if perchance, they were not forced to touch the doorknob at a store or a public restroom sink. This fear or behavior (i.e., excessively washing hands) would be unlikely to happen under different circumstances unless they deemed the place “unclean.’
Every day and every encounter would be treated differently. However, it could become ritualistic if the person was struggling with both OCD and mysophobia. Because mysophobia is similar to OCD, the two conditions are often comorbid (occur at the same time). Like OCD, there may be both genetic and environmental components to mysophobia.
For instance, people who have an anxiety condition or a close relative with an anxiety condition, and people who experience trauma linked to contamination or uncleanliness (i.e., a loved one who died of COVID or growing up in a dirty or dilapidated home) are more likely to develop mysophobia than those who do not have those backgrounds. For instance, researchers found that people who experienced trauma are more likely to develop mysophobia. Keep in mind, however, that a person does not have to have OCD to have mysophobia and vice versa.
How Are OCD and Mysophobia Similar?
Although OCD and mysophobia are two separate conditions, they do share some similarities, such as:
- Both conditions are considered an anxiety disorder.
- Both conditions can involve obsessions and compulsions.
- Both conditions cause emotional and physical distress (i.e., anxiety, depression, panic attacks, etc.)
- Both conditions can be emotionally and physically taxing.
- Both conditions involve a “fixation” or an obsession with cleanliness and a fear of becoming contaminated or “tainted” by something.
- OCD sufferers and people who have mysophobia have upsetting, intrusive, and anxiety-provoking thoughts, urges, fears, emotions, and visions, which cause them to feel compelled to perform certain behaviors to ease their stress and anxiety (like excessively washing their hands or avoiding situations that may trigger their symptoms).
How Are Mysophobia and OCD Different?
Although mysophobia and OCD share some similarities there are also some key differences, such as:
- Mysophobia and OCD are considered two different conditions. OCD is listed in the DSM-5, while mysophobia is not. If mysophobia was listed in the DSM-5, it would be listed under the category of “specific phobias.” But it is not included in this manual.
- Although both conditions may involve obsessions and compulsions. OCD is not just limited to excessive fear and avoidance of germs, it encompasses a wide variety of obsessions and compulsions, such as categorizing, counting, checking, repeating phrases or mantras, etc. Conversely, mysophobia is specific in its focus. In other words, it is more localized. Its obsessions and compulsions solely hinge on germs and avoiding or removing contamination (by cleaning) and nothing else.
- People with mysophobia only excessively wash their hands when necessary (when they cannot avoid the germs and bacteria), while people with OCD have a habit (ritual or routine) of washing their hands when they become overwhelmed, stressed, or anxious.
- People with mysophobia are obsessed with sanitation or cleanliness, while people with OCD, even contamination OCD, are more obsessed with orderliness and symmetry (making sure that everything is in place so they do not become contaminated and pass it on to others).
- People with mysophobia can become “fixated” on cleaning, bathing, hand-washing, etc. in certain situations (this can change from day to day), while people with OCD tend to excessively clean like clockwork (on schedule) when they become stressed or anxious.
- People with mysophobia will avoid places, things, or even people they deem “unclean” like the plague, while people with OCD will ruminate about or have intrusive thoughts, visions, emotions, and fears about someone or something being unclean. This will compel them to do “something” to ease their stress and anxiety.
- People with OCD believe that they have the power to prevent or stop something from happening, which in the case of contamination OCD, is becoming sick or contaminated. People with mysophobia believe that they can prevent or stop something from happening by avoiding it when possible or excessively cleaning when that is impossible. When a person develops a compulsion, it is normally focused on removing the germs and bacteria – not counting, organizing, etc.
- People with mysophobia tend to become distressed when they are unable to stop something by avoiding the germs and bacteria from contaminating them, while people with OCD become distressed when they are unable to prevent or stop something from happening (i.e., becoming contaminated and then getting ill or hurt due to their lack of action) with their actions.
- The main factor in mysophobia is the intense fear of germs, bacteria, and contamination. These individuals are deathly afraid of touching someone or something and then becoming sick.
It is the fear that takes centerstage, not necessarily the compulsion of cleaning. While the main factor with OCD is not touching something or someone because of a fear that they are “dirty.” It is this fear that makes them excessively clean their bodies and homes – they do it so they won’t become sick from the germs and bacteria.
Is It Hard to Tell Mysophobia and OCD Apart?
Yes, it can.
Spotting the key differences between mysophobia and OCD can be challenging, primarily because the focal point for both conditions may be contamination and the need to do “something” to combat it.
What Does The Research Say?
Research on mysophobia, especially in correlation to OCD, is limited. The few studies that exist on mysophobia focus on its relationship to trauma and schizophrenia.
An earlier study found that women who had experienced trauma were more likely to develop mysophobia. Researchers also found that schizophrenics were at risk of developing “moral mysophobia” and that delusions and mental tics were likely responsible for this development. Similarly, an earlier study found a link between people with obsessive-phobic disorders (i.e., schizophrenia-like) and mysophobia.
Likewise, a 2021 study suggests that people who struggle with mysophobia tend to have a negative or non-existent relationship with nature (biodiversity and microbiomes) which contributes to their fear of germs and bacteria. According to researchers, people with verminophobia (mysophobia) experienced an uptick in their symptoms (fear of germs and contamination) during COVID-19. Still, more research is needed on mysophobia and its relationship or lack thereof with OCD.
What Is It Like to Have Mysophobia?
The best way to understand what it is like to live with mysophobia is to hear from people who live with this condition.
- “For the past 3 years, my entire life has been consumed by my mysophobia. It ruined one of my relationships due to the fact that I couldn’t even touch my SO without having a panic attack. I haven’t been able to be physical with anyone else since this happened. I am scared that this will never stop. I am so lonely and only have a very small group of friends. I barely leave my dorm unless it is to go to class. Because of this, I am struggling with my eating habits because I run out of food and become too scared to go out and replenish my stock. If someone coughs near me in a class I get these waves of heat throughout my body and it breaks me down. I can’t be around children as they don’t always cover their mouths when they sneeze/cough. I shower compulsively. I shower at least 6 times a day which takes away from my time to study and do homework. Anytime I feel the least bit dirty I rush to my shower. I wash my hands compulsively and always have hand sanitizer on my person no matter where I go. It has driven me to the point of complimenting suicide to stop my constant torture. I don’t think I would ever attempt it because of how hard it would be on my parents. They don’t know the full extent of my mysophobia because I feel like they wouldn’t understand. I don’t know what to do. I am all out of options.”
- “I am a guy who is suffering from OCD and severe mysophobia. I have not left my home since April 2011. I have had OCD my entire life, mostly manifesting in the form of numbers. However, about two years ago, it started manifesting as an obsession for getting clean. I started spiraling downward from there until around December of 2010. It was then that I had to drop out of school and enroll in an online high school. The last time I left my house was in late April (or early May, I don’t remember). I left to take a standardized test that I could not take online. I have seen multiple “professionals,” have tried to get help, have taken some neat pills, and all kinds of other little things as well, but nothing has worked.”
How is Mysophobia Treated?
Mysophobia is treated like OCD. The first line of treatment is psychotherapy, CBT, and ERP therapy. Sometimes, other therapies and treatments are added such as family therapy, biofeedback, and stress management. Like OCD, natural remedies like deep breathing, mindfulness meditation, CBD, yoga, homeopathy, and acupuncture can help a person with mysophobia relax. OCD podcasts and forums, along with relaxation techniques, can help people with the condition better manage their condition.
Because OCD and mysophobia are similar, online programs, like Impulse Therapy, can be beneficial for people who struggle with mysophobia, OCD, or both. Like OCD, when psychotherapy and natural remedies are unsuccessful alone, medications, like antidepressants, may be added to the treatment plan. Medications can help ease the fear and accompanying symptoms (i.e., anxiety or panic attacks) associated with mysophobia.
- Bajwa M, et al. (2014). Prevalence and factors associated with phobias among women. Retrieved from https://www.aseanjournalofpsychiatry.org/articles/prevalence-and-factors-associated-with-phobias-among-women.pdf
- Eaton, W. W., Bienvenu, O. J., & Miloyan, B. (2018). Specific phobias. The Lancet. Psychiatry, 5(8), 678. Retrieved from https://doi.org/10.1016/S2215-0366(18)30169-X
- Wardenaar, K. J., Lim, C. W., Al-Hamzawi, A. O., Alonso, J., Andrade, L. H., Benjet, C., Bunting, B., Demyttenaere, K., Florescu, S. E., Gureje, O., Hisateru, T., Hu, C., Huang, Y., Karam, E., Kiejna, A., Lepine, J. P., Navarro-Mateu, F., Browne, M. O., Piazza, M., . . . Scott, K. M. (2017). The cross-national epidemiology of specific phobia in the World Mental Health Surveys. Psychological Medicine, 47(10), 1744. Retrieved from https://doi.org/10.1017/S0033291717000174
- Robinson, J. M., Cameron, R., & Jorgensen, A. (2021). Germaphobia! Does Our Relationship With and Knowledge of Biodiversity Affect Our Attitudes Toward Microbes? Frontiers in Psychology, 12, 678752. https://doi.org/10.3389/fpsyg.2021.678752
- N.D. (1954). A Case of Mysophobia. The Indian Medical Gazette, 89(11), 690. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5204294/
- Belova, N. A., & Koliutskaia, E. V. (2012). Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova, 112(6), 13–17. Retrieved from https://pubmed.ncbi.nlm.nih.gov/22983229/
- Arakelyan, Hayk. (2021). COVID-19 Phobia and Verminophobia. Retrieved from https://www.researchgate.net/publication/348590866_COVID-19_Phobia_and_Verminophobia
- Efremova M. D. (2001). Obsessivno-fobicheskie rasstroĭstva s iavleniiami mizofobii pri vialotekushcheĭ shizofrenii [Obsessive-phobic disorders with the phenomena of mysophobia in slowly progressing schizophrenia]. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova, 101(2), 12–17. Retrieved from https://pubmed.ncbi.nlm.nih.gov/11243027