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Mysophobia
Mysophobia is a common anxiety disorder
characterized by an overreaction to the slightest
uncleanliness or an abnormal, irrational, and intense
fear of dirt, contamination, or defilement through
touching familiar objects. Defilement means to make
unclean or unpure. A person suffering from mysophobia
is known as a mysophobe. Mysophobia is often a
problem that is the focus of people with obsessive
compulsive disorder (OCD) although it can occur in the
absence of OCD. OCD is a type of anxiety disorder
characterized by compulsive behaviors (e.g., repeated
hand washing or repeatedly showering to wash the
entire body) performed in response to obsessive
thoughts (e.g., worrying about being infested with
germs).

Excessive handwashing due to
mysophobia.
 
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WHAT MAKES MYSOPHOBIA DIFFERENT FROM A NORMAL AVOIDANCE OF
GERMS & CONTAMINATION?

While it is normal to try to avoid some exposure to germs and contamination (e.g.,
washing one’s hands), it becomes pathological when it significantly limits the person’s
daily functioning and/or causes harm. This includes the formation of blisters and chaffed
skin on the hands due to overwashing and excessive use of cleaning products (which
actually puts the person at greater risk of infection).
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It also includes not being convinced that all of the germs are gone
even after engaging in extreme cleaning measures, rarely going
outside of the home due to an extreme fear of getting sick, fear of
physical contact with others, avoiding specific places where germs
are more likely to be such as confined places (e.g., doctor’s offices, 
public transportation, restaurants, public restrooms, meetings,
parties), and avoiding eating food cooked by others.  People with
mysophobia often have difficulty sharing food and other personal
items (e.g., utensils). They also tend to avoid animals due to fears
of contamination. The overuse of cleaning products can lead to the
development of new bacteria that are resistant to medication. 

People with mysophobia may experience trembling, sweating, racing heart, heart palpitations, shortness
of breath, nausea, dizziness, lightheadedness, crying, chest discomfort, fear of loss of control, feeling
sick, and other signs of symptoms of anxiety when exposed to observed (e.g., touching dirt in a yard) or
unseen contamination (e.g., a handshake, a high five, turning a doorknob). If other people witness the
types of extreme behaviors described above, the person doing these behaviors may be perceived as
strange, unsocial, or paranoid. Mysophobia is sometimes related to nosophobia and hypochondriasis.
Nosophobia is an anxiety disorder characterized by an abnormal, irrational, and intense fear or dread of
having a specific disease. Hypochondriasis is a preoccupation with fears that one has a serious disease
based on a misinterpretation of bodily symptoms.

WHAT CAUSES MYSOPHOBIA?

Mysophobia can develop in response to a prior traumatic experience with uncleanliness or sickness.
Examples include being raised in unsanitary conditions, being very sick as a child, or the death of a loved
one. Mysophobia can also develop in response to exposure to media warnings about the danger of germs
(which can sometimes be life-threatening).  These media reports can cause extreme fear in someone with
mysophobia.  Increased availability of hygiene products such as sanitizing hand lotion, hand wipes, and
disposable seat covers can also increase the risk of developing mysophobia.

Some people may be at more risk genetically to develop mysophobia because they inherited a tendency
to be anxious. People with mysophobia who have children often extend their extreme behaviors to their
children and children may then learn mysophobic behaviors. These behaviors can decrease the chances
that their children will become sick but on the other hand, the children are more likely to develop allergies if
they are not exposed to germs. People with mysophobia often recognize that their behaviors are not
rational but find the behaviors difficult or impossible to control. They can also feel depressed because of
how much their lives are affected by their fears and resulting behaviors.

HOW IS MYSOPHOBIA TREATED?

A psychological technique that is very helpful in treating mysophobia is cognitive behavioral therapy (CBT)
in which people learn to change their thoughts to change their resulting feelings. The person learns not to
over-estimate the risk of being harmed by germs by understanding that not all germs are harmful or will
lead to catastrophic health outcomes. In this way, thoughts become less intrusive and anxiety-provoking.
CBT is the most common form of treatment. Another technique is a method known as desensitization in
which a person is taught how to relax when being exposed to progressively more intense forms of the
feared stimuli (e.g. a picture of dirt, a speck of dirt, a spoonful or dirt, having dirt placed on the skin). The
person is exposed to more intense forms of the stimulus as they master the fear at the less intense level. 
Sometimes, the more intense form of the stimuli is based on the amount of the stimuli whereas in other
cases it may be based on the duration of exposure (e.g., one minute, two minutes, three minutes, etc,
such as the length of time that elapses without cleaning ones hands after a handshake). CBT is often
combined with desensitization and typically works within a few months.

Another treatment technique is a behavioral method known as flooding in which the person is immersed
directly in the feared stimulus (e.g., a mud bath) to demonstrate that the fear is irrational. The fear is
replaced by realization of this and the application of relaxation techniques. Flooding is a faster but more
traumatic form of treatment than desensitization. A more insight-oriented technique involves exploring the
original cause of the phobia (e.g., a traumatic childhood event) and trying to resolve issues surrounding
this. This may involve use of CBT techniques and/or other counseling methods. An unproven technique for
mysophobia is hypnotherapy, in which a suggestible person is taught sub-consciously to not be so afraid
of the feared stimuli. Mysophobia can be treated by an anti-anxiety medication designed to decrease
anxiety.  Sometimes, antidepressant medications may be used because some anti-depressants are useful
for treating anxiety as well as depression.

WHAT ELSE IS MYSOPHOBIA KNOWN AS?

Mysophobia is also known as rhypophobia, germophobia, and germaphobia, bacteriophobia,
bacillophobia, molysmophobia, molysomophobia, and rupophobia.

WHAT IS THE ORIGIN OF THE TERM, MYSOPHOBIA?

The term “mysophobia” was created by a military physician and neurologist named William Alexander
Hammond when describing an OCD patient with repeated hand washing. Mysophobia comes from the
Greek word "mysos" meaning "defilement," and the Greek word "phobos" meaning "fear." Put the two
words together and you have "fear (of) defilement."