If your teen engaged in constant handwashing and kept a six-foot distance from people during the height of the pandemic, you likely praised their behavior. If they’re still doing it, there may be cause for concern.
There’s a big difference between taking sensible precautions to fight germs (or avoid them) and germaphobia. If your teen is dealing with adolescent germaphobia, contamination fears may literally dominate their life—and yours. Here’s what you need to know.
Key Takeaways
- Germaphobia is the fear of germs that cause disease such as bacteria, viruses, or parasites.
- Signs of germaphobia include frequent handwashing and showering, as well as constant sanitizing of objects and surfaces.
- Adolescents with prior trauma and anxiety disorders are more prone to germaphobia.
- Phobias are common mental disorders and are often successfully treated.
What Is Germaphobia?
Germaphobia, also known as mysophobia, is an extreme fear of germs such as bacteria, viruses, parasites, and the like. People experiencing germaphobia aren’t just afraid of germs. They harbor an intense fear of contamination and illness that interferes with their daily life. Additionally, germaphobic people are unable to discern the difference between a mild chance of exposure and a serious threat. Hence, they live in a state of alarm that’s out of proportion to their degree of actual risk.
In the Diagnostic and Statistical Manual of Mental Disorders, Vol. 5 (DSM-5), germaphobia falls under the definition of a specific phobia. Specific phobias are defined as marked fears or anxiety about a specific object or situation, which almost always provokes an immediate fear or anxiety response. That means that people experiencing a specific phobia actively avoid the anxiety-producing stimulus, or endure it with intense fear or anxiety that’s disproportionate to the actual danger posed. To be diagnosed with a phobia, the person must experience symptoms for at least six months, causing significant distress or impairment in social, occupational, or other areas of functioning.
Is Germaphobia a Mental Illness?
It’s not surprising that after living through COVID-19, many people—teens included—developed a fear of germs. But people with germaphobia go so far as to sacrifice activities and relationships they enjoy because their fear of germs is so overwhelming.
About 9 percent of children and teens suffer from a specific phobia like germaphobia. Specific phobias like germaphobia are very common mental illnesses. They’re associated with other mental disorders, as well, due to the impact they have on everyday life. For example, germaphobia can be a symptom of obsessive-compulsive disorder (OCD).
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Germaphobia Symptoms and Signs
The symptoms of germaphobia are wide ranging. In anticipation of exposure to germs, some germaphobes can experience panic attacks. Others might feel significant distress even speaking or thinking about the possibility of contamination.
If you have a healthy level of concern about germs, you might wash your hands before eating, after going to the bathroom, and whenever you’ve been in a public place. People experiencing germaphobia amplify those behaviors significantly. Some of the more common symptoms and signs of germaphobia include:
- Repeated and uncontrollable worries about becoming sick due to exposure to germs
- Extreme anxiety when exposed to bodily fluids, such as mucus or saliva
- Excessive handwashing throughout the day to the point that skin becomes chapped and dry
- Frequent showering to protect against contamination
- Incessant cleaning of belongings and disinfecting of surfaces to avoid contact with germs
- Putting on gloves or using a tissue to touch things outside of one’s personal space
- Refusing physical contact, like shaking hands or hugging
- Avoiding certain places, objects, and people for fear of contracting an illness
Physical Symptoms of Germaphobia
Moreover, the fear of germs can be so paralyzing that that physical symptoms arise, such as:
- Elevated heartbeat
- Rapid breathing or difficulty breathing
- Stomach pain
- Lightheadedness
- Sweating and shaking
- Brain fog
- Crying
- Yelling and screaming
What Causes an Adolescent to Develop a Fear of Germs?
Germaphobia often begins between childhood and young adulthood. In fact, the average age of onset is 7 years old. And experts don’t completely understand the causes of specific phobias. Germophobic teens may develop an extreme fear of germs due to trauma, neurobiology, genetics, or anxiety disorders. Here are some of the most common risk factors associated with germaphobia:
Trauma
Some teens develop germaphobia in response to environmental factors, such as a prior trauma or stressful life event. Examples include living through a divorce, experiencing a serious illness, or a surviving a death in the family, especially if a loved one got sick or died in a contaminated environment. One study showed that witnessing a traumatic event was a risk factor for specific phobias.
Neurobiology
Phobias and other anxiety disorders are more likely to develop when brain chemicals (such as dopamine and serotonin) are out of balance. Additionally, adolescents may be more susceptible to specific phobias if they have an overactive amygdala. The amygdala is the part of the brain associated with emotional reactions. Functional MRIs have shown that when phobic individuals are exposed to phobia-inducing stimuli, they demonstrate an increased level of activity in the amygdala.
Genetics
Just as parents pass down curly hair or brown eyes to their children, they can pass down anxiety, too. Even if a relative suffers from a phobia other than germaphobia, teens with a family history of anxiety disorders have an increased likelihood of developing germaphobia. Moroever, teens whose parents have phobia-related symptoms sometimes develop anxiety about the same things their parents are anxious about, via repeated exposure to their parents’ fears.
Anxiety and Obsessive-Compulsive Disorder (OCD)
Regardless of whether a teen’s anxiety has a genetic origin, the link between anxiety disorders and phobias is well established. A specific form of anxiety that increases the risk of becoming germaphobic is obsessive-compulsive disorder (OCD). People with OCD may become obsessed with their fear or germs. Thus, they engage in compulsive, repetitive behaviors, like handwashing or sanitizing counters, to reduce their distress and anxiety.
Are OCD and Teen Germaphobia the Same?
On the surface, it may seem like OCD and germaphobia are one and the same, especially if an individual’s primary OCD behaviors are focused on cleanliness. While the conditions can be co-occurring, it’s possible to suffer from germaphobia but not OCD, and vice versa.
Because handwashing is a common OCD ritual, it’s often used as a way to explain or characterize the disorder. However, many teens with OCD have obsessions that are unrelated to fear of germs, as well as compulsions that have nothing to do with cleanliness.
Ways to Help a Teen with Germaphobia
Living with a germaphobic teen can be stressful. Still, it’s possible to help your adolescent calm their anxiety so their fear of germs doesn’t overwhelm their existence. Some useful strategies include:
Model Healthy Behaviors
If you want your teen to develop a healthy mindset around germs, you need to model healthy behaviors yourself. If you’re constantly washing your hands, sanitizing surfaces, or commenting on how filthy your child’s room is, you may be contributing to your teen’s fear of germs. Examine your own behavior to ensure you’re not encouraging germaphobia in your teen.
Offer a Reality Check
If know your teen’s fear of germs isn’t based in reality, give them the facts. With sensitivity (and without judgment), educate your teen about germs in the form of books or videos. Inform them that bacteria are a natural part of our bodies and the environment. A recent study suggests that microbial literacy may be an important factor in preventing and reducing germaphobia.
Encourage Relaxation Techniques
To quell the anxiety that arises when your teen’s germaphobia escalates, suggest relaxation techniques. Deep breathing can slow a rapid heart rate and create a sense of calm. Meditation offers a way to detach from intrusive thoughts, while yoga can help diminish uncomfortable physical sensations. Encourage your teen to make a relaxation practice part of their daily routine by carving out a few minutes a day to begin.
Share Coping Strategies
When their fears soar, germaphobic teens can launch into a panic. It’s important for them to have a toolkit of coping skills to manage uncomfortable feelings and unproductive behaviors. Strategies might include journaling, making art, spending time in nature, volunteering, getting enough sleep, and connecting with friends.
Be Available for Conversations
Let your teen know they can turn to you if they’re worried, have questions, and need to talk. And don’t invalidate their experience. Their fears are very real—to them. Extend compassion while reminding them that most germs aren’t as dangerous as they think. If your efforts aren’t enough, seek support from a mental health professional and explore treatment options.
How to Overcome Mysophobia in Adolescents: Treatment Approaches
Phobias are some of the most common mental disorders. Fortunately, they’re also some of the most successfully treated. A range of treatment options exists. A mental health professional will be able to address the underlying cause of your teen’s germaphobia and determine the best course of treatment. Options include:
Exposure Therapy
The best way to minimize any form of anxiety is to face the fear. The more teens avoid situations due to fear, the more their fears expand. Working with a mental health provider, they’ll explore the origin of their fear of germs. As they feel more comfortable, they’ll be exposed to objects and situations where germs may exist.
Exposure and Response Prevention Therapy is designed to encourage people to confront their fears incrementally. Through gradual exposure—reading about germs, touching unsanitized objects, shaking people’s hands, taking public transportation—they learn to manage distressing thoughts and painful feelings.
Cognitive Behavioral Therapy (CBT)
Many mental health disorders respond well to Cognitive Behavioral Therapy (CBT). CBT which works especially well with severe anxiety disorders and specific phobias. Studies show that up to 70 percent of people with obsessive-compulsive disorder experience significant improvement after undergoing CBT.
In CBT treatment for germaphobia, Teens learn to discern the difference between thoughts arising from their “anxious” brain versus their “regular” brain. Next, they develop news ways to respond to them. Specifically, they work with irrational thoughts, reframing them so they become more realistic.
Psychiatric Care and Medication Management
Some germaphobic teens may need medication to calm their obsessive thinking and behaviors, especially if they also suffer from OCD. To determine which medications will best address their symptoms, a psychiatrist will conduct a comprehensive assessment.
After a medication is prescribed, an adolescent should be closely monitored, through further psychiatric evaluations, medication management, and psychoeducation. Medication doesn’t cure mysophobia, but anti-anxiety medications can help teens cope better in stressful circumstances.
Attachment-Based Family Therapy (ABFT)
Attachment-Based Family Therapy (ABFT) is an empirically validated approach for treating anxiety and depression in adolescents, and can also be used to support teens with OCD and their families. By identifying and repairing early childhood attachment ruptures in the parent-child relationship, ABFT rebuilds trust within the parent/primary caregiver-child relationship. Hence, it enhances teen mental health by allowing teens to feel safe turning to their parents for help when they’re struggling with fear of germs or other mental health issues.
Teen Treatment for OCD and Phobias at Newport Academy
At Newport Academy, we’re sensitive to how challenging it can be to live with teen germaphobia, for both the adolescent and their family. Our goal is to uncover the reasons underlying your teen’s fear of germs and to improve their overall quality of life. With effective treatment, teens don’t have to be overwhelmed by fear. They recognize anxiety triggers and learn strategies to overcome their phobias. As a result, they’re able to engage in relationships and activities that help them mature into resilient and confident young adults.
Our integrated approach to care provides teens and their family members with multidisciplinary support. Teens receive a comprehensive assessment and a tailored treatment plan that addresses their physical, mental, emotional, relational, social, and educational well-being. In addition to therapeutic goals, our treatment plans support teens’ physical health needs and may include medication recommendations.
Contact us today to learn more about our clinical model and our specialized treatment for adolescents.
Frequently Asked Questions
Sources
Front. Psychol. 2021 Jun; 12: 10.3389.
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Psychol Res Behav Manag. 2015 Jul; 20(8): 211–23.
