Contamination OCD is a subtype, or “theme,” of obsessive-compulsive disorder (OCD). It includes persistent fear of contamination and an overwhelming need to clean oneself and objects.
OCD involves having recurring, unwanted, and distressing thoughts and images (obsessions) and engaging in repetitive behaviors that aim to neutralize them (compulsions).
OCD can have different themes or focuses. These can change over time, and some people may experience more than one OCD theme simultaneously.
Subtypes of OCD (like contamination OCD) aren’t distinct diagnoses — clinically, all themes in OCD fall under the same condition.
Symptoms of contamination OCD
The two main symptoms of any type of OCD are obsessions and compulsions.
Obsessions are persistent, intrusive, and recurring thoughts or images that won’t go away at will. Compulsions are actions or behaviors that you feel driven to repeat to reduce the emotional and mental effects of obsessions.
For example, with contamination OCD, an obsession may include fear of being exposed to viruses and bacteria. These persistent thoughts may constantly increase your levels of anxiety. A compulsion to wash your hands every few minutes may develop as an effort to relieve this anxiety.
Contamination-related obsessions and compulsions can manifest in different ways, including:
- living with fear of being exposed to sources of contamination (for example, dirt, bacteria, or viruses)
- experiencing high levels of distress when you encounter contaminants (for example, when someone next to you sneezes)
- discarding items you perceive to be contaminated (for example, an object that the person sneezing touched or sat on)
- engaging in excessive cleaning rituals (for example, constant handwashing or house cleaning every few hours)
- avoiding going to places where you might encounter contaminants (for example, public bathrooms or transportation)
- avoiding experiences you think might “contaminate” you (for example, shaking hands or using someone else’s utensils, even if clean)
- excessively researching cleaning methods and new sources of contaminants
Compulsions might feel like scratching an itch: You might feel driven to engage in them, and they may provide temporary relief, but they won’t stop the obsessions. In fact, compulsions can sometimes reinforce obsessions, leading to what is called the “ cycle of OCD .”
Not everybody with contamination OCD has the same obsessions or compulsions, but the common theme is fear and avoidance of contamination.
More obsession and compulsion examples in contamination OCD
Obsessions and compulsions can vary from one person to the next. You may have obsessions that someone else with contamination OCD may not find distressing, and vice versa.
Obsessions
- persistent and irrational fear of germs, bacteria, or viruses that you feel will lead to illness or death
- excessive fear of toxins and chemicals
- intense aversion to dirt or dust
- anxious thoughts about spreading contamination to others
- recurrent images of germs or toxic objects
Compulsions
- spending hours cleaning and disinfecting household surfaces, personal items, or oneself
- washing hands excessively, often for a prolonged duration and with rigorous methods or harsh detergents
- avoiding public places, social interactions, or any situation where contamination is perceived as possible
- frequently changing clothes or laundering clothes you think are contaminated
- engaging in mental rituals, like persistently praying or mentally reviewing your cleaning schedule, to neutralize contamination fears
How is contamination OCD diagnosed and treated?
Living with contamination OCD can be difficult, but it is possible to manage your symptoms. A diagnosis can be the first step toward finding relief.
Diagnosis
A mental health professional diagnoses OCD based on a thorough clinical evaluation.
In the United States, clinicians often use the diagnostic criteria set out in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR).
According to the DSM-5-TR, an OCD diagnosis is warranted when:
- you experience obsessions, compulsions, or both (any themes)
- you have obsessions or compulsions that significantly affect your day-to-day functioning or take up at least an hour of your day
- these symptoms cannot be explained by using a substance or having another medical condition
A medical professional may also add a note to describe the degree of insight you have into your symptoms.
For example, you may receive a diagnosis of contamination OCD with good or fair insight. This means that despite having intrusive thoughts or feeling compelled to repeat cleaning actions, you understand at some level that you won’t get sick if you skip handwashing.
On the other side of the spectrum, someone with absent insight may be completely convinced they will get sick or even die if they don’t wash their hands every few minutes.
It is possible that someone may experience different degrees of insight at different times.
Treatment
Treatment for OCD can vary from person to person depending on individual needs. It can include talk therapy, medication, and support groups.
Different types of talk therapy can help with OCD symptoms, including:
A healthcare professional may also prescribe medications to help with severe OCD symptoms. These may include:
Depending on your experience with OCD, you may also find it helpful to participate in support groups. The International OCD Foundation has a list of local OCD support groups and a list of online or telephone support groups .
Takeaway
Contamination OCD is a subtype of OCD that involves persistent fears of contamination (obsessions) and repetitive behaviors aimed at neutralizing these fears (compulsions).
Treatment for OCD is available and effective. Psychotherapy, medication, and support groups can help you manage your symptoms and feel better overall.
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