Contamination OCD: Symptoms & Treatment

What is Contamination OCD?

Contamination OCD is a mental health condition and one of the most common subcategories of obsessive-compulsive disorder. In fact, it’s estimated that nearly half of all people living with OCD fall into the contamination subcategory.

People living with contamination OCD often experience an obsessive thought, fear, or feeling about becoming infected or contaminated, or about infecting or contaminating others. The fear often stems from the transmission of a deadly disease.

Repetitively experiencing these dreadful thoughts can ultimately lead to compulsive behavior in a desperate attempt to calm fears and anxieties.

For instance, someone with contamination OCD may shower or scrub themselves for hours, such as excessive washing, to try and decontaminate themselves. They may obsess over some infectious agent they actually did interact with, or they might be just convinced or scared they came into contact with a contaminant.

When people with OCD have a fear of contamination, they’re often afraid of contracting a specific illness or infection, like HIV — or more recently, coronavirus. Or, they may just be afraid of all sources of possible contamination. Though it’s commonly associated with illness and germs, contamination OCD can cause obsessive fear of a variety of contaminants, including:

• Blood
• Bodily fluids like saliva, sweat, tears, or mucus
• Bodily excretions like urine or fecal matter
• Garbage
• Mold
• Chemicals
• Semen
• Radioactive chemicals or fluids
• Household chemicals or cleaning supplies
• Things that are sticky
• Broken glass
• People who look unkempt
• Insects like lice, fleas, or maggots
• Rotten food
• Toxic materials like lead or asbestos
• Pets or animals
• Things that are dead
• Newspaper
• Soap (yes, soap)

This list is not exhaustive — there can be any number of things that might potentially cause stress and anxiety for somebody with contamination OCD. Illness and ailments are the leaders, though.

What are the causes?

We don’t yet fully understand what causes OCD, including mental contamination OCD. We’ll look more in depth at some specific risk factors below, but genetic predisposition from a family history of obsessive-compulsive disorder, and issues with how the brain communicates, seem to be likely causes.

Signs & Symptoms of Contamination OCD

Understanding OCD symptoms and signs can be challenging. By nature, mental health conditions are much more difficult to diagnose accurately because they’re often not marked by easy-to-see physical signs as obviously as they are by psychological ones. Still, knowing the signs and symptoms can be useful when trying to understand this condition.

Signs you may have contamination OCD

There are some common signs that might suggest contamination OCD. For example, someone might repetitively:

• Wash or scrub their hands
• Clean their house, clothes, or body
• Sterilize or disinfect things
• Change their clothes
• Throw things away
• Avoid specific places
• Avoid touching things
• Designate areas that are off-limits to others

Symptoms of contamination OCD

Most people who have contamination OCD know that the ways they think and act are inappropriate, but it can be exceedingly difficult for them to change. Common symptoms of mental contamination OCD include:

• Experiencing obsessive impulses, pictures, or ideas in their mind
• Intensely stressing about contracting a disease like an STI or developing cancer
• Fearing spreading illness or contaminants
• Being afraid of toxins, germs, dust, radiation, or dirt
• Worrying constantly about bodily fluids, including saliva, blood, or semen
• Persistently having undesirable and unwanted thoughts about cleanliness

For most people, the urges and impulses are uncontrollable. In severe cases, someone might be unable to function normally. They might become so consumed by an obsessive thought or feeling that they constantly engage in repetitive, compulsive behavior. This is an attempt to make their thoughts quiet. Contamination OCD can become a destructive, never-ending cycle.

Examples of Contamination OCD

All subtypes of obsessive-compulsive disorder are marked by unwanted, intrusive thoughts (obsessions), and repetitive behaviors (compulsions) aimed at relieving the anxiety caused by the obsessive thoughts. Let’s consider some examples of each.

Obsessions

People with contamination OCD can experience different obsessions. They can vary widely, but some general examples include feelings like:

• Wondering if germs are on a door handle and if they’ll get sick if they touch it
• Wanting to go to the store or restaurant, but being worried about the food or beverages being contaminated
• Worrying that trying on clothes in a store will contaminate them
• Constantly feeling like their hands are not clean, even after just washing them
• Thinking food is rotten and they might get ill
• Being too afraid to take public transportation, like a bus or cab, because they might catch something from the germs
• Wondering about air ventilation, or immediately feeling sick when they’re in a space
• Being convinced that they’re going to get sick
• Feeling the need to shower after being in a public place
• Thinking they have germs on their skin
• Wondering if the person who just walked by coughing gave them something

Compulsions

As with obsessions, people with the fear of contamination OCD can act out with various compulsive and repetitive behaviors. Their actions come from a deep need and desire to make the persistent thoughts, feelings, and images cease.

Common compulsions might include:

• Using harsh or abrasive chemicals to clean themselves or their surroundings
• Washing or disinfecting excessively
• Throwing away household items and clothing they feel might be contaminated
• Changing clothes excessively and repeatedly
• Throwing out food they’re convinced is going to poison or harm them
• Self-harm such as scraping off skin they believe is contaminated

Risk Factors for Contamination OCD

Risk factors increase the chance of developing an illness or condition. The risk factors for OCD and the subset contamination OCD can include:

• Having a family member who has OCD
• Experiencing a highly traumatic event
• Having another mental health condition, like an anxiety disorder, depression, or an eating disorder
• Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS)
• A strep infection

Stress can make OCD symptoms more intense. Severe stress, like a divorce, the death of a loved one, or physical violence, may cause or exacerbate obsessive-compulsive disorder. More research is needed to understand why this is.

Treatment for Contamination OCD

There is some good news. OCD treatments exist and treatment for contamination OCD is available. Options include therapy for OCD, possibly medication, and in very extreme cases, intensive treatment programs.

Medication:
For some people, certain medications can help. The most widely used OCD medication is a type of antidepressant known as a selective serotonin reuptake inhibitors (SSRI). While SSRIs are the first line of prescription treatment, other off-label medications — such as tricyclic antidepressants (TCAs) or benzodiazepines — can be tried when SSRIs haven’t been helpful.

The goal of OCD treatment is to address 3 major aspects of the condition:

• How you think
• How you feel
• How you behave

Cognitive behavioral therapy (CBT) is an excellent therapy modality for OCD because, unlike some other types of therapy, CBT largely focuses on behavior.

Therapy: Exposure and response prevention (ERP)
One of the most popular forms of OCD therapy is a type of cognitive behavioral therapy (CBT) called exposure and response prevention (ERP) therapy. Like all forms of CBT, ERP aims to change negative and harmful thought and behavior patterns that contribute to real-life problems.

ERP is a well-tolerated, highly effective therapy that gently exposes you to identified symptom triggers in a controlled, safe environment. Then, as this compulsive behavior is triggered, the therapist works with you, helping you understand that your behavior is not just unnecessary, it can also be harmful, and it ultimately changes nothing. Gradually, exposure will increase, and tolerance will build.

Therapy: Mindfulness-based CBT
Mindfulness-based CBT is another beneficial treatment for contamination OCD. The technique essentially involves becoming and remaining aware of breathing and thinking as they occur. By staying in touch with your thoughts as they develop, you can become better able to stay in control. This, in turn, allows you to make better behavioral choices on the spot.

The goal of clinical treatment for contamination OCD is to get you to a point where you understand your condition and can watch your thoughts and respond with healthier, more productive behaviors.

It’s not easy. There’s deep work to be done, but you can do it. If you think you have contamination OCD, consider the many benefits of working with a therapist who specializes in obsessive-compulsive disorder treatment.

Finding help with Talkspace

Talkspace is a unique online therapy platform that makes the process of getting therapy easier than ever. You can find an experienced, highly skilled therapist who can help you learn to live with contamination OCD.

Learn more about how Talkspace has helped countless people live a healthier, happier, more positive life, free from the grips of whatever mental health condition they’re living with.