Contamination OCD: Symptoms, Causes, and Effective Treatments

Contamination OCD can take over a person’s life in ways that aren’t always obvious to others. Beyond just being afraid of germs, this disorder causes a relentless sense of unease that something, somewhere, is contaminated and poses a threat. This fear can make ordinary things like touching a doorknob feel unbearable. For those struggling, it can not only be frustrating but also exhausting.

What is Contamination OCD?

Contamination OCD is a subtype of obsessive-compulsive disorder that revolves around extreme fears of coming into contact with contaminants. It’s common to think of contamination OCD as being just about germs, but it’s more complicated than that. For many, the idea of contamination can extend to bodily fluids like sweat or saliva, excretions like urine or feces, and even pets or people who seem unwell or disheveled.

What makes contamination OCD challenging is that the fear isn’t always rational. Some individuals might believe even the smallest trace of a contaminant has the power to spread and affect everything they touch. This obsessive fear can result in compulsive behaviors like excessive hand washing, cleaning, or avoiding certain places, objects, or people entirely.

Physical vs. Emotional vs. Mental Contamination

“Germaphobe” is a common term that many people with contamination OCD might hear, but this disorder doesn’t always look like scrubbing your hands after touching something “dirty.” It can manifest in different ways, including physically, emotionally, and mentally. Here’s a breakdown:

Type of Contamination	What It Is	Examples
Physical Contamination	Most well-known type that involves direct contact with something or someone considered “contaminated”	Feeling the need to sanitize after shaking hands, avoiding public restrooms, or fearing “dirty” objects
Emotional Contamination	The fear of “absorbing” negativity from people, objects, or places. This could be a bad vibe, energy, or personality trait	Avoiding sitting on a chair used by someone you dislike or feeling uncomfortable in a place linked to bad memories
Mental Contamination	A feeling of being “dirty” inside, triggered by intrusive thoughts, memories, or associations; doesn’t require physical contact	Feeling unclean after remembering a past betrayal, or being haunted by thoughts of a traumatic event

Physical contamination tends to get the most attention because it’s visible. We can picture someone washing their hands or avoiding touching a doorknob. However, emotional and mental contamination are just as debilitating, if not more so, because they’re invisible.

What Causes Contamination OCD?

Contamination OCD is driven by an irrational fear of being contaminated. For many, this fear is tied to a heightened sensitivity to disgust and anxiety. These emotions make everyday interactions, like touching a doorknob or shaking someone’s hand, feel like a big threat.

Additionally, cognitive distortions can contribute to a fear of contamination. One common distortion is sympathetic magic, which refers to irrational beliefs about how contamination spreads. For example, someone might think that a single “dirty” object can somehow contaminate everything it touches, even indirectly.

While the fear of contamination is central to the disorder, researchers have found that contamination OCD is influenced by a combination of genetic, biological, and environmental factors. Here’s what they found:

OCD often runs in families. If you have a relative with OCD, you’re more likely to develop it.
Certain parts of the brain, like the orbitofrontal cortex, don’t function the same way in people with OCD. Problems with brain circuits and chemicals like serotonin and dopamine may also contribute.
People with contamination OCD typically have distorted thinking, like believing they are responsible for preventing harm or imagining the worst-case scenario will happen.
Stressful experiences, trauma, or difficult childhood events can trigger or worsen OCD symptoms, especially in someone who’s predisposed to the condition.
Some research suggests that problems with the immune system, like autoimmune disorders or infections, might contribute to OCD symptoms.
Complications during pregnancy or birth might increase the chances of developing OCD later in life.

Despite these findings, researchers are still working to understand exactly what causes OCD.

What Are The Symptoms of Contamination OCD?

The symptoms of contamination OCD can look different depending on the person. However, there are some common threads that can be broken down into obsessions and compulsions.

Contamination OCD Obsessions

Obsessions are the intrusive, distressing thoughts that drive contamination OCD. These thoughts can feel impossible to ignore and can lead to severe anxiety. Obsessions can look like:

Feeling a deep fear of touching everyday objects like door handles, money, or shopping carts, believing they’re covered in harmful substances
Worrying that food packaging or grocery items might be contaminated with harmful chemicals or substances
Having an ongoing fear of bodily fluids like blood, sweat, saliva, urine, or feces and believing they could carry harmful diseases like HIV or cancer
Experiencing extreme anxiety about being coughed or sneezed on, which can result in avoiding people or crowded spaces
Worrying about wearing clothes that might have come into contact with contaminants, even if they’ve been cleaned
Feeling convinced that items in your home, like mail or packages, carry contaminants from outside and must be handled with extreme caution

Obsessions are frequently related to someone’s sense of responsibility, like the fear of unintentionally harming others by spreading germs or contaminants. This fear has the potential to cause an unrelenting need to “fix” the situation, which is where compulsions come in.

Contamination OCD Compulsions

Compulsions are the repetitive behaviors or mental acts someone with contamination OCD feels compelled to perform to ease their anxiety. These rituals take a significant amount of time and energy out of one’s day. Common compulsions include:

Washing hands, disinfecting surfaces, or showering multiple times a day
Ritualized bathing routines, such as scrubbing in a specific order or using excessive amounts of soap
Avoiding public spaces, bathrooms, or other areas that may be contaminated
Refusing to shake hands, hug, or come into contact with others, including loved ones
Throwing away clothes, shoes, or other belongings that feel dirty instead of attempting to clean or reuse them
Constantly asking others for confirmation that they are not contaminated or haven’t spread contamination

In addition to these behaviors, some people may have more subtle or unexpected compulsions. For example, they might create mental rules about how to clean or avoid contaminants, such as walking on certain parts of the floor or avoiding specific colors of items. Others may try to neutralize contamination by performing rituals like counting, praying, or repeating words silently.

How is Contamination OCD Treated?

Contamination OCD is treated with therapy, medication, or a combination of both. For those who don’t respond to these treatments, new treatments like transcranial magnetic stimulation (TMS) therapy could be worth considering.

Talk Therapy

The most common and often first-line psychological treatment for contamination OCD is exposure and response prevention (ERP) therapy. This type of cognitive-behavioral therapy gradually exposes individuals to their fears while preventing the compulsive behaviors they typically rely on. Over time, this process helps the brain unlearn the connection between the fear and the compulsion.

For example, someone with contamination OCD might be encouraged to touch a seemingly contaminated object like a doorknob without immediately washing their hands. While ERP can be effective, it can be challenging for some. In fact, many people find this therapy to be stressful, which is why researchers are looking into other approaches to OCD treatment like multisensory stimulation therapy.

Multisensory stimulation therapy is based on a trick called the “rubber hand illusion.” A fake hand is placed in front of the patient while their real hand is hidden. Both hands are stroked at the same time, making it feel as if the fake hand is part of their body. By contaminating the fake hand, patients may be able to confront their fears in a less stressful and more controlled way.

Medications

Medication is another option for treating contamination OCD and can be especially beneficial when paired with therapy. The most commonly prescribed medications are selective serotonin reuptake inhibitors (SSRIs) and the tricyclic antidepressant clomipramine. These medications regulate serotonin levels in the brain which are thought to contribute to OCD symptoms.

SSRIs that are approved for contamination OCD include:

Fluoxetine (Prozac, Sarafem)
Fluvoxamine (Luvox)
Paroxetine (Paxil)
Sertraline (Zoloft)
Citalopram (Celexa)
Escitalopram (Lexapro)

TMS Therapy

Research shows that up to 40% of OCD patients don’t see symptom relief from traditional treatments, making TMS a promising alternative. TMS is an FDA-approved, non-invasive treatment that uses magnetic pulses to target specific brain regions that are associated with OCD.

One benefit of TMS is its precision. By focusing directly on the areas of the brain involved in OCD, it has the potential to provide more targeted results. Compared to medications, TMS also tends to have fewer side effects with the most common being mild scalp discomfort or headaches that go away shortly after treatment.

Manage Your OCD with Cura Behavioral Health

Contamination OCD is an often misunderstood struggle that affects the way you think, feel, and live. The good news is that OCD doesn’t define who you are, and with the right care, you can find relief and regain control over your life.

At Cua Behavioral Health, we know that no two experiences with OCD are the same. That’s why we offer personalized treatment plans designed to meet you where you are. Whether you’re looking for therapy, medication management, or TMS therapy, we’re by your side every step of the way. Contact us today to learn more.

Sources:

Relationship between white matter alterations and contamination subgroup in obsessive compulsive disorder: A diffusion tensor imaging study – Human Brain Mapping

An Experimental Investigation of Moral Self-Violation and Mental Contamination – Cognitive Therapy and Research

Obsessive–compulsive disorder—contamination fears, features, and treatment: novel smartphone therapies in light of global mental health and pandemics (COVID-19) – CNS Spectrums

A Comprehensive Review on Obsessive-Compulsive Disorder: An Update – Pharmacophore Journal

Contaminating a fake rubber hand could help people overcome OCD, study suggests – University of Cambridge

Obsessive–compulsive disorder—contamination fears, features, and treatment: novel smartphone therapies in light of global mental health and pandemics (COVID-19) – Cambridge University Press

Is TMS Therapy Right for You?

Determining if TMS therapy suits your mental health journey should involve consultation with a qualified professional. At Cura Behavioral Health, we provide comprehensive assessments to help you make informed treatment decisions.

Begin Your Transformation Today

Don’t let a mental health condition hold you back any longer. Schedule a consultation with Cura Behavioral Health today. Our experienced team is ready to answer your questions and create a personalized treatment plan tailored to your unique needs.