Contamination OCD: Causes, symptoms, and how to find help

Contamination OCD is a type of obsessive-compulsive disorder (OCD) that causes strong and ongoing fears about germs, toxins, bodily fluids, and other things that might cause illness. These fears can lead to upsetting thoughts that repeat over and over. To feel safe, a person may do certain rituals, called compulsions, like washing their hands many times or avoiding objects they think are dirty.

While OCD is sometimes used casually to describe neatness or organization, it’s not a personality trait. It’s a serious mental health condition that can be incredibly challenging to live with and usually requires professional support to manage.

Left untreated, contamination OCD can deeply affect a person’s daily life. But with the right support, people can learn to manage their symptoms and regain a sense of safety and balance.

What are the symptoms of contamination OCD?

Everyone affected by contamination OCD will have their own unique experience with the condition. But many people who have contamination OCD experience some version of the following symptoms.

Fear of contracting or spreading illness

Many people with contamination OCD experience constant fear about getting sick or making someone else sick. These worries often focus on the idea that even small or everyday contact could cause serious illness.

• Constant worry that coming into contact with a certain substance, person, or object will result in serious illness.

• Worry about becoming fatally ill from an illness like AIDS or cancer after coming into contact with an object that someone with one of those conditions touched.

• Constantly scanning surroundings for signs of something that could result in sickness (for example, a stain on the sidewalk).

• Fear about transmitting a disease to others, even without actual evidence of exposure.

Excessive concerns around sanitation

People with contamination OCD may also become extremely focused on cleanliness or avoiding anything they see as dirty or unsafe. These fears can lead to strict rules or rituals meant to keep themselves or others from getting sick.

• Worry about contamination from being in the presence of a certain substance, person, or object (even without direct contact).

• Avoiding people, places, or objects believed to be unsanitary.

• Worry about accidental poisoning from toxins like household chemicals.

• Performing elaborate sanitation rituals like repeated or excessive hand washing or immediately changing clothes after coming into contact with a perceived source of contamination.

Food contamination OCD

Some people with contamination OCD have strong fears about food. They may worry that food is spoiled, undercooked, expired, or touched by germs, chemicals, or human contact. These fears can make eating feel stressful and overwhelming.

People with food contamination OCD might:

• Check expiration dates repeatedly before eating

• Overcook food to kill any possible germs

• Smell or cut into food many times to make sure it seems safe

• Avoid food other people have touched or prepared

• Throw away food they believe might be contaminated

These fears and behaviors can interfere with daily life. But with support and treatment, people can learn to feel safe around food again and rebuild a healthy relationship with eating.

What causes contamination OCD?

More research is needed to better understand the causes of contamination OCD. But there are some known factors that might make you more likely to develop the condition:

• Genetic factors like having a first-degree relative (like a sibling or parent) who also lives with contamination OCD or other forms of OCD.

• Neurobiological abnormalities caused by structural and functional changes to certain neural pathways and other areas of the brain.

• Environmental triggers like navigating a major life transition or living in a high-stress environment, especially if you have other factors that already put you at risk.

• Personal experiences of trauma are known to cause a mental health condition called post-traumatic stress disorder (PTSD). Research shows that people who live with PTSD are also at increased risk of developing OCD.

Daily challenges of living with contamination OCD

People living with contamination OCD live with fear that they’ll be exposed to life-threatening illnesses like AIDS or cancer. They worry that touching an object that someone else touched (like a doorknob or elevator button) will result in the transfer of a virus or bacteria that could make them seriously sick.

This can make moving through the world and attending to life’s responsibilities very difficult. While contamination OCD affects different people in different ways, some of the more common obsessions and resulting compulsive behaviors associated with the condition include:

Hand washing rituals

• Obsession: Fear of being contaminated by touching objects used by others.

• Compulsion: Repeated, extended hand washing or use of hand sanitizer.

Avoiding public spaces

• Obsession: Worry about contracting a serious illness through everyday activities like being in public spaces.

• Compulsion: Avoiding public spaces or public transportation in a way that negatively impacts your life.

Hypervigilance for sources of illness

• Obsession: Fear of being exposed to toxic chemicals or bodily fluids that could make you ill.

• Compulsion: Constant hypervigilance or checking to ensure that an area is free from anything “unclean or unsafe.”

Avoiding touching surfaces

• Obsession: Extreme fears that surfaces (like desks, handrails, or countertops) are unsanitary.

• Compulsion: Use of a barrier like a napkin or tissue instead of touching these surfaces directly, or constantly cleaning and sanitizing them.

Fear of food contamination

• Obsession: Significant concerns about food spoilage or contamination, even related to items that have been safely stored and are well within their expiration date.

• Compulsion: Throwing away or refusing to eat food you fear has been contaminated.

Avoiding physical contact

• Obsession: Worries that you might make someone else sick or transfer germs to them.

• Compulsion: Avoidance of all physical contact, including handshakes and hugs.

Contamination OCD treatment: What works

Contamination OCD can be challenging, but it is treatable. With the right support, many people see their symptoms improve and feel more in control of their lives again.

The most effective treatment for contamination OCD is usually exposure and response prevention (ERP). ERP helps people face their fears about contamination in small, manageable steps while resisting the urge to do compulsions, like washing or checking. Over time, this can reduce fear and break the OCD cycle.

Examples of ERP might include:

• Touching a doorknob and waiting longer than usual before washing hands

• Eating food without checking it repeatedly for signs of contamination

• Sitting on a public bench and resisting the urge to change clothes afterward

• Using a shared pen or keyboard without wiping it down first

Treatment may also include medication. You can work with your provider to see if medication is right for your unique needs. Some people benefit from combining therapy and medication for the best results.

Support from loved ones and learning healthy coping skills can also make a difference. With patience and practice, people with contamination OCD can learn to manage their symptoms and reduce anxiety.

Clinician's take

When treating contamination OCD, I remind clients that progress isn’t about eliminating every intrusive thought. It’s about learning to face fears gradually and safely. With the right support, recovery is not only possible, it’s sustainable.

Brandy Chalmers, LPC

Clinical reviewer

Find help for contamination OCD with Rula

Contamination OCD, like other forms of OCD, is a serious mental health condition that can make everyday tasks feel challenging. With the right support, it can be treated.

In working with a mental health professional, you can learn to manage your condition by reducing contamination anxiety and developing healthy habits. If you, or someone you care about, needs help for contamination OCD, Rula can help.

With Rula, you get access to our network of over 15,000 therapists with expertise in anxiety, depression, OCD, and over 100 other clinical specialties. If you’re looking for medication management, our team can also help you connect with a psychiatric provider.

When you’re ready, you can match with a mental health professional who takes your insurance in under 30 seconds.