Mysophobia is defined as a pathological or an irrational fear of germs and contamination. It is an abnormal fear related to dirt and filth which tends to incapacitate an individual by interfering in his day to day functioning. It is also known as germophobia, verminophobia or bacteriophobia as there is an excessive and persistent fear of germs, infection and disease.
We all appreciate cleanliness and would like our surroundings to be tidy and hygienic. However, those suffering from mysophobia are completely consumed, mentally and physically, by these thoughts of contamination. For them, the world is a dirty place. They have an excessive / exaggerated fear of being infected by germs and other harmful substances and in order to protect themselves, they compulsively indulge in specific behaviours.
Common reported compulsions include repeated hand washing, compulsive use of disinfectants, sanitizers and other cleaning rituals that could go on for hours a day, for weeks or more. There is an extreme preoccupation with ensuring healthy sanitary habits that creates unreasonable fear and anxiety, if it is met with resistance. Thus, the person gets stuck in a vicious loop of having a feared thought of contamination and infection; and compulsively washing hands and performing cleaning rituals, in order to keep the level of anxiety in check. They recognize the thoughts as irrational, intrusive, involuntary and causing extreme distress to them but are unable to resist performing the compulsions which continues to maintain the illness.
This fear of germs and contamination often compels people to avoid using public bathrooms or refuse to go a hospital or the doctor’s office as these are seen as places where the risk of catching infection is high. They may also start to avoid coming in any kind of physical contact with others or letting others use their belongings like clothes, comb, towel, cutlery etc.
A large part of their life gets spent in these compulsive behaviours which may often lead to other mental health illnesses like depression and anxiety disorders. The phobia not only affects the individual’s personal, social and occupational life but also the lives of those who are living with him. When the anxiety level related to the fear becomes very high, the need to ensure hygiene becomes so great that the sufferer may put pressure on other family members also to comply with their thought process. They may, for instance, forcefully make them wash hands repeatedly or use disinfectants, soaps etc repeatedly until they think they are clean. Rules and regulations may be set that satisfy their abnormal thinking such as no one is to bring outside food at home or that everyone is to remove their shoes before entering the house and compulsorily wash their hands a specific number of times before sitting on the bed or the sofa. This could often become a very confusing and an annoying exercise for the family resulting in arguments and / or fights. Lack of awareness on the family’s part could make them lose patience with the patient thereby further aggravating their stress and the compulsive behaviours. At other times, it is extremely painful and frustrating for the family to see their loved one feeling so helpless and out of control in his life and not being able to help him.
As family, the first step in helping is to understand that this irrational fear and the associated compulsions are not in the person’s control. Thus, simply telling him to stop engaging in it is futile. It will only make him feel more guilty. Giving in to their ritualistic behavior tends to reinforce it, thereby maintaining the dysfunctional behavioral pattern. Therefore, it is important to refrain from doing that. You can help the patient by offering support and care in the form of understanding the illness as a medical condition that needs proper treatment.
Educating oneself about the problem is the first to help and recovery. The more you understand about the illness, it is easier to accept and seek help for it. It is important that both the patient and the family try to maintain a healthy daily routine. This could be challenging but it must be kept as an important goal to achieve on a daily basis. Focus on family and social connections and work commitments which create a sense of normalcy in your life. Encourage the patient to seek professional help which would include meeting a psychiatrist and a psychologist, as a combination of medicine and psychotherapy especially, Cognitive Behavioral Therapy (CBT) is considered to be the most effective form of treatment. In recent years, one has seen gratifying results with Hypnosis and Repetitive Transcranial Magnetic Stimulation (rTMS) in dealing with chronic, compulsive behaviors.
Taking the first step towards recovery might be difficult but with the help of a supportive family, one can see great results that can pave the road for a hopeful future.
– Dr Sanjay Chugh is a senior consultant neuro-psychiatrist based in New Delhi.
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