Cleanliness Rules Germaphobes' Lives
Germaphobes are obsessed with sanitation and feel compelled to clean excessively, but they're really suffering from obsessive-compulsive disorder.
In the Monk TV series, gentle detective Adrian Monk
works the grimy streets of San Francisco but is so driven by a fear of germs
that he must scrub his hands after shaking hands with someone. Monk has been
called the "poster boy" for obsessive-compulsive disorder (OCD). In
fact, in an informal survey conducted by the Obsessive-Compulsive Foundation,
OCD patients said they liked the character, who triumphs even when his
condition interferes with his ability to do his work.
Monk is a "germaphobe," the popular name for people who
become obsessed with germs and dirt and feel compelled to act out rituals of
washing and cleaning. Real people with this condition include the late Howard
Hughes and Saddam Hussein, who reportedly often ordered visitors to strip and
wash with antibacterial soap.
True germaphobes have OCD, which can take various forms. For
example, some people with OCD are "checkers." They're obsessed with a
fear of losing control of aggressive urges, and their anxiety can be relieved
only by checking something, such as whether a burner on the stove has been
turned off. Hoarding, counting, and praying are some other manifestations of
the disease. People often have multiple forms of OCD.
What Causes the Compulsion to Wash?
OCD is believed to be caused by an abnormality in the brain's
circuitry. Brain scans show brain activity is different in people with OCD.
There's probably a genetic component as well, especially when OCD begins in
childhood. One-third to one-half of adults with OCD say their illness started
in childhood or adolescence.
Why someone with the disease is compelled to wash, as opposed
to check or count or hoard, isn't known. What's true with all types of OCD is
that a compulsion is acted out to relieve anxiety produced by an obsessive,
intrusive thought. For example, a woman accidentally cuts herself, washes the
wound, puts antibacterial ointment on it, and bandages it. That should be that,
but an anxious feeling and thought intrude: what if microscopic germs remain?
She knows it's irrational, but she's compelled to wash the cut again in order
to relieve the anxiety. She may have to repeat the act over and over.
When Is Cleanliness a Problem?
Every office has its neat freak. Maybe it's the woman who
cleans her cubicle every morning and keeps everything arranged just so. Is she
just a perfectionist or is she driven by OCD? It can be hard to tell at first
because OCD is a secretive illness, says Mary Guardino. She is the executive
director of Freedom From Fear, the national mental illness advocacy
organization she founded in Staten Island, N.Y., in 1984. "When you first
meet her, you notice how nice and organized and clean everything is. But she
may be hiding her rituals. If she heard a co-worker got the flu, she'd fear she
might have touched something that person handled, so she'll sneak into the
bathroom to wash."