Overcoming Anxiety: Coping with Obsessive Hand Washing and Cleanliness Fears

Feeling that the surroundings outside are very dirty?

Hello, doctor.
I have been repeatedly washing my hands since I was in the second year of junior high school.
Sometimes I feel like my hands are very dirty, and if I don't wash them, I feel very anxious.
It became more severe in the third year of junior high.
If someone touches my belongings, I feel they are unclean, and I use alcohol to disinfect them or even throw them away and buy new ones.
When I get home, I immediately take a shower.
I really dislike public places and crowded areas (but I still go out when friends invite me), as well as using public transportation (so I usually take taxis, but I still feel resistant).
I am very afraid of touching handrails on stairs and the handles of buses and subways.
I avoid contact with strangers (for example, when cashiers hand me change).
I don't like eating out (I try to avoid it unless necessary) because I'm very afraid that utensils have been used by many people or that food has been touched by the staff.
I carry a small bottle of hand sanitizer with me and use paper towels or tissues to handle items for others, avoiding direct contact.
My family understands me and tries to help me improve gradually, but this has affected my interpersonal relationships.
Although I know this behavior is not good and I have tried to change, I just can't seem to do it.
I have also thought that it might have started because a classmate licked my hand, which made me feel very dirty.
I would like to ask how I can change this behavior.
Thank you.

Ling, 10~19 year old female. Ask Date: 2016/11/20

Dr. Ding Shuyan reply Psychiatry

Hello, you can Google about obsessive-compulsive disorder (OCD).
It seems that your fear of dirt has significantly impacted your life.
I recommend seeking help from a professional.
If your family is supportive, seeing a doctor and possibly taking medication might expedite your recovery.
Psychological therapy and counseling are also beneficial; if there are resources available nearby, they can complement non-pharmacological approaches.
It can be challenging to resist the urge to clean or wash when these thoughts arise.
However, you can practice not immediately engaging in cleaning actions when such thoughts occur.
Gently redirect your attention to another activity and tell yourself, "I know this is important, but let me pause for 30 seconds and do something else before I come back to it." A simple technique is to perform a few relaxed, effortless abdominal breaths to help shift your focus.
Give it a try.
Wishing you all the best.
Sincerely, Dr.
Ding Shuo-Yan.

Reply Date: 2016/11/20

More Info

Overcoming anxiety related to obsessive hand washing and cleanliness fears can be a challenging journey, but it is important to recognize that you are not alone in this struggle. Many individuals experience similar feelings, often stemming from obsessive-compulsive disorder (OCD) or related anxiety disorders. Your description indicates that your fears about cleanliness and contamination have significantly impacted your daily life, relationships, and overall well-being.

Firstly, it is crucial to understand that OCD is characterized by intrusive thoughts (obsessions) that lead to repetitive behaviors (compulsions) aimed at reducing the anxiety caused by those thoughts. In your case, the fear of contamination from touching objects or being in public spaces has led to compulsive hand washing and avoidance behaviors. This cycle can be exhausting and can create a sense of isolation, as you may feel compelled to avoid situations that trigger your anxiety.

To effectively address these issues, a combination of professional treatment and self-help strategies is often recommended. Here are some steps you can take:
1. Seek Professional Help: Consulting with a mental health professional, such as a psychologist or psychiatrist, is a critical first step. They can provide a proper diagnosis and recommend treatment options, which may include cognitive-behavioral therapy (CBT) and medication. CBT, particularly exposure and response prevention (ERP), is a highly effective treatment for OCD. ERP involves gradually exposing yourself to the sources of your anxiety (e.g., touching objects in public) while refraining from performing the compulsive behaviors (e.g., washing your hands immediately afterward).

2. Medication: In some cases, medication may be prescribed to help manage symptoms of OCD and anxiety. Selective serotonin reuptake inhibitors (SSRIs) are commonly used and can help reduce the intensity of obsessive thoughts and compulsive behaviors.

3. Practice Mindfulness and Relaxation Techniques: Incorporating mindfulness practices, such as meditation or deep breathing exercises, can help you manage anxiety in the moment. These techniques can provide you with tools to ground yourself when you feel overwhelmed by intrusive thoughts.

4. Gradual Exposure: Start with small steps to confront your fears. For example, you might begin by touching a doorknob in a public place and then waiting a few minutes before washing your hands. Gradually increase the difficulty of these exposures as you become more comfortable.

5. Challenge Negative Thoughts: Work on identifying and challenging the irrational beliefs that fuel your anxiety. For instance, remind yourself that while it is important to maintain hygiene, the likelihood of becoming ill from touching a clean surface is very low. Keeping a journal to document your thoughts and feelings can help you recognize patterns and challenge negative thinking.

6. Build a Support System: Share your experiences with trusted friends or family members who can provide support and encouragement. They can help you stay accountable as you work through your challenges.

7. Limit Avoidance Behaviors: While it may feel safer to avoid certain situations, this can reinforce your fears. Gradually expose yourself to the situations you fear while practicing the coping strategies you’ve learned.

8. Educate Yourself: Learning more about OCD and anxiety can help demystify your experiences and empower you to take control of your situation. There are many resources available, including books, online forums, and support groups.

In conclusion, overcoming anxiety related to obsessive hand washing and cleanliness fears is a process that requires patience and persistence. By seeking professional help, practicing self-care techniques, and gradually confronting your fears, you can work towards regaining control over your life and reducing the impact of these compulsions. Remember, recovery is possible, and taking the first step by reaching out for help is a significant move towards healing.

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