What are common obsessions in contamination/disease/illness/health-focused OCD?

Health- or contamination-related OCD involves the fear of getting sick, making others sick, experiencing disgust, or being responsible for an unwanted outcome.

OCD: Fear of Getting Sick

Contamination- or health-related OCD is associated with persistent worries about one’s health or the health of loved ones. Common obsessions in contamination-related OCD include the fear of getting sick with a serious illness like rabies, ebola, H1N1 (swine flu), Creutzfeldt-Jakob disease, mad cow disease, hepatitis, or avian influenza.

Other frequent obsessions focus on the fear of contracting sexually-transmitted diseases (STDs) such as AIDS/HIV, herpes, HPV, syphilis, or chlamydia. Chronic progressive diseases, like AIDS, that have no known cure tend to evoke extreme anxiety. Individuals with OCD fear both getting sick and the negative consequences associated with illness, which may range from pain and discomfort to serious repercussions such as death, sterility, or deformity.

OCD: Fear of Making Others Sick

Other individuals’ obsessions focus almost exclusively on potentially infecting other people. These individuals may be convinced that they are carriers for certain illnesses and may worry that they will spread disease to children, loved ones, or strangers. This type of OCD is common in parents (especially mothers) who are afraid of infecting their children. Because OCD is based on fear rather than logic, these worries tend to persist even if the individual is in perfect health.

In other cases, individuals with OCD are actually disease carriers. These individuals often experience extreme guilt and fear over the possibility of infecting others with their illness. They tend to be very conscientious and possess a heightened sense of responsibility for guarding others’ health. This type of OCD is especially distressing in the context of chronic illnesses like STDs (herpes, HPV, AIDS), because the individual may feel guilt over having contracted the original illness.

OCD: Fear of Getting Sick in the Future

In still other cases, OCD health-related obsessions tend to focus more on negative health events that might occur at some future date. These fears include getting cancer, having a stroke, or developing Alzheimer’s disease. These events might occur relatively unpredictably or might involve exposure to present risk factors (e.g., smoking, exposure to asbestos/lead/mold, carcinogens, chemicals, or radiation).

OCD: Fear of Disgusting Things & Situations

Sometimes contamination-related OCD is triggered by exposure to “disgusting” things. Common triggers include oily and sticky substances, body fluids and bodily secretions, and animals. Feces, urine, sweat, saliva, blood, sexual fluids, and body hair can illicit a strong disgust reaction that may not be directly linked to the fear of a specific illness. Common worries focus on accidentally ingesting these substances or spreading them to others.

OCD: Fear of Specific Unwanted Outcomes

Some individuals have feared consequences that are linked to specific OCD triggers. For example, some men fear accidentally impregnating their partners (or even strangers) through non-sexual contact or through unintentionally spreading semen residue. They fear that they may cause an unwanted pregnancy by “contaminating” public places. These men often know logically that their fears are irrational or even impossible, but yet the worry persists.

Contamination- and health-related obsessions are effectively treated through exposure and response prevention (ERP), a form of cognitive behavioral therapy that was specifically developed to treat OCD.

Join me next time when I talk about the idiosyncratic nature of feared outcomes associated with health-related OCD.

Questions? Comments? If you have health-related OCD, what are your fears?

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