My Kid Has Become a Germaphobe-What Can I Do?

Life in a global pandemic has brought higher anxiety for all ages, including for many children. Fortunately, there are science-based strategies parents can use at home to help their children cope with transitioning back to more normal living.

An image of a boy looking out a window with a mask on.
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Mom of a Germaphobe

My 9-year-old became obsessed with germs ever since the pandemic. He constantly washes his hands and asks me if random things can get him seriously sick. I thought his phobia would die down as soon as things started getting better, but it hasn't. If anything, he seems even more scared about reentering the world. The other day he broke down in tears thinking we'd send him to camp this summer. I am really worried. Is there anything my husband and I can do to help him get over this fear?

—Mom of a Germaphobe

Dear Mom of a Germaphobe,

Although it seems like we should all be feeling relieved with increasing vaccines, decreasing COVID rates, and signs everywhere of some normalcy returning, I am hearing from people of all ages that anxiety has risen side by side with this progress. Under lockdown, staying in our bubbles gave us a sense of safety, so now that we are leaving those bubbles, it is understandable that anxiety would accompany this re-entry.

Why the Pandemic and Anxiety Are Partners

Anxiety is a fear response with nowhere to go; our brain perceives a threat (like a predator in the cave days), but if it's not one for us to physically outrun or fight, the adrenaline response we are biologically wired to have gets stuck in our minds and bodies.

The pandemic posed a real threat to our safety, but in an abstract way since it's not like we can see COVID-19 in the air or on surfaces. This invisibility creates more anxiety, though, since we then think, "this threat could be anywhere at anytime!" For your son, his hand-washing behavior makes sense as adaptive for the situation, but has now become a problem. This intense focus on germs and getting seriously sick is not helping him stay safe, but causing him (and you) distress that sounds like is getting in the way of his life.

How Parents Can Help Kids Face the Fear

The number one intervention for any form of anxiety is to face the fear. Parents often struggle with anxious behaviors in their children because what gives relief to the child in the moment (removing the source of anxiety) feeds more anxiety for the future. Instead of the temptation to avoid, you can work with your son to build his skills to confront his fear of germs and going places by using well-tested strategies for anxiety.

First and foremost, continue expecting his usual daily activities, including being in the world. But you can start teaching him two types of coping strategies to manage the anxiety he feels about germs and becoming sick: relaxation and working on his thoughts. Teach him about deep breathing, which helps his amped up body slow down (rapid heartbeat and problems breathing are common anxiety responses), and even starting a daily meditation practice can help him feel more control over his thoughts and body sensations.

In addition to relaxation, you can help your son work on his thoughts about germs and getting sick. I explain to kids that the "anxious brain" tries to trick them with thoughts that aren't true, but they can use their "regular brain" to talk back to these thoughts. So, if your son's anxious brain tells him "going to camp will make me so sick I'll end up in the hospital!" his "regular brain" (with some coaching from you) can reassure him with the facts, "thousands of kids go to camp and do not end up in the hospital," and "the camp is taking steps to make sure kids are safe and healthy."

Once he has some practice with relaxation strategies and challenging thoughts, you can work on the behaviors that are getting in the way, which in his case is the frequent hand-washing. One approach is to count the usual number of times he washes his hands in a day, and slowly decrease that frequency to help him tolerate not washing his hands when he feels like he should. While he's not washing his hands, he can practice the relaxation and thought strategies, and/or use distraction of a fun activity, to cope with the anxiety. The goal would be to reduce the hand-washing to when we all do it, like after being outside and before meals.

When to Get Help

If you work with your son on these strategies, and it seems like his germ phobia and fears of getting sick are either intensifying or not changing, he would likely benefit from seeing a specialist in childhood anxiety. Although his anxious behaviors started after the pandemic, it is possible that he has other risk factors for developing anxiety and the pandemic became the tipping point. A professional can comprehensively evaluate your son to determine if these anxiety symptoms may be part of a more serious condition that would require treatment.

It sounds like your son's fear is becoming seriously ill, and the hand-washing has become his way to make sure he avoids this fear. So, although the behavior of hand-washing itself is adaptive as we have all adopted more hand-washing in our lives, his use of it may be considered a "compulsion," depending on the frequency and if it causes other problems, like cracked and bleeding skin, or taking so much time it means he is not doing other important activities. A professional can evaluate the characteristics of his behaviors to determine how far from the norm they are, which also informs the most effective recommendations for how to treat it.

If this is the case, I want to reassure you that you and he are far from alone. Anxiety disorders in children have been rising in recent years for a variety of complicated and not fully understood reasons, but the upside is we really understand how to treat childhood anxiety. In my experience, these treatments often equip children with skills that help them thrive in managing all types of stress as they get older.

The Bottom Line

The pandemic and already high rates of childhood anxiety have created the perfect storm for many children to experience a variety of anxiety symptoms. As a parent, it can be hard to know when these symptoms may be a passing response to stress, and when it has become more serious. Using well-known strategies to decrease anxiety, you can start in the home, but if the problems persist, know that child mental health specialists are well-equipped to help.

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Emily Edlynn, Ph.D., is the author of The Art and Science of Mom parenting blog and a mother of three from Oak Park, Illinois. She is a clinical psychologist in private practice who specializes in working with children and adolescents.

Read More Ask Your Mom columns here.

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