Is there such a thing as cleaning addiction?

Some people suffer from a feeling of needing to clean constantly. Is that an addiction?

The Earth is surrounded by microorganisms invisible to the human eye that enable the long-term stability and development of ecosystems.

The carbon mass (organic matter) of the planet is estimated at 550 million tons (Gt) and bacteria contribute about 70 Gt, i.e. 15% of the total. of the total. These microorganisms are crucial for the conversion of matter and chemical reactions in the environment, so without them, life would not be possible.

Nor do we have to go very far to see the importance of those poorly categorized as "germs". Without going any further, in our intestine live 100 trillion bacteria (Firmicutes, Bacteroidetes, Actinobacteria and other genera) that help us digest plant cellulose, activate our immune system in the first vital stages and protect us from colonization by pathogenic microorganisms. It is estimated that there are 10 bacteria in our body for every cell in our body, so we are not lying when we say that we are our microorganisms.

Unfortunately, all these concepts can be overwhelming, difficult to understand and even dangerous for people who cannot fully internalize the role of prokaryotes in the ecosystem and in the body of living beings. Based on these premises, we pose the following question: Is there such a thing as cleanliness addiction? Let's see what this discomfort associated with the dependence on cleaning behavior that many people suffer from consists of.

Is it possible to be addicted to cleaning?

We will be direct: although this postulation requires of nuances, the answer is that no, this type of problems are part of a set of psychopathologies that are separate from addictions, as we shall see.. Addiction is conceived as a chronic and recurrent disease at the physiological level that is characterized by the search for relief and/or reward through the ingestion of substances or the performance of certain activities (such as gambling). As we will see below, compulsive cleaning does not fall into this category.

What is an addiction?

To elucidate all the questions on the table, we will use as a reference the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychological Association (APA) in 2013. This psychological diagnostic book sets the standard for what is or is not considered a pathology and what its limits are.

In the addictive mechanism, there is a clear physiological response that is described in all the classic cases: the dopaminergic circuitry.. For example, when a human being consumes nicotine, nicotine cholinergic receptors are activated, producing the release of neurotransmitters dopamine, GABA, serotonin, norepinephrine, opioid peptides, vasopressin and endorphins. The release of dopamine produces a state of transient euphoria which, unfortunately, only lasts a few seconds.

As the substance is consumed, a clear resistance develops to that psychoactive element (or activity) to which the patient is addicted. (or activity) to which the patient is addicted. In this mechanism, the nucleus accumbens and the neural reward circuit play essential roles, but in summary, we are left with "the more you consume, the more you need to feel the same peak of euphoria".

According to the APA addiction can develop to 10 different types of substances.such as alcohol, nicotine, Muscle relaxants or more famous drugs such as cocaine or opiates (heroin, among others). As far as activities are concerned, the only one that we have found to be truly classified as an addiction is pathological gambling, since the reward circuit when winning a cash prize in these patients is similar to that experienced by a patient addicted to a dose of cocaine.

Left out of this classic definition are compulsive shopping, excessive consumption of video games, pathological exercise and many other acts that we could consider as "addictions" and that are part of separate psychological disorders (and that also imply the need to attend therapy). Of course, obsession with cleanliness is also not clinically encompassed by addictive mechanisms, and the underlying psychopathology is of a different type, which we will see below. which we will see below.

The Real Answer: Obsessive-Compulsive Disorder

What may be mistakenly thought of as "cleaning addiction" is, in many cases, another clinical sign that the patient has obsessive-compulsive disorder (OCD). This is a type of psychological disorder characterized by the appearance of recurrent, intrusive and persistent thoughts that provoke in the patient restlessness, fear, worry and repetitive behaviors (compulsions). focused on reducing anxiety.

A patient with OCD presents obsession, compulsion or both. Obsession is established with the appearance of recurrent and persistent thoughts, in the form of urges or impulses, which are perceived as unwanted and which cause a great deal of anxiety in the patient. The key to this pathology at the conceptual level is that the person with OCD tries to suppress these unwanted thoughts and sensations with repetitive rituals, i.e. compulsions.

The compulsions themselves are the way of channeling the obsessionby performing rituals with a markedly controlled procedure that is meticulously carried out. The goal of performing them is to reduce the burden of anxiety that the person is experiencing, but these acts are not really correlated with the actual source of distress in any reality. As you can imagine at this point, excessive wiping of hands, nearby surfaces, or the body can be a compulsion in an OCD patient.

At a neurological level, it has been observed that people with this disorder show abnormal activity in several areas of the brain, such as the caudate nucleus and the caudate nucleus.such as the caudate nucleus and the orbital gyri. Hyperactivations and hypoactivations of certain neuronal groups occur during the performance of these compulsions, but clearly, the purpose is not to reach a peak of euphoria (as it happens during the addictive mechanism).

However, it is worth noting that some treatments with positive results have been associated with increased dopamine in the nucleus accumbens, a structure that is also involved in the reward mechanism of addicts. This evidence could indicate that differences in dopamine signaling could partly explain OCD, but of course, the correlation is much more diffuse than in the mechanisms described above.

• You may be interested in "Obsessive-Compulsive Disorder (OCD): what is it and how does it manifest?"

Washers and OCD

Although we may err on the side of reductionism (due to the complexity of the pathology), various sources categorize OCD patients into washers (cleaners), checkers (controllers), doubters (distrustful) and counters (obsessed with symmetry). As you can see many of the patients with this disorder channel their anxiety and stress into absolute neatness.They are obsessed with the idea of having germs on their surface and are afraid of becoming infected with any pathogens that may be present.

In conclusion, rather than talking about addiction to cleaning, we can affirm that this behavior is a typical compulsion in patients with OCDwhose performance is aimed at immediately reducing anxiety (triggered by a traumatic thought/event). The mechanisms of addiction are very different from those of OCD and, therefore, compulsive cleaning cannot be considered addictive, although it is still a problem that should be treated with professional help.

If you are looking for psychotherapy services or psychiatric assistance for this type of sources of discomfort, please contact us. At CITA Clinics we have been helping patients for many years with all kinds of disorders related to addictions and poor impulse regulation.