Obsessive fear of germs or dirt and the compulsion to wash the hands over and over is one of the most common manifestations of obsessive-compulsive disorder (OCD). For people who suffer from OCD, hand washing goes well beyond a concern with cleanliness. It is extreme behavior whose real purpose is to lessen intense feelings of fear and anxiety. The distinction between concern about germs and obsessive-compulsive disorder is based on the degree to which the concern affects and disrupts – even dominates – one's life.