Everything you need to know about thanatophobia, otherwise known as fear of death.
Many of us have a fear of death and dying, or worry from time to time about how friends and family will cope when we’re gone.
This can be more intense if we have had a recent health scare, diagnosis or illness in the family. However, with time, these concerns usually fade.
If you have a fear of death or dying that is persistent and longstanding, causes you distress or anxiety, and is so extreme that it interferes with your day-to-day life, you may be suffering from thanatophobia, otherwise known as, fear of death.
What is thanatophobia?
First described by Sigmund Freud in 1915, thanatophobia is an anxiety condition characterised by extreme and excessive fear of your own death or the process of dying. Whilst it is not a recognised anxiety disorder in its own right, it is often seen in those experiencing Generalised Anxiety Disorder (GAD) and in some cases is best understood as a type of Specific Phobia; an intense and irrational fear of a specific object or situation which is either endured with intense distress or is avoided completely to the extent that it impacts negatively on your life.
A person with thanatophobia will experience cognitive, emotional, physical and behavioural symptoms:
Common cognitive symptoms include worrying about the future and the unknown, losing control, how you will die and what will happen to your body. Worries may also focus on physical suffering, feeling lonely and how your friends and family will cope if you die. You may also have images about your own death and dying which are hard to switch off from.
Emotional symptoms such as a feeling of dread, anxiety, fear and panic at the thought of death or anything to do with dying are common as are other emotions such as feeling guilty, angry or sad about the impact these fears are having on you, your life and your loved ones.
You may also experience common physical symptoms of anxiety such as dizziness, sweating, heart palpitations, nausea, stomach pain as well as other physical sensations such as feeling like you are choking. You may be more aware of feelings in your body than others, including normal physical sensations that occur.
Behavioural symptoms of thanatophobia include avoiding triggers which might cause you to think about death or dying, such as watching TV dramas based in hospitals, listening to the news or talking about death with others. You may also find that you try to avoid situations, people or activities in an attempt to prevent the possibility of dying, such as not leaving the house or taking a flight and taking extreme measures to try and avoid illness or stay young. Symptoms may come and go and be more obvious at times of illness or uncertainty. As your life becomes more and more restricted in an attempt to keep safe, you may find yourself feeling isolated from friends and family and no longer experiencing enjoyment or pleasure from life.
The exact causes of thanatophobia remain unknown. However, it has been hypothesised that a specific life event, such as severe illness or the sudden death of a loved one and/or having an existing anxiety condition where you fear the unknown and losing control, may contribute to its development.
Thanatophobia risk factors
Little research has been conducted to ascertain the risk factors for thanatophobia however it has been found that those with existing physical health problems are more likely to fear their own death. Age has also been found to play a part as it’s onset most commonly occurs in a person’s 20s. Whilst younger people have been found to be more likely to fear death itself, older people have been found to be more afraid of the dying process.
Whilst younger people are more likely to fear death itself, older people are more afraid of the dying process.
Both men and women have been found to experience thanatophobia equally, although women have been found to have a higher incidence than men in their 50s.
One study found that people who are more humble have been found to be at lower risk of developing thanatophobia as they have a lower sense of self-importance and are therefore are more willing to accept their passing.
When to see a doctor
If you are experiencing frequent, intense and persistent anxiety about death or dying that is causing you distress and is impacting on your quality of life, affecting your life, work and relationships, then it may be time to seek help.
You can speak to your GP about the symptoms you are experiencing or find a qualified and accredited therapist who will be able to help you find the right support and treatment.
As thanatophobia is not a clinically diagnosable condition, there are no clinical diagnostic tests or formal guidelines for its treatment. However, like other anxiety conditions, there are a number of options that will help you to manage and overcome symptoms, including self-help techniques, talking therapy and medication.
Although they are sometimes prescribed on a short-term basis, medication use isn’t usually recommended for treating phobias. This is partly because talking therapy has been found to be so effective and also because medications often have side effects, may initially make your anxiety worse and do not deal with the underlying cause of the anxiety.
Self-help techniques include activities that help you feel calmer and more relaxed such as breathing exercises and guided meditations, as well as other activities that help you improve your overall mental health, such as eating a nutritious diet, getting enough sleep and regular exercise. They may not help you overcome your fears in the long-term but can help you to reduce the physical symptoms of anxiety you are experiencing and feel better able to cope.
If you want to find a way to overcome your anxiety in the long-term you may benefit from a course of counselling or therapy. This will provide you with a safe space to talk about your fears and concerns and can help even if you have been suffering for many years.
Cognitive Behaviour Therapy (CBT) is the most effective treatment for many anxiety conditions and if you are experiencing symptoms of thanatophobia you may also be experiencing another anxiety disorder such as Post-Traumatic Stress Disorder (PTSD), Panic Disorder (PD), Health Anxiety, Generalised Anxiety Disorder (GAD) or other specific phobias. During a course of CBT therapy, you and your therapist will therefore work together to determine the factors that caused your anxiety in the first place as well as the processes that maintain it on a day-to-day basis.
Common maintaining processes include finding it hard to accept uncertainty in general, especially the uncertainty and unknown around death and dying and therefore striving to find ways to feel more in control, such as by worrying about death and dying at the expense of the present moment or alternatively trying to avoid these thoughts altogether.
Other common maintaining processes include avoiding activities or situations that you fear may lead to death, such as long-haul travel and avoiding activities that may trigger thoughts of death, e.g. listening to the news. These may help you to feel better and more in control in the short-term but maintain your anxiety in the long-term as you don’t get a chance to come to learn how to tolerate distressing thoughts about death or that you are able to deal with them.
Your therapist will also support and encourage you to make the changes you need to overcome the anxiety you’ve been feeling. This will be unique according to how your anxiety developed and the factors maintaining it but may include gradually exposing yourself to your core fears in a supported and safe environment, such as gradually doing more of the things that you have been avoiding. This will help your mind to see that the things that you have been fearful of are not as threatening or harmful to you as they seemed and as a result your anxiety will reduce. Therapy may also include exercises that help you to learn to accept and tolerate the uncertainty inherent in death and dying without trying to control it and/or learning methods that help you to focus your attention on the present moment rather than getting caught up in worries about the future.
A course of therapy will not only help you to find a way to accept the uncertainty, lack of control and unknown factors inherent in death and dying but will also help you to experience less anxiety so that you can live your life to the full again.