— Symptoms And Treatment
It’s natural to worry about death—whether it’s your own or a loved one’s. But for those with thanatophobia, feelings of worry and anxiety over dying are so intense, it impacts their ability to function day-to-day.
Though death is unavoidable, it’s possible to overcome thanatophobia. This requires knowing the symptoms, understanding the reasons why it can develop, being properly diagnosed and working with a mental health professional. When left untreated, fear of death can prevent one from living the full life they deserve to live.
What Is Thanatophobia?
Thanatophobia is the fear of death or the dying process. “We all fear things, and many people are afraid of death,” says Jenna DiLossi, Psy.D., a specialist in phobias and the co-founder of the Center For Hope and Health located in Pennsylvania. “But a phobia has a certain level of intensity and pervasiveness of fear.”
Rachel Menzies, Ph.D., is a clinical psychologist, the director of the Menzies Anxiety Centre in Australia and a leading expert on thanatophobia. She has written several books on the topic, including Free Yourself From Death Anxiety. Thanatophobia can involve fear of death itself or the dying process, she explains. “It could be related to the fear of not existing one day or it could be the fear of death being really painful,” she says. Thanatophobia can also mean having a phobia of others’ dying, she adds.
The difference between having a “normal” fear of death and a true phobia is the level it impacts one’s daily life, says Dr. DiLossi. For example, someone with thanatophobia may avoid certain activities, such as driving, because they worry it will kill them.
Thanatophobia is not in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5); instead it’s considered a “specific phobia.” The criteria for being diagnosed with a specific phobia is as follows:
- Fear about a specific object or situation (in this case, death or dying)
- The situation almost always causes immediate fear or anxiety
- The fear is disproportionate to the actual danger
- The situation is actively avoided or endured with intense anxiety
- The fear impacts one’s daily life, such as their social life or job
- The fear has been present for at least six months
- It cannot be explained by symptoms of another mental health disorder
Dr. Menzies emphasizes that feeling queasy or anxious about death is natural. It’s when the anxiety surrounding death starts impacting one’s daily life that it’s considered a phobia. For example, someone with thanatophobia may be unable to focus at work or the phobia gets in the way of them pursuing meaningful activities, such as traveling, she says.
Thanatophobia Causes and Risk Factors
Both experts say that anyone can be thanatophobic; both old and young people, people who have strong religious beliefs and people who don’t, people who are physically healthy and people who are sick. However, there are some risk factors that can make someone more likely to experience this specific fear. Both experts say that individuals with obsessive compulsive disorder (OCD) are more likely to be thanatophobic. Dr. Menzies explains that for some people with OCD, the reason why they engage in compulsive habits (such as hand washing) is because they believe it will prevent something bad from happening, such as an untimely death.
Women are more likely than men to have thanatophobia since women tend to have more general anxiety than men, says. Dr. Menzies. Research also shows that people in middle age are more likely to have a fear of death than elderly adults. Dr. Menzies hypothesizes that older people may be less anxious about death because they come to accept it more, in part by seeing others die. However, she notes that witnessing someone experiencing a painful or traumatic death can also make thanatophobia more likely.
In terms of the link between religious beliefs and thanatophobia, anecdotally, Dr. Menzies has noticed in her clinical practice that people who are unsure of their beliefs tend to be more fearful of death than those who believe strongly in what will happen after death.
“Both very committed religious believers and committed atheists are less likely [to be thanatophobic] than people in the middle who are uncertain about the afterlife,” she says. Scientific studies show there is not a connection between one’s specific religious beliefs (such as Christian or Muslim) and the likelihood of having a fear of death.
Thanatophobia Diagnosis
As previously mentioned, thanatophobia is not its own specific condition included in the DSM-5. The closest diagnosable condition is “specific phobia,” says Dr. DiLossi. When diagnosing someone with thanatophobia, clinicians refer to the list of criteria for specific phobia, she explains.
Both experts emphasize that the main sign that someone is thanatophobic is that their fear of death (either their own or someone else’s) is impacting their daily life. This can include getting in the way of work (such as being unable to focus), being preoccupied during social events (such as being unable to enjoy spending time with friends or family due to being preoccupied by thoughts of death) or avoiding meaningful activities because of the fear that it will lead to death (even though the risk for this happening is low).
Thanatophobia Treatment
With professional help, thanatophobia is treatable. According to both experts, as with other phobias, the most common treatment for thanatophobia is cognitive behavioral therapy (CBT), a psychological treatment that examines what one thinks and what one does. First, a therapist will explore where the client’s fear of death stems from. They will also ask about the ways this fear is limiting their life. Then, they will work through actionable steps so that it no longer holds them back.
For some individuals, longer term and more intensive psychodynamic and existential therapies are needed if the symptoms of their thanatophobia return after CBT.
With other phobias (such as spiders, driving or heights), both experts explain that CBT uses exposure therapy to incrementally help someone become more comfortable with the object or circumstance surrounding their fear. For example, someone with a fear of driving may look at a car, then work up to sitting in a car and then eventually driving it. Working through a fear of death has similarities and differences; for example, Dr. Menzies says that she may have a thanatophobic client start by reading the obituaries. Then, she may ask them to plan their funeral or will. “Really anything that moves toward acceptance of death and away from denial or avoidance [will help],” she says.
Unlike with other phobias, Dr. Menzies says that being around death itself is not part of overcoming thanatophobia. Treatment also does not involve doing risky activities that would jeopardize one’s safety, says Dr. DiLossi.
Living With Thanatophobia
Death is inevitable. This raises an interesting question: How does the death of a loved one impact someone with thanatophobia? “For some people, this experience will actually help them cultivate an acceptance of death, particularly people who are desperately trying to prevent their own death,” says Dr. Menzies. But for others, the death of a loved one can exacerbate their fear, making it worse. “It greatly depends on the circumstances surrounding the death,” she says. “Was the person in pain? Was it peaceful?”
If the death of a loved one has made someone’s fear of death more pronounced, it’s especially important to reach out to a mental health provider who can provide actionable tips based in CBT that can help them cope, says Dr. Menzies.
Both experts say that overcoming thanatophobia does not mean that someone will not be fearful of death at all; what it means is that their fear will not impact their daily life.
When to See a Doctor
If a fear of death is impacting your daily life, it’s important to see a mental health provider who specializes in phobias or CBT, experts note. One way to find a CBT therapist near you is by using the directory created by the Association for Behavioral and Cognitive Therapies. You can also see your primary health care provider, who can connect you to a mental health provider.
“There’s a misconception that since death is unavoidable, people with this phobia need to just ‘get over it.’ That is untrue. There is specific treatment for thanatophobia,” Dr. Menzies says, referring to CBT. “There is very good evidence that people can overcome thanatophobia. This is not something someone has to live with.”
Complete Article ↪HERE↩!