What Is Fear of Being Alone?

Monophobia, sometimes called autophobia, eremophobia, or isolophobia, is the fear of being alone. Monophobia occurs when a person is so afraid of being alone or abandoned that it causes extreme anxiety that far outweighs the actual threat or experience. The fear is so intense that it impacts daily functioning.

This article discusses monophobia, as well as its symptoms, causes, diagnosis, and treatment.

Defining the Fear of Being Alone

Some mental healthcare professionals may consider monophobia a situational phobia, which is a type of specific phobia (an intense, unreasonable fear of an object or situation that poses little real danger).

However, the fears associated with monophobia are generally more complex and often stem from other psychiatric conditions such as anxiety, mood disorders, or personality disorders.

Situational phobias occur under conditions that are generally not threatening or concerning to most people. When people with monophobia are faced with the idea of isolation, they'll likely experience symptoms of severe anxiety. This response is out of proportion to the risk or danger actually posed by the situation.

Symptoms

Like most phobias, fear of being alone has both mental and physical characteristics. People with monophobia will experience symptoms when alone or faced with the idea of being alone.

Symptoms of a fear of being alone include:

• Morbid fear and anxiety when they are physically alone or perceiving that they are alone
• Intense apprehension and anxiety just thinking about being isolated or secluded
• Intense anxiety that is out of proportion to the actual danger of being alone
• Experiencing feelings of impending disaster or doom when they are left alone
• Going to extreme lengths to avoid being alone
• Feeling isolated and alone even while physically in crowds or with groups of people
  
• Nausea or abdominal discomfort
• Difficulty sleeping
• Panic attacks

Diagnosis

To obtain a diagnosis of monophobia, a mental health professional or healthcare provider will refer to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the American Psychiatric Association's official handbook.

The manual uses the following diagnostic criteria to diagnose specific phobias:

• The fear is persistent and lasts for greater than six months.
• The fear is actively avoided and almost always causes immediate anxiety.
• The fear is out of proportion to the actual danger of the object or situation.
• The fear causes significant disruption to essential areas of function, including social and occupational functioning.

Causes

Phobias trigger a person's stress response, also known as the fight-or-flight response. There are several reasons this stress response becomes triggered by a fear of being alone, including:

• Genetics: The genes people inherit are known to play a role in phobias and other anxiety disorders.
• Observed learning experience: A person might have learned to fear being alone if a parent or sibling feared the same thing.
• Direct learning experience: A history of trauma or a traumatic experience such as being left or abandoned, or the loss of a parent or caregiver, can contribute to a fear of being alone.
• Informational learning experience: Hearing about a situation on the news or watching a movie in which a person was alone and something traumatic happened can lead someone to develop a fear of being alone.

Treatment

The goal of treating a fear of being alone is to reduce the symptoms associated with the fear. This can help you get to a place where you feel comfortable being by yourself.

Primary modes of treatment involve different types of therapy. Although medication is available to control symptoms, it's not always necessary.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy, or CBT, is a type of talk therapy that helps people explore how they are thinking and behaving. It helps people better recognize and change distorted and maladaptive (negative) thoughts and behaviors. This is thought to also change how people ultimately feel.

CBT is considered a first-line treatment for anxiety disorders and may be helpful for phobias, because it allows a person to examine their feelings and actions in response to their automatic thoughts.

Eye Movement Desensitization and Reprocessing (EMDR)

Eye movement desensitization and reprocessing, or EMDR, is a trauma-based treatment. It was designed to help people with trauma and post-traumatic stress disorder (PTSD) overcome the emotional distress of their traumatic memories. A 2019 meta-analysis found that EMDR therapy demonstrated a positive effect on both panic and phobic symptoms.

Virtual Reality Exposure Therapy (VRE)

Exposure therapy, which involves exposing a person with phobias to the phobic object while in the care of a mental health professional, has been the primary therapeutic treatment for phobias for years.

Virtual reality offers a whole new realm of exposure therapy. People with phobias who participated in individualized virtual reality exposure therapy experienced a decrease in symptoms.

Medication

Selective serotonin reuptake inhibitors (SSRIs) and selective serotonin-norepinephrine reuptake inhibitors (SNRIs) are effective treatments for certain anxiety disorders. Although not generally first-line in the treatment of specific phobias, they may help with some of the symptoms associated with monophobia.

• SSRIs: Lexapro (escitalopram), Paxil (paroxetine), Prozac (fluoxetine), and Zoloft (sertraline)
• SNRIs: Effexor (venlafaxine) and Cymbalta (duloxetine)

Coping With Fear

There are some ways to cope with phobias that people can try at home. These include:

• Journaling: It may help to record thoughts, fears, apprehensions around being alone and isolated to help better understand the fear and anxieties.
• Relaxation techniques: Learning to relax the nervous system can be helpful for people with phobias. Techniques helpful in reducing stress and tension stored in the body include deep breathing exercises (gentle, concentrated breathing), progressive muscle relaxation (tensing muscles as you breathe in and releasing them as you exhale), and visualization (using mental imagery to produce a relaxed mindset). There are free phone apps and videos online that can offer guided meditations, tips, and techniques to help.
• Mindful meditation: Mindful meditation is about focusing on the present moment and allowing intrusive, anxious thoughts to pass without judging the thoughts, but just observing them.
• Yoga: Yoga offers not just movements and exercises but ways of breathing that can also reduce anxiety and stress in the nervous system. Look for free videos online or local classes.

Summary

Monophobia, or autophobia, is the fear of being alone. It can be thought of as a type of situational phobia, which is a form of specific phobia. Symptoms of monophobia vary based on the severity of the condition but can include anxiety, avoidance, difficulty maintaining relationships, or physical symptoms like nausea and trembling when faced with the notion of being alone. Treatment for monophobia includes different types of therapy and medication when necessary.

A Word From Verywell

Having a fear of being alone can severely impact or restrict your quality of life. Fortunately, there are treatment options available to help you overcome your fear. You can start by seeking out a mental health professional or counseling services to help you face this fear and live well.