What Is Thanatophobia?

Thanatophobia is an intense fear of death or the dying process. While many people have uncertain feelings about death, thanatophobia (also known as death anxiety) is so extreme that it causes panic attacks and interferes with a person's emotional well-being, as well as their ability to function in daily life.

Thanatophobia is a type of anxiety disorder classified as a specific phobia in the Diagnostic and Statistical Manual of Mental Health Disorders, 5th Edition (DSM-5) issued by the American Psychiatric Association (APA).

This article discusses what causes someone to develop a fear of death and dying, and the symptoms they can experience because of it. It also reviews how this disorder is diagnosed and treated, and how you can better cope while undergoing therapy.

Symptoms of Thanatophobia

Thanatophobia can cause symptoms that can impact both physical and mental wellness.

Symptoms of thanatophobia may include:

• Sweating
• Trembling
• Chills or feeling flush
• Fear of losing control
• Deep feelings of dread or powerlessness
• A rapid heartbeat
• Chest pain or tightness
• Feeling dizzy or faint
• Shortness of breath or difficulty breathing
• A choking sensation
  
• Nausea
• Headaches
  
• Numbness or pins-and-needles sensations
• Dry mouth
• Ringing in your ears
• Confusion or disorientation
• A sudden need to rush to the bathroom

Symptoms of thanatophobia occur when you are confronted with random thoughts or a specific event associated with death, such as being in a hospital, reading an obituary, or hearing about someone's death.

Thanatophobia is characterized by the avoidance of any topic related to death irrespective of whether you have a direct relationship with the person who has died or is dying, or even if the death is fictitious or real.

Reading a book or watching a TV show or movie in which someone dies can trigger symptoms of thanatophobia.

Thanatophobia in Children

Children can also experience thanatophobia, but it tends to manifest with defiant behavior rather than the typical symptoms of anxiety.

For example, signs and symptoms of thanatophobia in a child might include:

• Refusal to follow directions at home or in school
• Throwing tantrums
• Crying
• Headaches
• Stomach pain

Unlike an adult with thanatophobia, a child isn't able to understand that their fear is irrational.

The term thanatophobia is derived from Thanatos (the personification of death in Greek mythology) and phobia meaning fear. It was first mentioned by Sigmund Freud in 1915 and was thought to be related to an unconscious belief in immortality.

What Causes a Fear of Death?

The exact cause of thanatophobia is unknown, but a variety of factors can increase a person's risk of developing the disorder:

• Trauma: Phobias can develop from personal trauma or near-death experiences or from hearing someone else talk about their traumatic experiences.
• Environment: Children who are raised with anxious, overprotective, or overly critical parents are vulnerable to all types of anxiety, including specific phobias.
• History of abuse: People who have been sexually, physically, or emotionally abused are more likely to develop specific phobias.
• Death of a family member: A fear of death can occur after a person experiences the death of a parent or a sibling.
• Religious teachings: Certain religions teach people that they will be punished after death for the way they lived their lives. This can lead to thanatophobia.
  
• Age: Thanatophobia often occurs in middle-age people as they begin to experience the death of friends and family.
• Chronic illness: People living with chronic illnesses like cancer or advanced chronic obstructive pulmonary disease (COPD) are more likely to have thanatophobia, especially if the illness is incurable.
• Public health crises: Pandemics like COVID-19 and the AIDS crisis of the 1980s and 1990s can intensify a person's fear of death.

Diagnosis of Thanatophobia

All psychiatric conditions listed in the DSM-5 are diagnosed based on a clearly defined list of criteria. If the individual meets the diagnostic criteria for a specific condition, they can be treated in accordance with the recommendations outlined in the manual.

Thanatophobia is not its own distinct disorder but falls under the larger umbrella of specific phobias.

Specific phobias have the following diagnostic criteria:

• There is marked fear or anxiety about a specific object or situation (in this case death or dying).
• The object or situation almost always provokes immediate fear or anxiety.
• The fear or anxiety is out of proportion to the actual danger.
• The object or situation is actively avoided or endured with extreme fear or anxiety.
• The fear or anxiety (or avoidance of fear or anxiety) causes ongoing distress and/or interferes with a person's ability to work, engage in social activities, or function normally in daily life.
• The fear or anxiety is persistent and lasts for longer than six months.
• The symptoms are not explained by other conditions like agoraphobia, obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), separation anxiety disorder, or social anxiety disorder.

Treatment for Thanatophobia

Psychotherapy is the cornerstone of treatment for thanatophobia. Medications are also sometimes used to manage symptoms of anxiety.

Psychotherapy

Cognitive behavioral therapy (CBT) is the most effective type of therapy used for thanatophobia. The focus of CBT for thanatophobia is the identification of behaviors, thoughts, and feelings about death and dying, after which steps are taken to change negative thought patterns.

Exposure therapy is a particular type of CBT that has been found to be successful in treating phobias. It is considered by most to be the treatment of choice for specific phobias.

Exposure therapy involves gradual exposure to the object of your fear while working through the anxiety symptoms with positive self-talk and relaxation techniques. For example, with fear of death, this might involve watching movies in which someone dies.

It is conducted over multiple sessions of roughly two hours and can be performed one-on-one or in groups sessions in specific cases.

Medications

Medications are less commonly used to treat phobias but may be useful in reducing anxiety symptoms that can negatively impact a person's life.

Antidepressants known as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are commonly used to treat anxiety caused by phobias. While effective, it can take weeks for these drugs to markedly improve your symptoms.

Options include:

• Zoloft (sertraline)
• Lexapro (escitalopram)
• Prozac (fluoxetine)
• Effexor (venlafaxine)
• Celexa (citalopram)

Benzodiazepines are another class of medications that can be used to treat phobias. These drugs are fast-acting and are taken during acute anxiety or panic episodes. These medications can be addictive, however, and have side effects like fatigue and drowsiness.

Examples include:

• Ativan (lorazepam)
• Xanax (alprazolam)
• Valium (diazepam)
• Klonopin (clonazepam)

Coping With Thanatophobia

The best way to cope with thanatophobia is to seek treatment with a qualified therapist or psychiatrist. With that said, there are coping strategies that you can use to better avoid or deal with acute anxiety episodes.

Among them:

• Deep breathing techniques can help slow your heart rate and respiration and ease anxiety symptoms.
• Mindfulness practices like meditation and guided imagery can help center your thoughts and teach you not to react to stress triggers.
• Healthy lifestyle practices like exercising regularly, eating a healthy diet, and getting enough sleep can not only make you feel better physically but increase feelings of well-being.
• Hobbies and activities can spur good feelings and positivity.
• Building a support network can give you an outlet to share your fears with close friends and family. Don't isolate yourself.

Summary

Thanatophobia is an irrational fear of death and dying. This condition causes severe anxiety symptoms when confronted with even the topic of death or dying. Symptoms can include sweating, shortness of breath, increased heart rate, nausea, and feeling powerless.

Thanatophobia can develop as a result of older age, previous trauma, a history of abuse, the death of a loved one, or the environment in which you were raised. Treatment primarily involves therapy, although medications can help.

A Word From Verywell

Living with an anxiety disorder such as thanatophobia can feel isolating. But the truth is, these conditions are common throughout the world.

Ignoring your symptoms won't make them go away. Be proactive and talk to your healthcare provider about therapy and other treatment options to reduce your feeling of anxiety or panic.