Thanatophobia, or ‘’death anxiety’’ as it is often called, is an anxiety disorder or specific phobia disorder that causes an intense and irrational fear of death or the dying process. It differs from necrophobia, which is the fear of dead bodies (corpses) or graveyards.
Read on to find out whether thanatophobia is common, its causes and risk factors, whether it could be prevented or treated, how it is currently managed, and much more!
Also referred to as ‘’death anxiety’’, thanatophobia1 is a type of anxiety disorder or specific phobic disorder that causes a person to experience irrational and intense fear, worry, or panic over their own death or the death of a loved one.
Thanatophobia is sometimes confused with necrophobia, and despite large similarities between both terms, stark differences exist. Whilst thanatophobia is the fear of death or the dying process, necrophobia1 is the fear of dead bodies (corpses) or graves.
Unsurprisingly, thanatophobia is quite common as most of us want to live forever and keep those near and dear to us alive for as long as possible. It is estimated that over 3-10%1 of people suffer from thanatophobia.
Causes of thanatophobia
Thanatophobia is thought to be caused1 by specific events or experiences such as:
- Experiencing trauma
- Having a near-death experience
- Experiencing the death of a loved one, e.g. a parent or sibling
- Witnessing the death of someone, especially a painful or distressing one
Signs and symptoms of thanatophobia
The main signs1 of thanatophobia include:
- Avoiding places or situations that appear unsafe and dangerous
- Becoming so obsessed with your own health that you constantly research the signs and symptoms you experience and keep track of specific markers e.g. blood pressure
- Becoming overly concerned about becoming ill (hypochondriasis)
- Experiencing intense dread, fear, and even depression when merely thinking about death
Resembling those experienced during a panic attack, the most common symptoms1 of thanatophobia include:
- Dizziness or lightheadedness
- Profuse sweating (hyperhidrosis): this type of sweating is unrelated to vigorous exercise or excessive heat and causes a person to sweat more than is deemed ‘normal’ or tolerable
- Shortness of breath (dyspnea)
- Trembling or shaking
- Stomach pain and/or digestion issues (dyspepsia)
Diagnosis of thanatophobia
At present, there is no specific diagnostic test for thanatophobia. A healthcare provider will provide a diagnosis1 for thanatophobia mainly by looking at the signs and symptoms the patient has and ruling out other anxiety disorders and mental conditions via:
- Medical history and physical examination
- Diagnostic and Statistical Manual of Mental Disorders (DSM-5): the healthcare provider will use this diagnostic criteria to compare the signs and symptoms the patient has to those commonly experienced in people with specific phobias. A patient may be diagnosed with a specific phobia if:
- Symptoms last for 6 months or longer
- Symptoms arise as soon as the feared place, object, or situation, in this case, death, is encountered.
- The phobia or irrational fear is caused by a specific place, object, or situation, such as death or the dying process in those with thanatophobia.
- The fear causes the person to avoid specific places, objects, or situations that might be dangerous or feel unsafe.
- The phobia or irrational fear interferes with everyday life activities, e.g. school, work, relationships, etc.
Management and treatment options
Unfortunately, like other anxiety disorders, thanatophobia has no cure, at least not to date. However, there are certain management and treatment strategies1 that might help relieve the signs and symptoms of thanatophobia including:
Also referred to as ‘’talk therapy’’, the two main types of psychotherapy used to manage and treat thanatophobia are:
- Cognitive behavioural therapy (CBT): CBT focuses on transforming negative beliefs such as those experienced over death and dying into more positive and healthy ones. In doing so, CBT helps the person feel less afraid of death and more in control when experiencing thoughts of death. Deep breathing exercises are often used alongside CBT.
- Exposure therapy: As the name suggests, exposure therapy involves exposing the person to the places, thoughts, situations, or objects that cause the fear of death. Exposure therapy has been demonstrated to be particularly helpful and beneficial for people with thanatophobia. Examples of common exposure techniques used to manage thanatophobia include:
- Writing about your worries and thoughts over death
- Writing a will
- Visiting a hospital
- Visiting and meeting someone with a terminal illness
- Reading obituaries
These mostly involve anti-anxiety medications such as:
- Selective serotonin reuptake inhibitors (SSRIs): commonly known as ‘’antidepressants’’
However, it is important to note that these drugs have been proven to be quite ineffective for thanatophobia and can cause certain side effects. It is, therefore, very important to work alongside a healthcare provider if and when considering taking any medication, including those listed above or others.
Is thanatophobia normal?
It is completely normal and natural to feel scared of death and worry about losing those you love most. After all, the process of death is unknown to us and is not something we can prevent or control. However, fear of death (thanatophobia) becomes abnormal1 once it starts to affect certain aspects of everyday life, including professional (work or school), mental (mood, cognition, and energy), emotional, sexual, and social (relationships).
What are the risk factors of thanatophobia?
The main risk factors1 that are thought to trigger thanatophobia include:
- Age: children and young adults are suggested to fear death more than elderly people, whilst elderly people tend to experience more fear over the dying process
- Trauma: especially when death is witnessed regularly. As a result, healthcare providers and social workers are thought to be at high risk of developing thanatophobia.
- History of mental disorders and phobias: e.g. depression, anxiety, obsessive-compulsive disorder (OCD) etc
- Lack of religion: religion is thought to help people come to terms with death and feel better prepared for it, and therefore, not having religious beliefs is thought to be a risk factor for thanatophobia
- Having parents or loved ones who are ill, dying, or elderly
- Poor health: Understandably, people with health issues, such as those with serious chronic illnesses, fear death as their lifespan and prognosis tend to be lower compared to healthy people
- Low self-esteem and feeling unsatisfied with one’s life: these issues may prevent the affected person from looking forward to the future, hence triggering constant thoughts and worries over death, which can develop into thanatophobia over time
Can thantophobia be prevented?
Unfortunately, no.1 Thanatophobia cannot be prevented, but it can be managed and controlled to the point that it does not interfere with day-to-day activities as it normally does. This can be achieved by:
- Decreasing and/or limiting caffeine and alcohol intake: both beverages are thought to exacerbate anxiety symptoms, and therefore, limiting their intake may prove helpful for people with thanatophobia.
- Joining or forming a support group
- Maintaining strong, healthy relationships with family members
- Seeking help as soon as symptoms of thanatophobia arise: by speaking to your general practitioner (GP) and/or healthcare provider, for example, or someone you trust such as a family member or a close friend.
What is the prognosis for people with thanatophobia?
The prognosis1 (outlook) of thanatophobia is good, with most patients responding well to treatments, mainly exposure therapy.
When should I call a doctor?
See your doctor1 immediately if thanatophobia:
- Persists for a minimum of 6 months
- Worsens over time
- Triggers symptoms of a panic attack, such as those described in the ‘’signs and symptoms’’ section above
- Interferes with everyday life
Thanatophobia is a phobia that causes irrational and intense fear, worry, panic, or dread over death or the dying process. People who experience thanatophobia fear their own death or the death of someone near and dear to them.
Although both terms are often used interchangeably, thanatophobia and necrophobia are two different terms. Whilst thanatophobia causes fear of death or the dying process, necrophobia causes fear of dead bodies (corpses) or graveyards.
Feeling scared of death or worried about losing a loved one is normal and natural. After all, as human beings, we like feeling in control and dislike uncertainty and the unknown. However, thanatophobia is not normal and is, in fact, a type of anxiety disorder or specific phobia disorder that decreases overall quality of life and causes affected people to avoid anything related to death or the dying process.
People who experienced trauma, witnessed the death of a loved one and/or have a history of mental disorders (e.g. depression or anxiety) or other specific phobias, poor health, no religious beliefs, or low self-esteem are thought to be at high risk of developing thanatophobia.
The signs and symptoms of thanatophobia resemble those experienced in a panic attack, including dizziness, chills, nausea, and shaking (to name a few).
At present, thanatophobia is diagnosed mainly via a physical examination and medical history check-up as well as the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) assessment criteria.
Although thanatophobia cannot be prevented, at least not to date, it can be managed and treated via:
- Psychotherapy: e.g. cognitive behavioural therapy (CBT) and/or exposure therapy (high efficacy)
- Medications: e.g. selective serotonin reuptake inhibitors (SSRIs) or beta-blockers
See a doctor if thanatophobia:
- Persists for a minimum of 6 months
- It affects everyday life activities, e.g., work, school, relationships, etc.
- Causes symptoms of a panic attack
- Worsens over time
- Cleveland Clinic. Thanatophobia (Fear of Death) [Internet]. [cited 2023 August 29]. Available from: https://my.clevelandclinic.org/health/diseases/22830-thanatophobia-fear-of-death#:~:text=from%20Cleveland%20Clinic-,Thanatophobia%20is%20an%20intense%20fear%20of%20death%20or%20the%20dying,healthcare%20provider%20about%20your%20fears.