Thanatophobia (Fear of Death) Explained

Thanatophobia is an intense fear of death or dying. For some, this involves a fear of being dead.

Others are afraid of the dying process. A person with thanatophobia can fear their own death or they might fear the death of someone they love.

Fortunately, thanatophobia can be treated, such as by engaging in psychotherapy. This requires first identifying the symptoms, then receiving a formal diagnosis.

What Does Thanatophobia Feel Like?

While thanatophobia is not specifically listed in the DSM-5, there are symptoms of a phobia that could be applied in examining whether someone has a typical fear of death or something more. Namely, it may be a phobia if they:

• Have excessive worry or fear of death or dying that gets in the way of their life
• Actively avoid any situation involving death or dying
• Experience intense anxiety when encountering or thinking of death or dying

More specifically, an anxiety disorder could produce the following physical symptoms:

• Sweating
• Shortness of breath
• Racing heart
• Nausea
• Headache
• Fatigue or insomnia

Diagnosis

As there are so many possible causes and complications, it is important that thanatophobia is diagnosed only by a trained mental health professional. They will try to determine if the fear is persistent, lasting more than six months, and how appropriate the fear is considering the circumstances. They can ask guided questions to help figure out exactly what is going on, and they can recognize the symptoms of related disorders and prescribe the appropriate course of treatment.

Risk Factors

According to the National Institute of Mental Health, a number of factors could put someone at risk of developing an anxiety disorder. Namely, experiencing stressful or traumatic life events, genetics, traits of shyness as a child, and other physical health conditions.

Related Conditions and Fears

The fear of death can also be present in other conditions and may even be linked to their severity. A 2014 study published in Clinical Psychology Review tied death anxiety to a number of different mental disorders, including hypochondriasis, panic disorder, and anxiety and depressive disorders. In addition, a 2019 study linked death anxiety to more severe symptoms across 12 different disorders.

People who deal with thanatophobia may develop related phobias as well. Fears of ghosts, tombstones, funeral homes, and other symbols of death are common, as they can serve as reminders of the main phobia.

Fear of Death in Children

A child's fear of death can be devastating to the parent, but may actually be a healthy part of normal development. Children generally lack the defense mechanisms, religious beliefs, and understanding of death that help adults cope. Whether the fear qualifies as a phobia depends on its severity and the length of time it has been present.

Causes

The exact causes of phobias are not clear. However, they typically develop in childhood and teenage years. An anxiety disorder could be a result of stress over a long period of time, traumatic life events, or genetics.

The Role of Religion

Religion can play a role in someone's feelings towards death. On the one hand, religion could be a source of comfort in providing answers to the questions about the unknown. On the other, religion could contribute to the idea that the path to salvation is very straight and narrow, and someone could fear that any deviations or mistakes may cause them to be eternally condemned. Current research indicates there is a weak tie between death anxiety and religiosity.

Religious beliefs are highly personalized, and even a therapist of the same general faith may not fully understand a client's beliefs. If the fear of death is religiously based, it is often helpful to seek supplemental counseling from one's own religious leader. However, this should never be used to replace traditional mental health counseling.

Reasons for Thanatophobia

There are numerous reasons for thanatophobia, some of which commonly include the following.

Fear of the Unknown

Thanatophobia may have roots in fears of the unknown. It is part of the human condition to want to know and understand the world around us. What happens after death, however, cannot be unequivocally proven while we are still alive.

Fear of Loss of Control

Like knowledge, control is something for which humans strive. Yet the act of dying is utterly outside anyone's control. Those who fear the loss of control may attempt to hold death at bay through rigorous and sometimes extreme health checks and other rituals.

Over time, it is easy to see how people with this type of thanatophobia may be at risk for obsessive-compulsive disorder (OCD), illness anxiety disorder (formerly called hypochondriasis), and even delusional thinking.

Fear of Pain, Illness, or Loss of Dignity

Some people with an apparent fear of death do not actually fear death itself. Instead, they are afraid of the circumstances that often surround the act of dying. They may be afraid of crippling pain, debilitating illness, or even the associated loss of dignity.

This type of thanatophobia may be identified through careful questioning about the specifics of the fear. Many people with this type of fear also suffer from nosophobia (fear of a specific disease), illness anxiety disorder, or other somatoform disorders.

Fear of Abandoning Relatives

Many people who suffer from thanatophobia are not nearly as afraid to die as they are of what would happen to their families after their death.

How Do I Stop Thanatophobia?

The course of treatment largely depends on the person's personal goals. Are they trying to resolve a religious conflict? Do they simply want to be able to attend Halloween events without panicking? The clinician must first determine the person's needs and expectations before designing a treatment plan.

Generally, however, treating an anxiety disorder involves psychotherapy, medication, or both.

Psychotherapy

Depending on the circumstances, a variety of talk therapy solutions may be appropriate in the treatment of thanatophobia. These may range from cognitive behavioral to psychoanalytic therapies.

Supplemental religious counseling, medications, and other therapeutic alternatives—for example, exposure therapy—may also be used in conjunction with psychotherapy.

Medication

Medications used to treat anxiety include benzodiazapines, selective serotonin reuptake inhibitors (SSRIs), or beta blockers. Be sure to speak with a healthcare provider if you have questions about whether medication is the right option for your specific situation.

Coping With Thanatophobia

Whether or not to seek treatment for any phobia is a very personal decision. Regardless of whether you choose to get professional assistance, coping with the fear of death can be an ongoing daily struggle.

Unlike many phobias that are triggered by specific incidents, such as seeing a spider, thanatophobia may be constantly at the back of your mind. You may be interested in discussing this phobia with others who share your fear. Other anxiety coping tips like deep breathing and meditation could help give you some relief in the moment.

Summary

The stress and fear one experiences in thanatophobia are very real. We all have to come to terms with the fact that we cannot live forever. Ultimately, thanatophobia is a fear of the unknown, but if you're living with this phobia, there are ways to cope through therapy and support.

This article may not cover all the symptoms, treatment, and outcomes of thanatophobia. Be sure to reach out to a mental health professional if you have any concerns.