Your Death Anxiety Could Be Thanatophobia

If you experience severe anxiety when you think about death, you might have thanatophobia. Read on to discover the symptoms of thanatophobia and how to treat it.

Learn more about our Clinical Review Process

Most people don’t love thinking about dying –– but for some people, the thought of death is downright terrifying. This intense fear of death to the point of phobia is known as thanatophobia. 

“It is normal and natural to fear death, but people with thanatophobia can experience severe anxiety symptoms when faced with thoughts of death,” says Beth Couture, MSS, LSW, a Charlie Health Experiential Therapist. These intense anxiety symptoms can seriously interfere with quality of life and day-to-day functioning.

This phobia is difficult to cope with, but multiple treatments can help lessen the fear and anxiety symptoms. Read on to learn about thanatophobia, including symptoms, causes, treatments, and more.

Understanding thanatophobia

Thanatophobia is not a formal diagnosis found in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Rather, it is considered a “specific phobia,” which is considered an anxiety disorder in the DSM-5-TR. Specific phobias cause extreme distress, and to be diagnosed with a specific phobia, the duration is at least six months. 

If you have thanatophobia, your fears go above and beyond the average person’s discomfort surrounding death. “A ‘normal’ fear of death can cause some distress, but it is usually situational and manageable. A person with such fear of death can put their fears aside and focus on activities in their lives,” Couture says. “However, thanatophobia is more difficult to manage and often requires treatment. If ‘normal’ fear of death is like ‘normal’ worry, thanatophobia is like anxiety––more persistent, more severe, and much more distressing to live with.”

Thanatophobia encompasses fear of:

• Yourself dying
• Your loved ones dying
• The process of dying
• No longer existing 
• The unknown surrounding death

Symptoms of thanatophobia

Thanatophobia can present in many ways in your day-to-day life. According to Charlie Health Contemplative Practitioner Jordanne Greenberg, M.A., RYT, thanatophobia symptoms include: 

• An unreasonable and excessively severe fear of death or dying
• Intense feelings of dread, anxiety, panic at the thought of death 
• Avoiding situations where thoughts of death or dying may occur 
• Having panic attacks when thoughts of death or dying are triggered
• Becoming obsessed with your health (spending a significant amount of time checking for signs of illness, researching any possible signs of disease, and scheduling doctor appointments)
• Hypervigilance or feeling on edge
• High levels of general anxiety
• Depression 
• Hopelessness
• Loneliness 

Causes of thanatophobia

It’s possible for a specific phobia like thanatophobia to seemingly come out of nowhere. However, there’s often a trigger that sets this phobia in motion. Couture says some possible causes are:

• Losing a loved one
• Witnessing someone dying (especially in a particularly difficult or painful way)
• Experiencing a traumatic event related to dying or death
• Being diagnosed with a serious illness (or a loved one with a serious illness)
• Being exposed to a fear of death as a child
• Feeling regret or dissatisfaction about one’s life 

Not to mention, having certain mental health conditions can contribute to developing thanatophobia, says Couture. These include:

• Anxiety disorders
• Obsessive-compulsive disorder (OCD)
• Post-traumatic stress disorder (PTSD)

What are the psychological impacts of thanatophobia?

“Because death is something so abstract, pervasive, and inevitable, the psychological impact of thanatophobia can be profound and extremely isolating,” Greenberg says. “Individuals may experience a sense of anxiety, dread or despair that is pervasive, and begin to withdraw from meaningful engagement in life.”

Many people with thanatophobia develop severe health anxiety. “In order to prevent or avoid premature death from occurring, individuals with thanatophobia may become obsessively preoccupied with their health and develop compulsive checking behaviors consistent with OCD,” Greenberg says. 

For example, someone with health anxiety might constantly check for physical discomfort, Google their symptoms, and visit doctors to get reassurance that they aren’t dying. Or, the pendulum might swing to the other extreme. “Some people with extreme death anxiety avoid doctors and medical checkups for fear of getting bad news related to their health,” says Couture. 

Additionally, since people with thanatophobia may have panic attacks at the thought of death, it’s possible to develop agoraphobia, as well, says Greenberg. Some people become agoraphobic after experiencing a panic attack or multiple panic attacks, which leads them to avoid situations where they might have a panic attack and feel trapped or unable to easily escape. This fear can lead to avoidance behaviors and, in severe cases, the inability to leave home. Greenberg says this further perpetuates the isolation and psychological distress surrounding thanatophobia. 

What are the treatment options for thanatophobia?

Many therapy modalities can address thanatophobia. “Death anxiety is a nuanced, abstract, and multifaceted phenomenon,” says Greenberg. “Every individual is unique in how and why they experience death anxiety, and a combined therapeutic approach is typically best.

Here are some examples of therapeutic approaches that can help with death anxiety.

1. Cognitive-behavioral therapy (CBT)

CBT is often a first-line treatment for people who have an anxiety disorder. This therapy helps you examine your negative thoughts and behaviors, determine which could be contributing to your symptoms, and make positive changes. “CBT can help you to identify and challenge the maladaptive thought patterns surrounding death that contribute to the irrational fear,”  Greenberg says. 

2. Exposure therapy

Exposure therapy is a branch of cognitive-behavioral therapy specially designed to help people face their fears, including specific phobias. When someone has a phobia, they typically avoid what they’re afraid of at all costs. However, exposure therapy aims to combat avoidance behaviors, empowering you to face your crippling fear head-on. “For thanatophobia, this involves exposure to imagined or visualized death-related scenarios, and not exposure to actual or intended danger or bodily harm,” Greenberg explains. Your therapist will guide you through the process, and over time, your fear of death will lessen.

If your thanatophobia has entered into OCD territory and you engage in compulsive behaviors like excessive checking, Googling, or reassurance seeking, you may benefit from a specific form of exposure therapy called exposure and response prevention (ERP). On top of exposure to triggers, you will actively avoid engaging in compulsions or safety behaviors. “ERP can support individuals in developing a tolerance for and sense of resiliency surrounding their fear object,” Greenberg says.

3. Existential therapy

Existential therapy is more philosophy-based than other modalities. “It can help you overcome your fear of death by confronting the fact that death is an inevitable and meaningful part of life,” Greenberg says. “An existential therapist would support you in your search for your purpose not only despite, but because of, our own impermanence.”

Due to the abstract and philosophical nature of this therapy, it’s usually a better fit for people with less severe death anxiety, used in combination with other treatment modalities, says Greenberg.

4. Eye movement desensitization and reprocessing (EMDR)

If your death phobia is due to a traumatic instance, EMDR can help you address the memories fueling your fear, Greenberg says. This therapy requires you to recall traumatic memories while your provider engages you in bilateral (side-to-side) stimulation –– in the form of back-and-forth eye movements, taps, or sounds. This process changes the way trauma is stored in your brain. 

“EMDR can support you in reshaping your association with death in such a way that traumatic memories surrounding death are no longer so emotionally dysregulating for the nervous system,” Greenberg says. 

5. Medications for thanatophobia

There are no FDA-approved medications for treating thanatophobia or a specific phobia in general. However, if you have a co-occurring anxiety disorder, such as generalized anxiety disorder or panic disorder, taking medication can help lower overall severe anxiety levels. Antidepressants–– selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs)––are common first-line treatments for anxiety.

Additionally, if you’re suffering from severe, frequent panic attacks, your provider might prescribe anti-anxiety medication on a short-term, as-needed basis. 

How Charlie Health can help

If your fear of death is getting in the way of your day-to-day functioning and quality of life, Charlie Health can help. Our virtual Intensive Outpatient Program (IOP) provides more than once-weekly mental health treatment for people who are dealing with serious mental health conditions, including debilitating anxiety disorders and specific phobias.

We incorporate evidence-based treatments, such as cognitive-behavioral and exposure therapy, into individual counseling, family therapy, and group sessions. With this kind of holistic treatment, you can find relief from death anxiety and start living life to the fullest. Fill out the form below or give us a call to start today.