Dementophobia: Symptoms, Causes, & Treatments

What Is Dementophobia?

Dementophobia is an extreme and debilitating fear of insanity, and is one of many specific phobias listed in the DSM 5. Specific phobias are a type of anxiety disorder in which a person’s symptoms can be traced back to a distinct fear. The symptoms of anxiety are only triggered when a person thinks about or encounters the object or situation they’re afraid of.¹

Symptoms of Dementophobia

Unlike generalized anxiety, people with specific phobias only experience anxiety symptoms in response to specific triggers.¹ For those with dementophobia, a perception of going insane is the trigger. This might include fears or doubts about their current mental and emotional state, or irrational fears that they will go insane in the future (aka phrenophobia).

All mental health conditions are diagnosed using criteria outlined in the DSM 5, which is widely used by health and mental health clinicians to diagnose mental illnesses. The symptoms of dementophobia are the same as the symptoms used to diagnose any specific phobia.¹

Symptoms of a specific phobia such as dementophobia include:

• Having a persistent, extreme, and excessive fear of an object or situation
• Immediate symptoms of anxiety when encountering the object or situation (may or may not escalate to a panic attack)
• Avoidance of the feared object or situation or extreme distress when encountered
• Fear, avoidance, or distress caused by the object or situation results in significant impairment in a person’s ability to function or follow a routine, or negatively impacts an important area of life
• Anxiety caused is disproportionate to the actual threat posed by the situation
• Fear and anxiety are persistent and lasts for six months or more
• Anxiety and avoidance aren’t attributable to another physical or mental health condition (like PTSD or the effects of a medication)

Some specific symptoms that someone may experience when they’re anxious include:¹

• Excessive worrying, concern, or intrusive thoughts
• Feeling nervous, anxious, or afraid
• Feeling restless, on-edge, or jittery
• Faintness, dizziness, or feeling like you’re about to pass out
• Racing heart or increased blood pressure
• Pain or tightness in your stomach, head, throat, or chest
• Shortness of breath or feeling unable to breathe
• Feeling tense or unable to relax
• Increased irritability
• Changes in sleep or eating (i.e. insomnia, reduced appetite)
• Trouble thinking, concentrating, or completing tasks
• Panic attacks which include sudden, intense physical symptoms of anxiety–often mistaken as a heart attack or medical emergency

Signs of Dementophobia

There is a long list of different phobias included in the DSM 5, and each can cause slightly different signs and symptoms. Unlike many specific phobias which focus on an object or situation, dementophobia is a fear of an internal mental and emotional state.² This can influence how a person’s anxiety manifests, the specific triggers for anxiety, and the person’s responses.

Cognitive Patterns in Dementophobia

The fear of madness or insanity can manifest differently in each person. For some people, dementophobia is linked to a certain mental illness that runs in their family, or one they’ve encountered at work or in their personal life. For others, the phobia develops in response to becoming overly focused on a specific trait, problem, or symptom of mental illness that they worry they may have.²

Someone with dementophobia may become anxious about one or more of the following:²

• Excessive doubt or questioning of the accuracy of their perceptions
• Frequently worrying about memory loss, or questioning their memory
• Concern about dissociative episodes or symptoms of dissociation
• Fears of developing schizophrenia or another a psychotic disorder
• Concern about having a psychotic break or a nervous breakdown
• Preoccupation with stories of people who have had psychotic breaks
• Extreme fears of developing a mental illness that runs in the family
• Fears that they will inevitably develop a mental illness
• Irrational fears about being institutionalized or placed in a psychiatric hospital
• Becoming fixated on one particular type of mental illness they are afraid of developing
• Mentally ‘rehearsing’ what life would be like if/when they go crazy
• Someone making a joke or off-handed comment about being ‘crazy’ or ‘psycho’
• Comparisons to someone who is mentally or emotionally unstable
• Fear that being around mental illness can cause them to develop one
• Being overly worried about risk factors that may cause the onset of mental illness

Behavioral Patterns of Dementophobia

Most people who have severe phobias use avoidance coping strategies to manage their symptoms. Avoidance behaviors are driven by an attempt to avoid situations that trigger anxiety, and are a common symptom of specific phobias.¹ In the short term, avoidance strategies can lower anxiety; but long-term, they tend to make the condition worse.^7,8

Unhealthy coping behaviors that can worsen dementophobia include:

• Spending time researching mental illness or looking up symptoms online
• In-depth tracking or monitoring of thoughts, mood, and behaviors (aka hypervigilance)
• Frequently seeking reassurance of their sanity from external sources or experts
• Taking evaluations or mental health surveys online to determine a diagnosis
• Isolating oneself from others, or withdrawing from support systems
• Relying on rigid routines and behaviors to feel sane or mentally/emotionally stable
• Psychoanalyzing thoughts, feelings, and past actions for signs of insanity
• Distracting or needing to stay busy to avoid difficult feelings and fears

*Some people who display signs and symptoms of dementophobia may be struggling with Obsessive Compulsive Disorder (OCD), which shares many of the same features.¹

How Common Is Dementophobia?

There isn’t any research that has identified how common dementophobia is, but specific phobias are quite common in the US.³ Between 12-15% of the population will develop a specific phobia in their lifetime, making it the number one most common mental health condition in the US.^3,5,7 Moreover, according to the NIH, 9.1% of the adult population in the US suffered from a specific phobia in the last year.^5,4 Some of the most common phobias involve animals or insects, blood or needles, storms, or public speaking.  Dementophobia is less common, but still as impactful.^2,4

What Causes Dementophobia?

Anyone can develop a specific phobia, but there are certain factors that place a person at higher risk. Certain populations are more likely to develop a specific phobia than others. For example, women face a higher risk of being diagnosed with a phobia than men. ^4,5,7 Also, situational phobias (including dementophobia) are more common in older adults than in children, teens, or young adults.⁴

People who have a family history or personal history of severe mental illness may also have a higher risk of developing dementophobia.² While there isn’t enough research to confirm this, it’s possible that certain factors might increase the risk for developing dementophobia (as opposed to other phobias).

Possible causes of dementophobia include:^4,7,8

• Having a family history of mental illness (i.e. having an immediate or extended family member with bipolar or schizophrenia)
• Having a personal history of mental illness (i.e. struggling with depression as a teen or having a prior suicide attempt)
• Close encounters and interactions with people who have severe mental illnesses (i.e. working or having volunteer experience in a psychiatric ward )
• Being directly traumatized or indirectly impacted in a negative way by mental illness, or being exposed vicariously to someone else’s story of mental illness
• Stressful or traumatic events and hardships that negatively impact a person’s mental health leading to a concern about going insane
• Having the fear of mental illness or insanity instilled by someone else (i.e. an abusive partner who gaslights you, or a parent who is excessively worried you’ll develop a disorder that runs in the family)

How Phobias Develop

According to researchers, the development of a phobia is generally predictable. A negative experience–or even just having a lot of stress–can sometimes trigger a person to develop a new fear. However, most fears don’t turn into phobias.

In order for a fear to become a phobia (a diagnosable anxiety disorder), the following process usually needs to take place:⁸

1. Stressful, traumatic or negative experience causes fear to develop (i.e. meeting someone with catatonic schizophrenia, loved one diagnosed with bipolar)
2. Rumination & preoccupation on distorted negative thoughts increases anxiety (i.e. “What if I develop schizophrenia?”)
3. Reinforcement of fear through avoidance, overreaction, or control further develops phobia (i.e. avoidance coping, excessive research or reassurance seeking)
4. More extreme “safety behaviors” or precautions worsen the phobia (i.e. more avoidance, research, or controlling behaviors needed to reduce anxiety)

Experts believe that it is possible to interrupt this cycle and prevent specific phobias from developing. In most cases, this requires professional help from a licensed therapist or other mental health specialist. Unfortunately in this case, only about 1 in 3 people will seek treatment.³ It’s likely that the societal stigma around mental illness prevents many from seeking treatment for specific phobias like dementophobia.

Impacts of Dementophobia

Dementophobia can become very debilitating for people who suffer from it, especially when it goes untreated. Without treatment, specific phobias tend to progress and become more severe over time.^4,7 More than half of people diagnosed with a specific phobia describe moderate or severe impairment as a result of their symptoms.⁵

Some negative impacts of dementophobia include:^1,4

• Interpersonal problems: Someone with dementophobia might withdraw and socially isolate themselves from others to reduce the risk of criticism or judgment. Or, they may  avoid developing close relationships for fear of others ‘finding out’ that they’re crazy
• Poor mental health and lowered life satisfaction: Dementophobia can cause significant anxiety, stress, and persistent problems with self-esteem, making it difficult for someone to feel fulfilled and satisfied in their lives.
• Impaired decision making & high self-doubt: Someone who questions their sanity will often have a lot of self-doubt that makes it difficult to make basic decisions or trust their own judgment, which can impact their work and their personal lives
• Impaired basic functioning: For some people, dementophobia can become so severe that it interferes with their ability to complete tasks, follow their routine, and function normally in their daily lives. Rumination, researching, or avoidance behaviors can begin to take a more primary role in their routines.
• Poor concentration, focus, & task completion: Anxiety makes it difficult for people to focus, concentrate, and get things done. Concentrating on worried thoughts can take up so much of a person’s mental bandwidth, that there is little left to devote to things they need and want to focus on or do
• Problems with sleep or appetite: Stress and anxiety can interfere with a person’s sleep, appetite and nutrition. It’s common for people with high levels of anxiety to experience insomnia, feeling unrested after sleep, or having increased or decreased appetite.

How to Overcome Dementophobia

If you’re living with dementophobia, there are ways to overcome this fear and greatly reduce or even resolve your symptoms. In fact, phobias are some of the most easily treatable mental health conditions, and most respond quickly to therapy.^3,7 In addition to seeking professional help from a therapist, psychologist, or other mental health provider, there are numerous things you can try on your own to cope with this anxiety.

Some tips for coping with dementophobia include:

• Start a mindfulness or meditation routine: Mindfulness and meditation are proven to reduce stress, anxiety, and help you unhook from worried thoughts. Consider starting small by dedicating 10-15 minutes per day to a mindfulness activity or using a meditation app.
• Don’t pathologize your thoughts & feelings: Difficult, negative thoughts and feelings are something that everyone experiences–try not to pathologize them by labeling them as ‘symptoms’. Instead, consider that they may be normal occurrences anyone can experience from time to time.
• Continue your normal routine: Instead of changing your routine in response to your fear of insanity, try to stick to your normal schedule. This way, you won’t accidentally reinforce an irrational fear that there’s something wrong with you.
• Open up to people you trust: Open conversations with people you trust can teach you that your feelings and experiences are more normal than you think. Even if they can’t relate to your specific fears, most people have dealt with their own (irrational) fears, and hearing their stories can help you feel less alone.
• Work on building trust with yourself: Dementophobia causes people to question and doubt themselves and their sanity, which is why rebuilding self-trust is so important. Start by asking yourself, “what would I do if I trusted myself 100%?” or “If I knew I wasn’t crazy, I would…” Work on checking some of these things off your to-do  list. Over time, these exercises can boost confidence and self-trust, making you less prone to believing every worried thought you may have.

Dementophobia Treatment

While living with a phobia can be extremely difficult, there are many reasons to be hopeful for the future. Because specific phobias are typically easy to treat, most respond quickly to therapy.^3,4 Some people opt for a combination of therapy and anti-anxiety medication, while others are interested in therapy alone. Often, phobias can be successfully treated in short-term therapy, with some studies suggesting improvement after just one session.^3,6

The most effective treatment for phobias is exposure therapy, a type of CBT that gradually exposes someone to their fears, while also teaching them relaxation and coping skills.^4,6,7 Sessions can be performed through real-life experiences, or just by imagining or seeing imagery of a feared situation. Virtual reality exposure therapy is a newer therapeutic method that may be available to you, depending where you live.⁷

While exposure therapy is the fastest and most effective way to overcome a phobia, there are other alternatives that don’t require exposure. Types of therapy that can also be used to treat dementophobia include Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), Mindfulness-based approaches, and Eye Movement Desensitization and Reprocessing (EMDR).^3,4,5,6

How to Find a Therapist for Dementophobia

Finding an experienced therapist who specializes in treating anxiety is important, but it’s equally important to choose a therapist who has an approach and style that resonates with you. Many begin their search for a therapist online by using a free online therapist directory that allows them to filter their search by location, insurance, and specialty.

Final Thoughts

Dementophobia is an excessive and irrational fear of going insane. People who struggle with this phobia often have debilitating anxiety, self-doubt, and worried thoughts regarding their sanity.² Left untreated, this phobia can worsen until it becomes hard for a person to function, make decisions, and focus on responsibilities. The good news is that specific phobias are highly treatable with short term therapies like exposure therapy or CBT.^3,4,7,8