Thanatophobia: Signs, Symptoms, & Treatments

What Is Thanatophobia?

Thanatophobia is a specific phobia regarding the fear of death. Specific phobias are one group of mental health conditions that fall into the anxiety disorder category. All phobias are marked by an extremely powerful anxious or fearful response to a particular situation or object, in this case death and dying.¹ For someone with thanatophobia, the fear of death can be very specific to their own death, or they may be afraid of the process of dying, the fear of losing someone they love, or witnessing a loved one dying.

Thanatophobia is not a mental health diagnosis on its own. Rather, someone who has a fear of death or a fear of dying would receive a diagnosis of specific phobia from a mental health professional with the understanding that thanatophobia was the issue of concern.

Thanatophobia Vs. Necrophobia

Thanatophobia and necrophobia overlap greatly as they both involve the fear of death, but there are subtle differences. Thanatophobia relates to death and dying of self or a loved one.

Necrophobia, on the other hand, encompasses many other aspects of death, including:

• Seeing dead bodies
• Cemeteries
• Funeral homes
• Grave stones

How Common Is Thanatophobia?

Around 10% of people in the U.S. may have a specific phobia each year, but currently, there is no way of telling how many people have thanatophobia. Experts may be more interested in studying the more common triggers of phobia like animals, natural environments, and other situational events.

Is Death Anxiety Normal?

Death is a topic that tends to stir up a strong emotional reaction in people, no matter their age or background, so in this way, the fear of death is normal. What is not normal, though, is a level of fear that produces high stress, significant anxiety, distress, and panic.

Because there is a fine line between a healthy fear of something dangerous and a mental health disorder, experts are needed to appropriately assess and address the symptoms. Specific fears in children are also normal with as many as 90% of children having at least one. A child could worry about death and dying, but unless it begins to drastically impair their life or functioning, it is an acceptable childhood behavior.²

Symptoms of Thanatophobia

The symptoms of specific phobias like thanatophobia include extreme fear and active avoidance.

Some of the most common symptoms of thanatophobia include:¹

• Notable fear or anxiety about a certain situation, object, or item related to death and dying. For some, it could be going to hospitals, hearing about another’s illness, or reading the obituary section in the newspaper.
• Thoughts of death create this powerful reaction immediately and consistently
• The person goes to great lengths to avoid death, thoughts of death, knowledge of other people dying, and seeing death on TV
• The fear of death is not proportional to the actual situation with the person having strong reactions to minor stressors

With all specific phobias, these symptoms must continue for at least months to meet criteria for the condition. Additionally, the symptoms related to thanatophobia cannot be more strongly linked to other conditions like obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), or separation anxiety.¹

Co-Occurring Mental Health Conditions

Something that may cloud the symptoms of thanatophobia is that most people with specific phobias will also present with other mental health symptoms and conditions. In clinical practice, people rarely seek treatment only for fear of death and dying.¹

Some of the mental health disorder that regularly emerge alongside phobias include:¹

• Depressive disorders
• Other anxiety disorders
• Substance use disorders
• Bipolar disorders
• Somatic disorders like illness anxiety disorder and somatic symptom disorder
• Personality disorders, especially dependent personality disorder

Each of these disorders has the power to shift and distort the symptoms of thanatophobia. They also complicate proper diagnosis and treatment.

Outward Signs of Thanatophobia

A person with thanatophobia could spend each day thinking about death, whether their own or the death of a loved one. Because they are so focused on the issue, they could appear unable to do anything else. Since people with phobias generally work hard to avoid their fears, a person with thanatophobia could avoid going anywhere, doing anything, or being around anyone if there is a chance of danger or injury.¹ They may choose to stay in their home or a few areas they deem as “safe.”

Thanatophobia can appear to share symptoms with other conditions like illness anxiety disorder or somatic symptom disorder because it creates excessive anxiety related to physical health conditions, but thanatophobia is grounded in the irrational fears of dying specifically.

Thanatophobia in Children

Children with thanatophobia and other specific phobias may appear to be more defiant and disobedient. As they try to avoid triggers that may refuse to follow through with directives from parents and teachers. They may tantrum often or cling closely to their parents for reassurance.¹

What Causes Thanatophobia?

Even though a phobia of death is an individualized issue composed of unique thoughts, feelings, and behaviors, the condition is a specific phobia with the same causes and triggers of other phobias. Like other phobias, the causes and triggers of thanatophobia are a combination of biological and environmental factors with a focus on previous experiences with death.

Some of the risk factors that expose people to a higher risk of thanatophobia include:^1,2,3

• Age: Specific phobias commonly emerge before age 10, but they may present at any age
• Personality and temperamental factors like being inhibited behaviorally and being prone towards anxiety
• Genetic and physical issues like having a family member with anxiety disorder or a similar type of phobia
• Environmental risk factors involving the person’s experiences and their reactions to these experiences, like the death of a parent or having overprotective parents
• Having a scary or very negative experience with an illness or death
• Seeing loved ones react in extreme or excessively fearful ways involving loss
• Reading about the intense fear of death and dying other people have

Of course, avoiding triggers will decrease the risk of thanatophobia presenting, but the role of protective factors is invaluable. When a person is surrounded by strong supports, a safe environment, and uses healthy coping skills, phobias are less likely to occur.

Does Religion Impact the Fear of Death?

Experts have studied the connection between the fear of death and religion. Based on their findings, there is little evidence to believe these two variables are connected at all. There is no obvious link between religion and fear of death, which means all people are equally at risk, regardless of their religion.⁸

How Is Thanatophobia Diagnosed?

As a specific phobia, thanatophobia will be diagnosed by a mental health professional who completes a thorough evaluation of the individual. If they meet enough of the diagnostic criteria for the condition, “specific phobia – other” will be the diagnosis.

Related Conditions & Fears

A person with thanatophobia could experience other related conditions. Some of these co-occurring fears could include:

• Fear of the unknown
• Fear of illness/pain
• Fear of losing control
• Fear of abandoning loved ones/children
• Fear of going to hell

Treatment of Thanatophobia

Phobia treatments may follow many paths, but one set of interventions involving a precise combination of therapy and medication can quickly and effectively resolve thanatophobia symptoms in children and adults. Even better, this form of treatment may help to address symptoms of co-occurring conditions like depression and anxiety.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy (CBT) addresses a person’s symptoms by looking at their thoughts, feelings, and behaviors surrounding death, dying, and the fear of death to understand the issue and treat the concern.⁴ When viewing a person through the lens of CBT, the therapist will inspect how a person’s thoughts about death and previous death-related behaviors will create feelings of intense anxiety and panic.

CBT can help people learn new ways to shift their thinking patterns and calm their bodies to prevent and reduce the phobic response. CBT therapists can also educate and support people throughout the entire recovery process.

Exposure Therapy

More specific styles of CBT, like exposure therapy and systematic desensitization, further aid the treatment process. These therapy techniques involve putting the client in increasingly close contact with the anxiety provoking situation. In this case, the therapist will use creativity to have the client confront their fear of death.⁵

Through pictures, videos, guided imagery, and in-person exposure, desensitization encourages the person to experience, not avoid, their fear while practicing relaxation techniques and positive self-talk. Exposure sessions can be very distressing, but the therapist will always supervise the experience to ensure safety and improvement.

Treatment Outcome & Timeline

Standard CBT can create wanted results in about 12 weeks, but exposure therapy can work more rapidly.⁶ Studies indicate exposure-oriented treatments can produce symptom relief and lasting change in as little as one 4-hour session. Similar studies show progress in four 1-hour sessions.⁴

Medication

Although therapy and lifestyle changes can create powerful symptom relief for the condition, doctors, psychiatrists, and nurse practitioners may also recommend medications for thanatophobia. A range of antidepressant and antianxiety medications can reduce the panic and anxiety that comes with the phobia.

All antidepressants have the potential for side effects, including having a black box warning, the most serious warning given by the FDA, for increased risk of suicide in certain people.⁴ Talk with your doctor or health care provider about antidepressants and the risks to see if they are a good fit for you.

Dealing with a Thanatophobia-Induced Panic Attack

With any phobia, panic attacks are a real concern, which means people with thanatophobia need to acknowledge the risks and take steps towards prevention. As it may be impossible to avoid all anxiety attacks, people can also benefit from exploring ways to quickly recover after they occur.
Panic attacks are marked by sudden and unexpected surges of:¹

• Heart pounding and palpitations
• Sweating
• Shakiness
• Chest pain
• Nausea
• Feeling dizzy or light-headed
• Fear of dying

Panic attacks are scary episodes, and anyone who has had one or worries about having one should consult with their therapist to derive a treatment strategy designed for their needs. By combining relaxation techniques, self-talk changes, and an analysis of triggers, a person can gain some control over their panic attacks and work towards eliminating the unwanted symptoms.

How to Get Help for Thanatophobia

Often, the first step towards getting help for thanatophobia is to acknowledge that your fear and anxiety surrounding death are too extreme. If you notice your stress and worry are constantly elevated by the subject, you should consult with the nearest reputable health professional to schedule an evaluation as quickly as possible.

You can find the right therapist by asking for a referral from your primary care physician, or by using an online therapist directory where you can sort by specialty and insurance coverage.

How to Get Help for a Loved One

The process of finding help for a loved one may be more challenging, but the basic principles are the same. It always starts with the person seeing the need for treatment.

If your loved one isn’t sure about the effects of their worry and stress, let them know kindly that you believe their fear is excessive, and they could really benefit from treatment. Let them know that you cannot help them properly with their concerns, professional treatment is the best answer. Offer to attend appointments and help with their therapy homework to show your support.

How to Get Help for a Child

Having a child with thanatophobia can create even more questions, but luckily, childhood phobias may resolve quickly. Let your child know what you see in them, and that you are invested in boosting their happiness.

Be sure to find a therapist who specializes in the unique needs and concerns of children. Engage in the sessions as much or as little as the therapist requests and get involved in at-home activities.

Thanatophobia Statistics

Phobias come in so many shapes, sizes, and names that keeping detailed statistics on each one would be impossible. Instead, experts tend to study the overall group of specific phobias to look for trends and applicable patterns.

Some of the most relevant specific phobia statistics include:^1,4

• Each year about 8% of people in the U.S. have a specific phobia
• The average age of onset for specific phobias is 10.
• 16% of children ages 13-17 have a specific phobia
• 5% of younger children and adults has a specific phobia
• Specific phobia affects twice as many women as men
• Nearly 60% of people with phobias will make a suicide attempt

How to Overcome the Fear of Death

Having a mental health disorder does not mean that the condition must consume your life, your worldview, and your self-esteem. Thanatophobia is a serious condition, but by following through with positive coping skills, a person can live a fulfilling life while reducing the disorder.

Some of the most effective ways of coping with thanatophobia include:

Practice Physical Health Self-Care

Mental health concerns, like an excessive fear of death, need mental health treatment, but no one should neglect the physical health side. By increasing physical activity, setting aside enough time for sleep, and eating a balanced diet, people can put themselves in a situation to thrive.

Follow Treatment Recommendations

The therapy recommendations for phobias may seem overly stressful, causing people to not follow through with treatment. If you trust your provider, listen to their strategies and plans for addressing the fear. Desensitization will reduce symptoms, but if you back out of treatment, the fear may grow stronger.

Focus on Living

A fear of death and dying can shift the focus on the end of your life. When it occurs, you may lose sight of your life, your goals, and your loved ones. Dedicate yourself towards doing something special with or for your valued friends and family members daily to enjoy the life you live.

Find Your Special Purpose

Finding your passion in life may seem impossible in the face of excessive worrying about death, but doing so could reduce your stress, anxiety, and fear. Look for the people, places, things, and activities that make you feel productive, worthwhile, and fulfilled to find your purpose in life.

Avoid Negative Coping

High levels of anxiety make people want to find immediate relief, and unfortunately, alcohol and other drugs may provide this relief temporarily. The problem comes when the body begins to depend on the substances to create symptom relief, and when no substances are available, anxiety will skyrocket.

Call in the Professionals

No one should assume that phobias will just go away on their own. In many instances, professional interventions involving therapy or a combination of therapy and medication will quickly and effectively reduce symptoms and improve well-being.

Avoid Avoidance

When a person has any specific phobia, their brain will convince them to avoid their triggers at any cost. Obituaries, cemeteries, and any other stimuli may lead to increased anxiety, but escaping from thoughts of death and dying is not the answer. Under the guidance of a professional, practice getting exposure to the stress and let it gradually fade.

Share Your Story

The stigma of mental health conditions may lead people towards feeling guilty or ashamed of their condition. Refuse to fall victim to this trend by letting the people that you care about know what’s on your mind. With their love and support, symptoms can improve.

Can Thanatophobia Be Prevented?

There is no true way to fully prevent thanatophobia in people, but there are some common sense tips that could help reduce the risk. Tips include:

• Talking to kids about death and dying
• Avoid exposing people to scary movies before they are mature enough
• Giving people choices about going to visit sick family members and funerals

What’s the Outlook for People With Thanatophobia?

The typical forms of treatment for phobias will still apply to thanatophobia, but the clinician will have to be more creative since a fear of death is much different than a fear of driving. Still, with an effective treatment plan, someone with thanatophobia could address and treat their symptoms in a few months of treatment.