Emetophobia is a panic fear of vomiting. It is one of the phobic disorders.
What is emetophobia?
Almost every person is afraid of throwing up. Thus, nausea and vomiting are very unpleasant sensations. However, some people feel a downright panic fear of it just by even thinking about it. The fear of vomiting is present even when there is no reason for it at all. In such cases, doctors speak of emetophobia. Emetophobia is counted among mental illnesses and significantly exceeds the normal disgust of vomiting. Thus, it is considered an anxiety disorder because the affected individuals feel irrational fears of throwing up. They have this fear even when they observe other people vomiting. Even movies, photographs, or vomiting as a topic of conversation cause them anxiety. Women seem to be affected by emetophobia more often than men. Thus, studies showed significantly higher numbers of cases among them.
Causes
What causes emetophobia has not yet been precisely determined. However, many affected persons suffered in their childhood from traumatic experiences in which vomiting was in the foreground. This could be, for example, a punishment because the child had to vomit in the car. As a result, the child believed that vomiting made him or her less loved. However, in numerous other patients, there was no such traumatic experience. However, they find it difficult to deal with external pressure. Thus, emetophobia in them is merely the symptom of other psychological problems. It is not uncommon for those affected to be trapped in a vicious circle of social anxiety and panic attacks. Many patients also have a pronounced eating disorder. Because they are afraid of throwing up after meals, they eat only small portions or only irregularly. Certain foods are avoided altogether. To prevent vomiting, about 75 percent of all sufferers eat only certain foods and check their shelf life thoroughly because they are afraid the food might be spoiled.
Symptoms, complaints and signs
Emetophobia is manifested by both physical and psychological symptoms. The physical symptoms resemble panic attacks. For example, patients often suffer from rapid heartbeat, nausea, sweating, stomach pain, tremors, bouts of weakness, and chills. In addition, they are accompanied by the constant fear of throwing up. Adult and adolescent patients are often aware that their fear of vomiting is exaggerated, but are unable to do anything about it. Instead, they increasingly limit their professional and social lives. Some emetophobics strictly avoid any situation that might trigger vomiting in them. For example, they avoid festivities such as family gatherings, company celebrations or parties. Especially at parties where alcohol is consumed, they are afraid of possibly having to see a drunk person throw up. Affected children avoid class trips or outings. Travel or riding on public transportation is also too risky for emetophobics because of fear of motion sickness or possible illness in foreign countries. Eating in places other than at home is avoided. If illnesses such as gastrointestinal flu occur in the professional environment, emetophobics take a precautionary sick leave. Pregnancy is unthinkable for affected women. Even contact with pregnant women is avoided because they might vomit. The greatest fear of emetophobics is being locked in a room where people might vomit. Therefore, they are always on the lookout for escape routes. They do not go into doctors’ offices or hospitals because they are afraid of the germs that are rampant there, which trigger nausea and vomiting. As a preventive measure, they often take anti-emetic drugs. It is not uncommon for them to become dependent on these medications as a result. In contrast, they avoid medications that have potential side effects such as vomiting.
Diagnosis
Diagnosing emetophobia is considered difficult. Thus, this mental disorder is poorly known to date.In addition, only a few suitable diagnostic instruments are available. A special questionnaire has been developed by Dutch physicians for use in research. It contains a total of 115 questions dealing with the fear of vomiting as well as physical sensations. The patient has to answer the questions on a scale between 1 and 5. The symptoms of emetophobia, such as avoidance behavior, also play an important role. If the patient succeeds in persuading himself to visit a doctor and undergo therapy, the chances of successful treatment of emetophobia are good. However, the patient must also have a firm commitment to therapy.
When should you go to the doctor?
The fear of vomiting should be clarified by a doctor in any case. Only a medical examination can determine whether it is actually an emetophobia. If a physical ailment is the cause, it must be clarified and, if necessary, treated. A psychological cause does not necessarily require therapy. However, if the condition leads to restrictions in everyday life or is associated with further anxiety for those affected, a visit to a psychologist is advisable. Parents who notice signs of emetophobia in their child are best advised to talk to their pediatrician. If the phobia is treated therapeutically at an early stage, subsequent disorders and further effects on the psyche can usually be avoided. At the latest when professional or private problems arise due to the fear – for example, because the affected person withdraws from social life or often takes sick leave – the family doctor should be consulted. Other contacts are the psychologist or a specialist in phobias and anxiety disorders.
Treatment and therapy
Behavioral therapy represents one treatment option for emetophobia. This involves behavioral stimulus concentration in which the patient is exposed to the very situations of which he or she is afraid. This means, for example, that the sufferer has to watch video films in which people throw up. They also go to parties or visit restaurants to eventually overcome their fears. With the help of special breathing exercises and relaxation techniques, patients learn to relax better.
Outlook and prognosis
In principle, anxiety disorders and phobias are among the diseases that can be cured. Because emetophobia is little known, making a diagnosis is among the most challenging tasks for physicians. In addition, those affected do not see a doctor until late, when the symptoms are already very pronounced. The later the disease is diagnosed and treatment can begin, the longer the suffering and the healing process usually are. The vulnerability for the occurrence of further mental disorders is high in those affected and must be taken into account when making a prognosis. In the case of emetophobia, spontaneous recovery is possible at any time with or without medical care. Cognitive processes or events of habitual life circumstances can lead to sudden changes. Without therapy, most patients’ well-being deteriorates over time. A steady increase in symptoms is to be expected until the quality of life is significantly disturbed. Medical or therapeutic care focuses on the existing causes and takes into account the patient’s individual circumstances. The healing process takes several months or years. The patient’s cooperation and a good relationship of trust with the therapist are essential for a good prognosis. Emetophobia can recur at any time despite a cure. A long period of illness and frequent relapses increase the risk of a chronic course of the disease.
Prevention
Preventive measures against emetophobia are not known. Thus, the exact triggers of the mental disorder could not yet be determined.
Aftercare
In the case of emetophobia, the patient has very limited options for aftercare. Therefore, the focus in this disorder is also on the direct and rapid treatment of emetophobia so that further complications or discomfort do not occur. First and foremost, early detection with prompt treatment has a positive effect on the further course of the disease. Most patients are dependent on behavioral therapy in the case of emetophobia.This is carried out by a psychologist and should be continued until the symptoms subside. In many cases, some exercises from this therapy can also be performed in the patient’s own home, which may speed up the healing process. Furthermore, exercises and techniques for proper breathing and relaxation can also be practiced in the patient’s own home to alleviate the discomfort of emetophobia. Patients also rely on the support of their own family and friends in their daily lives. In this regard, loving and intensive care of the affected person has a positive effect on the course of emetophobia. As a rule, the patient’s life expectancy is not reduced by the disease.
What you can do yourself
To cope with everyday life, regular attendance at a support group has proven effective for emetophobics. For many, it helps to be able to talk about their fears with other sufferers and share experiences and coping strategies. The self-help group offers the chance to return to public eating in a protected setting, for example by visiting restaurants together. The goal of the self-help group is to promote self-acceptance and to enable an unbiased approach to the topic of eating again. For some sufferers, the prophylactic use of a gastroprotective medication seems to be an important option. It should be noted that preparations from the proton pump inhibitor group of drugs can have risks and side effects. They should therefore not be taken over a long period of time without a doctor’s prescription. In some cases, symptom relief can be achieved with herbal or homeopathic remedies, whose mode of action is based mainly on the placebo effect. Professional anxiety management techniques, which can be learned as part of behavioral therapy, represent another self-help option. The fear of vomiting can be gradually reduced by most sufferers with consistent, regular use of these techniques. Upcoming stressful situations such as family celebrations, business dinners, etc. can be better managed in this way. In contrast, the tactic of recalling positive public situations, which is well established in the therapy of anxiety disorders, does not seem to work so well with emetophobics: recalling that the expected event has never occurred so far has unfortunately proved helpful only with a few sufferers.
