Emetophobia (Fear of Vomiting) : Symptoms, Causes, Diagnosis and Treatment

Have you ever met someone who is scared or afraid of vomiting or watching other vomit? Yes, people exist who are afraid of vomiting. This fear is known as Emetophobia. Emetophobia means fear of vomiting. It involves a fear of vomiting, seeing vomit, watching other people vomit, or feeling sick.

There are many people who do not like vomiting but this phobia contains other symptoms as well. Emetophobic people spend most of their time worrying about puking even if he/she or the people around them are not ill. Just thinking of these scenarios can make them cause distress among them. Emetophobia is usually treatable with the help of a therapist or medications.

Vomit phobia can develop all sudden or followed by some traumatic experience. Once, it starts, your fear can worsen as you start avoiding places and things connected with vomiting, you become gradually more hypervigilant, and fear soon controls your life.

The more you avoid, the greater your fear becomes. Dietary habits usually become strict, and anything unfamiliar or with the least possibility of causing sickness results in obsessive checking and avoidance.

Individuals suffering from this phobia often experience significant social and occupational impairment, going to great lengths to make sure they don’t vomit. Adults may miss work, stop eating at restaurants, kids may refuse to go to school or visit a friend’s house.

It means missing out on much of life and a great deal of worrying and strategic planning. The uncertainty of not knowing when it will happen is what causes so much distress.

Suffering from emetophobia means you are likely to avoid being in situations where you or someone else might vomit. There are chances you might avoid being present in such scenarios. The symptoms include:

• Eliminating foods that you associate with vomiting
• Eating very slowly or very little or eating alone at home
• Smelling any eatery items
• Avoid touching surfaces that could have germs that lead to illness, such as doorknobs, toilet seats or flushes, handrails, or public computers
• Washing hands, dishes, food, and food preparation tools excessively
• Avoid drinking alcohol or taking medication that could cause nausea
• Avoid travel, school, parties, public transportation, or any crowded public space
• Chest tightness
• Vomiting

Mental health symptoms include:

• Fear in looking at someone who is vomiting
• Fear of puking but not being able to find a washroom
• Fear of not being able to vomit
• Panic at the thought of not being able to leave a crowded place if someone vomits
• Anxiety
• Thinking about vomit

It is very common to experience emetophobia or other phobias in many different ways. For example, you may be scared about vomiting yourself, while others might worry more about thinking other people are throwing up.

Emetophobia can also develop without any cause, leading experts/doctors to believe that genetics and environment play a role. For example, having a family history of specific phobias or other anxiety disorders can increase your risk.

The causes begin in childhood and adults who have lived with this phobia for over ten years may not remember the first triggering event. Treatment for this phobia can still help if you don’t know what originally caused the phobia.

Some phobias often develop after an incident involving the feared thing. The causes include:

• Getting sick in public
• Having a bad case of food poisoning
• Watching someone else vomiting
• Thinking of someone puking on you
• Experiencing a panic attack during an incident of vomiting

Extreme fear or anxiety around a particular object or situation is typically diagnosed as a phobia when it starts to cause distress that negatively affects your life at home, school, or work.

Diagnosis includes:

• Fear & anxiety response that happens immediately after seeing or thinking about vomit
• Avoidance of situations that could involve vomit
• Symptoms that last for at least six months

Obsessive-compulsive behavior is one of the main symptoms of emetophobia. This phobia appears similar to agoraphobia. Seeing other people vomit can sometimes become so strong that it leads to panic. But if you only avoid visiting public places because of fear of vomit then you will likely be diagnosed with emetophobia, not agoraphobia.

Phobias do not require treatment. In many cases, people find ways to work around them. Some of the treatment ideas are mentioned below:

Exposure therapy:This therapy is considered to be one of the most effective treatments for specific phobias. In exposure therapy, you will work with a therapist to slowly expose yourself to what you’re afraid of. For the treatment of emetophobia, this therapy will involve eating new food items in restaurants until you feel slightly nauseous. When you start trying these things, you will be given different techniques to help you cope with feelings of anxiety and fear. In exposure therapy, your fears are tackled over the course of multiple exposures that become more intense.

Cognitive-behavioral therapy: Cognitive-behavioral therapy or CBT may help if you do not feel ready to try exposure therapy. In CBT, you’ll be working with a therapist to challenge and reframe negative thoughts about vomiting. With the help of this therapy, you will learn how to identify negative thoughts that cause distress. Many types of research proved that CBT has a positive effect on the treatment.

Medication: Medications cannot specifically treat phobias but yes, consuming some drugs can definitely help you reduce symptoms of anxiety and panic attacks.

• Beta-blockers: These drugs keep your blood pressure and heart rate at a steady rate & reduces other physical symptoms of anxiety.
• Benzodiazepines: These medications are sedatives. They help in reducing anxiety symptoms, but they’re typically only prescribed for a short time or for occasional use, as they can be addictive.
• D-Cycloserine (DCS) also shows benefits when used during exposure therapy.

Fear of vomiting or emetophobia has a deep impact on your daily activities but the treatment could help you get control over your fear. It might take time to find the right therapist and treatment, but once you get it, you have a more fulfilling life.

Be objective - To overcome your fear of vomiting, it can be useful to focus on the facts. Ask Yourself, how many times you have vomited and how many days have I adjusted my life because of this fear? If you have phobia, you may find that you’ve made significant life changes for something that happens rarely. Being able to see that nervousness is driving nausea and fear rather than actual sickness can help you challenge and debunk your irrational fears.

Be honest - The feelings of shame or embarrassment can keep people from speaking up about their phobia. Individuals might make excuses about missing a dinner with friends rather than speak the truth about their fear. Be honest with your loved ones about your struggle related to your fear, so that you will have more support when you begin to try new food, or travel or do any of the activities which pose a challenge for your phobia.

Be assertive - Don’t be afraid to get specific and be assertive when asking for help. Consult your doctor or counsellor about your fear of vomiting that controls your life. Don’t worry about being embarrassed as no professional will be surprised or confused by this fear. It is a common phobia and is treatable, so the more information you will provide to your doctor, the better they can treat you.

Emetophobia can have a severe impact on your daily life. For example, you may be scared of eating anything out of fear that it will make you vomit. People also avoid driving as there are chances of you getting carsick. There are lots of other examples too.