Some anxiety over death is natural. Here's what to do if that fear is debilitating
The difference between general anxiety and a condition known as thanatophobia or death anxiety is that thoughts about death is the trigger and focus of the anxiety.
by Loraine Lee · CNA · JoinWhenever Daniel (not his real name) experiences an ailment, however minor, his mind races with fear that it could be a symptom of something worse and it has the potential to lead to his demise.
He has been getting these panic attacks over how he might lose his life since a near-death experience a few years back, when he was hospitalised for three days after he suffered a sudden difficulty in breathing.
It might seem odd that a 32-year-old has such a strong fear of death that it inhibits the way he lives his life.
In general, most people harbour some form of fear of the inevitable — after all, what do we know about what happens after death? Or how we might die?
Researchers have found that certain world events can increase people's fear of death.
Take the COVID-19 pandemic as an example: Psychologists around the world said that a phenomenon known as salience bias made people fear death more as they were exposed to daily reports of death tolls rising globally.
Salience bias simply means that when people are confronted with a higher level of certain information or stimuli, it will dominate their thoughts more.
However, for some people such as Daniel, this fear can be more pronounced even without an event like COVID-19 and this fear can inhibit their day-to-day life as they panic and avoid activities that they regard as having the potential to cause death.
These shunned activities can be as basic as leaving home or crossing roads.
This condition is known as thanatophobia, or death anxiety.
Psychologists told CNA TODAY that death anxiety is more common among older adults, those with terminal illnesses and people who have had traumatic experiences related to death.
So why are some people so afraid of the inevitable? At what point does our fear become anxiety, and what can we do about it?
FEAR OR ANXIETY?
Dr Tsao I Ting, a clinical psychologist from Redwood Psychology clinic, said that humans generally like certainty and a sense of control. This is unlike death, which can come without warning even if it is inevitable.
"Very few people have died and come back to life to tell us what to expect. Hence, there is a great mystery surrounding this very certain event and yet there are no certain answers that will quell our anxiety," he said.
However, thanatophobia is more severe and is considered a form of anxiety disorder. Typically, such intense fear about death would have lasted for more than six months and impairs a person's daily functioning.
Dr Tsao said that an elderly person might, for example, experience intense fear of dying due to falls. To avoid the risk of falling, he or she might become home-bound. This leads them to isolate themselves from family and to miss crucial medical checkups.
He noted that as with most mental disorders, the risk factors for developing thanatophobia are "multi-faceted". They can include having a traumatic experience such as witnessing a death, having a near-death experience or suffering the loss of a loved one as a child.
The psychologist added that thanatophobia comprises two kinds of fears: The fear of death and the fear of the dying process.
"What has been found so far is that younger people are more fearful of death, while older people are more fearful of the dying process," he explained.
He also said that some children have a greater fear of their parents' deaths than their parents do of their own demise.
"Such a discrepancy can result in difficulties in communication between the two generations about the anxiety."
But what is the key difference between thanatophobia and general anxiety? It is the trigger and focus of the anxiety.
Dr Sam Roberts, founder and director of Olive Branch Psychology and Counselling Services, said that people suffering from thanatophobia often experience persistent and intrusive thoughts about mortality.
Those with general anxiety on the other hand have a broad range of worries about everyday issues such as work, relationships or finances, he added.
GETTING OVER THE FEAR OF DEATH
So how do we get on with life without fearing the end? The health experts said that adopting the "YOLO" (you only live once) mindset is not the solution. Rather, the best approach is finding purpose in life.
Beyond simply acknowledging the fear, Dr Roberts suggested that one may engage in meaningful activities based on one's interests and personality.
"It provides a sense of purpose and helps people stay grounded in the present," he said, adding that volunteering is one way as this enables people to give back to society while fostering community connection.
He also suggested that:
- Creative activities such as writing, painting or music may help process existential concerns healthily
- Fostering strong relationships with loved ones may "alleviate the isolation that often comes with thoughts of mortality"
- Spiritual and religious practices such as meditation and prayer can provide comfort
- Learning a new skill and pursuing a hobby can redirect one's focus beyond life's end
However, when it comes to a fear of death that rises to the level of thanatophobia, both Dr Tsao and Dr Roberts said that it is important for people to seek help from a mental health professional.
"Therapeutic work with a mental health professional would include cognitively restructuring the unhelpful beliefs that may have contributed to the disorder, gradual exposure to death-related situations or triggers, and developing a radical acceptance to the idea of one’s death," Dr Tsao said.
Daniel, who struggles with thanatophobia, has been seeking support from Dr Roberts and has made progress by acknowledging and exploring his emotions around death.
This includes identifying his specific fears of death and having a safe outlet for expressing his thoughts.
As Daniel continues to recover, he is learning to differentiate between his normal bodily sensations and anxiety-driven panic. And soon, he hopes to have a healthier perspective on life and mortality.
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