Necrophobia and Thanatophobia

"If you would not be forgotten,
As soon as you are dead and rotten,
Either write things worthy reading,
Or do things worth the writing."
Benjamin Franklin (1706-1790)

It is reasonable to chuckle with amusement and agreement at the witty limerick composed by this great and famous forefather of the United States; however, individuals burdened with Necrophobia and its more relevant sister Thanatophobia, like myself, find it uncomfortable to take such sentiments about untimely demise and wasted mortality so lightly. Necrophobia and Thanatophobia are abnormal psychological conditions which comprise an irrational fear of death. They differ slightly in that Necrophobia concerns death and dead things, whereas Thanatophobia concerns death and one's own dying. In most cases, an individual that suffers from one condition, will also suffer from the other.

A phobia is something a person fears to the point that they feel they have to change how they behave. Necrophobia and Thanatophobia are both called specific phobias, which are considered anxiety disorders and may be a patient's solitary condition or a singular part of a more complex anxiety disorder, including but not limited to Post-Traumatic Stress Disorder or Depression. While most specific phobias pertain to objects and situations which pose no foreseeable danger to the patient, it is clear and irrefutable that death is an inevitable stage of life; and, as a result, both Necrophobia and Thanatophobia should not be easily dismissed or left untreated. Understandably, the average individual with healthy use of his or her emotions, exercise a certain degree of fear and respect for his or her own mortality, as well as for death in general. What sets Necrophobic and Thanatophobic individuals apart is the extreme level to which this fear embeds into the subconscious. As a psychological disorder, severity can range from mild and unobtrusive to severe and can result in incapacity to work, travel, or interact with others; therefore, it has become imperative to measure the degree of a patient's condition. As a result, the Collett-Lester Fear of Death Scale was crafted to assess the patient's overall fear of death and dying as well as four separate fears: fear of death of self; fear of death of others; fear of dying of self; fear of dying of others. The onset of the condition is unique to the patient, and can be developed naturally from birth or transpire from trauma. Patients who develop the condition without trauma are likely to show signs before they reach the age of twenty years old, and female individuals are twice as prone to the condition as males.

Symptoms of this condition manifest in pathophysiological forms, including sympathetic nervous system activation resulting in elevations of heart rate and blood pressure, and symptoms such as tremor, palpitations, sweating, shortness of breath, dizziness, and/or paresthesias. The victim suddenly feels persistent and irrational panic, dread, horror, or terror when he or she is in a situation that is realistically harmless. The patient may recognize that the fear goes beyond normal boundaries and any actual threat of danger; however, the phobic reaction is automatic, uncontrollable, pervasive, and overwhelming on the patient's thoughts and imagination. In self-defense, the patient will flee the situation or withdraw socially to avoid confrontation with the acknowledged fears and triggers of the more severe reactions.

Treatment for Necrophobia and Thanatophobia has rendered significant results in sufferers. In fact, most of the patients can completely overcome their fears, even when the condition was aggravated from trauma in adulthood. The most effective treatment method is known as "exposure," which relies on exposing the person to specific objects and situations which trigger pathophysiological reactions and is required to remain exposed to such situations and objects until the phobic reactions subside and the mind becomes accustomed and loses its terror. The majority of other methods of treatment is therapeutically dependent and, therefore, requires full participation and willingness from the patient to be effective.

Necrophobia and Thanatophobia may have a more physiological hold on the patient than behavioral specialists may suspect. As a mood disorder, it is conceivable to consider whether there is an imbalance of serotonin in the patient. The serotoninergic system modulates mood, emotion, sleep and appetite; and, as a result, is implicated in the control of numerous behavioral and physiological functions. Extensive evidence suggests that serotonin receptors have a role in learning and memory which strongly supports physiological, pathophysiological and therapeutic roles in the cognitive processes. By including Necrophobia and Thanatophobia as biochemical disorders, a patient can be treated with medication.

As medical science progresses and the basic public understanding of anxiety disorders and phobias increase, there is a greater acceptance of Necrophobia and Thanatophobia with increasing methods of effective, long-term treatment. While the origins and development of these disorders touch on a wide assortment of possibilities, diagnosis and treatment can now be assured to the patient willing to be healed from the debilitating effects of excessively fearing the inevitable.