What is Emetophobia or Fear of Vomiting?
According to the DSM-IV diagnosis of emetophobia or fear of vomiting, it accounts to 300.29- specific phobia of other type. The term "other type" means the symptoms leading to vomiting, illness and choking. If emetophobia or fear of vomiting is treated at the right time (earlier) it can help to overcome the problem. But when it is left untreated the condition of emetophobia or fear of vomiting may become worse. The treatment varies from person to person depending on the complexity. The fears within the person are one of the main reasons why the treatment becomes so difficult.
Usually the people suffering from emetophobia or fear of vomiting face anxiety along with vomiting. They might feel dizzy also when seeing other people vomit. This is quite common in women and more precisely in the adolescents than adults.
Causes of Emetophobia or Fear of Vomiting
There can be many causes for emetophobia or fear of vomiting. As per the professionals, only one symptom does not lead to any health condition but there are lots of factors which count. People suffering from emetophobia or fear of vomiting may suffer from vomiting but not in every case. A few may not feel other symptoms of emetophobia or fear of vomiting. Most of the psychotherapists are of the view that such cases are the result of sexual or physical abuse that creates a negative though in their mind. But there might be other causes as why one is going through such a traumatic condition.
Just like the symptoms of people differ, so is the reason of their causes. The feeling of anxiety, staying away from people, vomiting etc... are some of the common issues faced by the sufferer of emetophobia or fear of vomiting but the causes may vary and do not remain the same. Sometimes the hereditary factors also account to such a problem. No matter what the root cause of the emetophobia or fear of vomiting may be, the first thing is to calm the person and make sure that they do suffer from any kind of fear as it just makes the situation terrible. So it is important to make them feel secure and protected as it will make a difference to their condition.
Signs and Symptoms of Emetophobia or Fear of Vomiting
Emetophobia or fear of vomiting is the case of a severe fear of vomiting and in many cases people have the fear of vomiting only before other people or seeing someone vomit. The signs and symptoms of emetophobia or fear of vomiting differ from mild to acute attacks and the person may find difficulty in breathing, experience dizziness, sweat more, and feel numb. Derealization is also one of the symptoms of emetophobia or fear of vomiting that can be related to PTSD (Post traumatic stress disorder) flashback.
People go through a terrible situation and wish to die rather than suffering from emetophobia or fear of vomiting. Symptoms of Obsessive Compulsive Disorder or OCD are also visible in few cases and sometimes they may suffer from superstitions like the last date when they vomited etc...
Some of the symptoms of emetophobia or fear of vomiting include:
- Fear of eating the food prepared by someone else or even when eating outside as the sufferers of emetophobia or fear of vomiting are afraid that the outside food may cause food poisoning and leads to vomiting.
- Diarrhea, nausea, stomach cramps etc... are some of the common signs you will find in people suffering from emetophobia or fear of vomiting. These symptoms might be occurring because of anxiety.
- Too much of cleanliness.
- Fear of having any medicine which have vomiting as their side effect.
- Fear from the kids as they usually vomit because of infections.
- Staying away from animals that vomit.
- Fear of visiting the hospitals.
- Fear of getting pregnant as morning sickness causes vomiting.
- Anesthesia fear as it has a possible side effect of vomiting.
- Fear of going to places where alcohol is available which might include bars or parties etc...
- Fear of going to places where others are sick such as nursing homes or hospitals.
- Fear of watching media like TV, movies etc...
- Experiencing fear related to career for not performing well.
- Psychotherapy fear as they use exposure therapy in which the person has to face the fear.
- Keeping away from people who vomit or are sick.
- Not using the public toilets with the fear of vomiting.
- Always complaining of not feeling good.
- Vomiting nightmares.
- Feel frustrated, terror and full of anger as others are not able understand their problem.
- Having the fear of vomiting.
If anyone is suffering from emetophobia or fear of vomiting sees other person who are ill or vomit, they usually go through the following situations:
- Panic a lot and will want to move away from that place.
- They will cry, scream and even harm other people in severe cases.
- Nausea is a common problem and if convinced they might also vomit.
- Get a feeling of terror if closed in any room or trapped.
- Try to move away from people without thinking about their own safety.
- Do not stay in vacant house, car or any enclosed place.
If the sufferer of emetophobia or fear of vomiting feel nauseous, they will behave in the following way:
- Will not eat or drink with the fear of vomiting again.
- Have the fear that nausea will always lead to vomiting.
- Do not want to take any medical assistance.
- Refuse to take any medicines or treatment.
- Will panic for a long time.
- Will assume that panic attacks will lead to vomiting.
- Love to be alone and do not want to be in the company of other people.
- Run from people who try to harm them. Scream, cry and ask for help in case of fear.
- Do not stay in any place for a long time.
- Use medications to end nausea. This is done because vomiting is the main reason of all the issues.
Tests to Diagnose Emetophobia or Fear of Vomiting
Once the patient explains their symptoms the doctor will ask questions in order for proper diagnosis of emetophobia or fear of vomiting. The doctor will ask many questions so that there is no misdiagnosis.
Misdiagnosis of Emetophobia or Fear of Vomiting
Sometimes the misdiagnosis of emetophobia or fear of vomiting can cause a lot of problems if presented with the following conditions:
- Anorexia Nervosa. Some of the emetophobia or fear of vomiting sufferers also suffer with anorexia nervosa as they have a feeling that they will vomit. There is no other symptom that you will come across in such patients.
- OCD or Obsessive-Compulsive Disorder. This is yet another big problem wherein the patient keeps washing their hands with the fear of having germs that will result in illness. The treatment is what makes the difference and the right diagnosis can definitely prove helpful in this concern. The most important thing to consider is the type of disorder the person is suffering from, whether it is the axis I disorder or not.
- Social Phobia. People suffering from social phobia only have one problem and that is the emetophobia or fear of vomiting in public or before the people. It is because they get the feeling of being shame of doing such a thing.
- Agoraphobia. It is not found alone but in combination with emetophobia or fear of vomiting. In the worst cases the person may not move out of their home with the fear of getting any virus that leads to emetophobia or fear of vomiting or seeing someone vomit in front of them.
- Repressed Memory. This may not be a clear sign of emetophobia or fear of vomiting as there are many other signs that may account to such a problem. The people may relate to several incidents that result in phobia either from their childhood or when they have grown into adults.
- IBS or Irritable Bowel Syndrome. In some cases IBS can be another disorder that people would be suffering with together with emetophobia or fear of vomiting. But the best part is that IBS can be treated easily with the help of medications as it is related to anxiety. So overcoming it is simple.
- Schizophrenia, Depression, Bipolar Disorder, Other Psychoses. It is essential that the patient is diagnosed carefully for the different types of illness keeping the symptoms of emetophobia or fear of vomiting in consideration. A few people suffer from mental disorder but not everyone is therefore the right diagnosis is necessary to begin the treatment.
- Post Traumatic Stress Disorder or PTSD. If the person is going through a traumatic condition then PSTD can be the right way of diagnosing the same. Severe feeling of fear and terror are quite common among such patients and some may also go through nightmares. Somatic flashbacks can be one of the reasons with the combination of single and many incidents.
Treatment for Emetophobia or Fear of Vomiting
One of the best treatments of emetophobia or fear of vomiting is Cognitive Behavioural Theory or more popularly called as CBT. It is really typical to make the patient comfortable as their fears always counter attack the situation so making them expose is a tricky task. That is why the experts try to calm the patient and then expose them to different kinds of fears to build the environment that can help them to understand the patient in a better way. The degree of fear cannot be specified as this varies from person to person. They might not take any medicine and sometimes may not like to talk to people and will want to stay alone. This is a reason that a caring approach has to be followed so that the patient trusts you and discusses what they are going through. Understanding their behaviour is the first thing to do.
Once the patient is diagnosed with emetophobia or fear of vomiting and the treatment begins, the therapist will try to figure out their feelings, the problems they are facing using any suitable method which they feel will be right keeping their condition in mind. As such people develop fear very easily, you need to ensure that they are made comfortable and there is nothing around them which creates a sense of fear. With the help of Cognitive therapy, the person starts understand the things as how vomiting takes place and what is the reason behind it. Thus they are able to think and analyze aspects which improve their mental ability.
As the patient is now well versed that they are being treated for emetophobia or fear of vomiting, it is better to discuss things openly with them. Make them familiar with the kind of treatment you will be following along with the other information. Ask them about the therapy and what they feel about it and whether they are comfortable with it or not. Let them understand that the treatment for emetophobia or fear of vomiting is for their own benefit and can help them a lot. Do not force them to begin with the treatment unless they make up their mind for the same.
EMDR Training for Emetophobia or Fear of Vomiting
Eye Movement Desensitization and Reprocessing or EMDR training is one of the best things as it proves highly beneficial in the long run for the sufferers of emetophobia or fear of vomiting. There are many who have tried this technique and are pleased with the results. It is like a miracle because the technique has done wonders for the patient thereby treating them completely. In some cases EMDR alone is not helpful and therefore other treatments have to be combined in order to get the desired results.
Medications for Treating Emetophobia or Fear of Vomiting
Medications are also a excellent option for the people who are suffering from emetophobia or fear of vomiting, depression or OCD. The only thing to consider is the fact that most of the patients refuse to take the medicines and in that case it is quite disturbing to continue with the treatment for emetophobia or fear of vomiting. That is why one will need the help of the psychiatrist who will try to deal with their fear and make sure they start taking the medicines as it will bring a lot of relief.
Some of the patients have even complained that their doctor increased the dosage and still it was not working. That is why it is the duty of the doctor to understand the amount of medicine dosage that will be right for the patient. You just cannot increase the dose with the mindset to get the desired outcomes. Try the dosage for a few days and assure that patient will get well soon. Inquire whether the patient is feeling better or not. If they are facing any problem after taking the medicine they should discuss the same with the doctor so that necessary action can be taken. In such cases some other treatment for emetophobia or fear of vomiting can be tried. Sometimes the patient will not want to take the medicine orally and then you have to think of the other options.
Recovery Period/Healing Time for Emetophobia or Fear of Vomiting
The recovery period/healing time for emetophobia or fear of vomiting depends on many factors. If the case of emetophobia or fear of vomiting is severe then complete success in the treatment is not possible but conditions will improve.
In mild cases the treatment for emetophobia or fear of vomiting may continue only for a small period of time. Proper care, CBT (cognitive therapy) etc... are some of the treatments that will be combined in order to enjoy the best results. You need to motivate the patients that things will improve and they will get better. With time you will see a growth in the patients thereby showing that the treatment is actually working. 16 to 24 sessions may be needed in order to treat emetophobia or fear of vomiting for the mild cases.
The right approach is very necessary and therefore never asks the patient to vomit in order to get rid of the emetophobia or fear of vomiting. This may have adverse effects and so you need to try something else in order to overcome their emetophobia or fear of vomiting. Experts who have tried this technique have not been successful as it may lead to re-traumatization.
The good idea is not to let the person vomit but try to make them understand how to get rid of it. Assure them to feel free and in this way their anxiety will get reduced to a large extent. Understanding the body feeling of the patient is essential only then the treatment can be started. They need to understand that life is beautiful and they should enjoy it. Overcoming their fears is the biggest motive before the experts of and they need to follow the right methodology to achieve the same.
Assuring them that vomiting is not the right way to treat them will definitely help and build trust in their mind. This will take a long way and even the patient of emetophobia or fear of vomiting will feel free to talk to you.