Emetophobia is a condition where an individual fears vomiting or others vomiting (but commonly both). You may often feel sick but not actually be sick. It may become a preoccupation and the only thing you think about. It is often linked to a fear that you will lose control, become very ill or that others will find you repulsive.
As a result, you try too hard to avoid a wide range of situations or activities that you believe might increase the risk of vomiting. These include being near people who are ill; going on a fairground ride; travelling by boat; going on holidays abroad; travelling by aeroplane; drinking alcohol; going into crowded places or using public transport; or eating certain foods.
Some people with emetophobia have avoided general anaesthetic for surgery. Some women with emetophobia have avoided getting pregnant or terminated a pregnancy. Women with babies might experience a great deal of distress about their child vomiting. You might excessively check the sell-by date of foods in a shop or eat only small amounts of food. You might be excessive hygienic; check the health of yourself & others; use superstitious behaviours; seek reassurance about whether others are ill or could be sick; or excessively clean the kitchen area.
If you think you are going to vomit, then might look for an escape route; try to keep tight control of your behaviour, take anti-nausea medication or suck a sweet. All these are called “safety seeking behaviours” and maintain your fear as you never find out whether you need to use them or not and increase your fear.
When does a concern with vomiting become a phobia?
Many people are fearful of vomiting to a certain extent, but to be diagnosed with a specific phobia of vomiting (the official title) it must be significantly distressing or have an effect on your life. For example, it may interfere with an important relationship or your social life or work.
How common is emetophobia?
It’s hard to say as there have been no good large-scale surveys conducted. Many people with a phobia of vomiting are often too ashamed to talk about their problem or feel very misunderstood.
The best estimate is about 1 in every 200 (0.5%) of the population. This is different to a fear of vomiting which is more common in up to 7% of the population. A fear of vomiting means it is not significantly distressing or interfering in your life.
What causes emetophobia?
There is very little research into the cause of emetophobia. Causes are thought to be a mixture of psychological and biological. There is probably a genetic influence. It usually develops in childhood, sometimes after a bad experience of vomiting.
Once a phobia develops it is maintained by the way you avoid anything linked to vomiting and maintain a constant state of preparedness. Emetophobia is much more likely to occur in women.
Is emetophobia linked to other conditions?
You may feel demoralised or clinically depressed. Some sufferers restrict their food believing that a range of food may cause vomiting. You may then become very underweight and be misdiagnosed with anorexia nervosa. Others may have a broader range of problems linked to obsessive compulsive disorder.
How is the condition likely to progress?
No long term follow up studies of emetophobia have been done. People with emetophobia often have a chronic condition since adolescence. If left untreated, then the condition is likely to persist.
What about medication?
Anti-nausea medication is often prescribed. It is unhelpful in the long term as it reinforces the idea that you can prevent yourself from vomiting. Sometimes a type of anti-depressant called an SSRI (for example, sertraline, citalopram, or fluoxetine) may be prescribed that can help reduce anxiety or treat other problems such as depression and OCD.
There are no controlled trials on medication in emetophobia.