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Fear of Vomiting (Emetophobia) in Children and Youth

Summary: It is normal to dislike the thought of vomiting, but for someone with emetophobia (fear of vomiting), the fear of vomiting becomes so overpowering that the person avoids more and more situations in order to avoid vomiting, and may even become housebound, lose relationships and be unable to function at school and work.
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What is the Fear of Vomiting (Emetophobia)?

It is normal to dislike the thought of vomiting, but for someone with emetophobia, the thought of vomiting is so terrifying that it can end up controlling a person's life.

 

The person may:

  • Avoid going out, due to fear of vomiting
  • Avoid eating in public places (such as restaurants), or with other people
  • Avoid any place or situation where there is the slightest possibility that the person (or others) may vomit
  • Become upset even at the mere mention of the word ‘vomit,' or synonyms like ‘throw up', ‘barf,' ‘puke,' etc.
  • In some cases, individuals will severely restrict their eating out of fear of vomiting

There are two types of emetophobia:

  1. Those who are mainly afraid of vomiting themselves
  2. Those who are mainly afraid of others vomiting

Furthermore, people with emetophobia may be:

  1. Type 1 (anxiety-based), which refers to individuals who have an underlying anxiety condition. The anxiety leads to nausea, which then leads to more anxiety.
  2. Type 2 (nausea-based), which refers to individuals with medical conditions that cause nausea. This nausea leads to a secondary anxiety and phobia, which then continues to cause more symptoms.

Under the DSM-IV (Diagnostic and Statistical Manual of Mental Disorder), emetophobia would be considered a type of Specific Phobia.) 

 

Having just a little fear of vomiting is actually helpful. It encourages one to 1) stay away from people who may be sick, and 2) take measures to avoid getting sick. However, it's a problem when that fear starts to get in the way of one's life.

 

For most people, there is often an event that triggers a fear of vomiting, although in most cases, the person can't remember why they might have the fear.

 

It may have been a real-life event such as getting sick and feeling nauseous (e.g. having the flu or food poisoning), or it could have been even seemingly harmless events like watching something on TV.

 

Emetophobia may resemble other conditions

 

The person with emetophobia may have difficulties eating, therefore they may be mistakenly viewed as having an eating disorder.

 

Because they are afraid to meet with others, they may appear to have symptoms of a social phobia or social anxiety disorder.

 

If you think your child has vomiting fears (emetophobia), the first step is to take your child to see a family physician or pediatrician.

 

The doctor can check to see if there are any medical conditions that might be contributing to the symptoms of emetophobia.

 

If no medical cause can be found, it can be helpful to see a mental health professional.  A  mental health professionals can help someone with emetophobia to learn coping strategies for the vomiting fears.

How are Vomiting Fears (Emetophobia) Treated?

Some of the main treatments used for vomiting fears are:

  • Cognitive behavior therapy (CBT) which looks at a person's thoughts, feelings and behaviors to help them overcome emetophobia.
  • Hypnosis, or hypnotherapy: with this technique a professional "hypnotizes" the patient into a "trance", which is a state of deep relaxation. By becoming relaxed, the person is able to overcome the severe anxiety that normally occurs with the fear of vomiting.

Medications, which can be used if non-medication treatments aren't effective:

  • Specific serotonin reuptake inhibitors (SSRIs) are a group of medications commonly used for various types of anxiety. Examples include Fluoxetine (Prozac), Sertraline (Zoloft), Citalopram (Celexa) and , Escitalopram (Cipralex)
  • Nausea-related medications have been reported as helpful by some individuals who have emetophobia as well as nausea. Examples of these medications including Metoclopramide.

Although medications can sometimes be helpful, they are not a cure-all, and to date, there have been few quality studies to evaluate their effectiveness.

 

For mild nausea, some people report that acupressure is helpful. This technique involves pressing your middle/index fingers down on the groove between the two large tendons on the inside of the wrist (National Institutes of Health, 2008). Although there are also no controlled studies on acupressure for emetophobia, it is worthwhile to try, because it is a safe and harmless technique.

CBT in more detail

Cognitive behavioral therapy (CBT) is one of the major treatments used for most anxieties and phobias.

 

The theory is that the vomiting phobia tricks the person into having unhelpful thoughts (e.g. "I can't get on the bus because I might throw up!"), which leads to behaviours such as avoidance.

  

In cognitive behaviour therapy, the person learns to replace those unhelpful thoughts with more positive, helpful thoughts (e.g. "I'm not going to throw up on the bus. And even if I did, its not the end of the world!") to allow the person face his/her fears.

Recommended Websites

There are unfortunately no "official" emetophobia websites. Nonetheless, in the interest of providing at least some information, the following are websites by individuals with emetophobia. Remember to check with a professional regarding any information that you read on a website!

Useful Books

Living with Emetophobia: Coping with Extreme Fear of Vomiting, by Nicolette Heaton-Harris, 2007

References

Boschen M: Reconceptualizing emetophobia: a cognitive-behavioral formulation and research agenda, J. Anxiety Disorders, 21(3): 407-419, 2007.

 

Nausea and Acupressure, National Library of Medicine, The National Institutes of Health, Retrieved Jan 5, 2008 from http://www.nlm.nih.gov/medlineplus/ency/article/002117.htm

About this Document

Written by the eMentalHealth Team and Partners.

Disclaimer

Information in this pamphlet is offered ‘as is' and is meant only to provide general information that supplements, but does not replace the information from your health provider. Always contact a qualified health professional for further information in your specific situation or circumstance. 

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Date Posted: Nov 4, 2008
Date of Last Revision: Oct 8, 2016

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