Sunday, 27 November 2011

Panic attacks & thanatophobia

Imagine you know for certain that tomorrow you will die. There is not a thing you can do about it, tomorrow will be your last day on earth and tonight will be your last night. How would you feel? I can’t imagine many people, if any, would answer with anything that isn't fear, frustration, anger, confusion or sheer panic. Well I don't know for sure that I will die tomorrow. But what I do know for sure is that there will come a night that will be my last. Following that last night will be my final day on earth. It may not be tomorrow, it may not be the next day. It may not even be for the next 50 years, I don't know. But it will come.

I guess the best way to sum up my thanatophobia is to explain the feeling you would probably be overcome by, knowing you are about to die, is how I feel almost all the time. It is a constant state of fear, of worry, of anxiety. Sometimes the sheer desperation of the situation, the situation that everyone who is born must inevitably face, manifests in what I am forced to call a panic attack.

Panic attacks are defined as "episodes of intense fear or apprehension that are of sudden onset and of relatively brief duration." To clearly define a panic attack, many specialists believe that at least four of the following symptoms should be experienced:

  • Clear intense panic
  • Palpitations, or accelerated heart rate
  • Sweating
  • Trembling or shaking
  • Muscle tension
  • Blurry vision
  • Sensations of shortness of breath or smothering
  • Feeling of choking
  • Feeling waves of being flushed
  • Chest pain or discomfort
  • Nausea or abdominal distress
  • Feeling dizzy, unsteady, lightheaded, or faint
  • Derealisation (feelings of unreality) or depersonalization (being detached from oneself)
  • Fear of losing control or going insane
  • Fear of dying
  • Paresthesias (numbness or tingling sensations)
  • Chills or hot flashes
  • Weakness in the knees
  • Confusion
  • Tunnel vision
  • Blank mind
  • Sensing time going by very slowly
  • Feeling the need to escape
  • Feeling of warmth inside, expanding from within
  • Head pressure, unlike headache

In my moments of thanatophobia-induced panic, I have at some point, experienced all of these symptoms and consistently experience 15 of the 25 symptoms. However (and this is very much a point of interest to my psychologist and my psychiatrist) the most glaringly obvious sign of my panic and distress that he hasn't heard of before is my uncontrollable, piercing and blood-curdling screams. I actually reach a state of such frenzy and desperation that I scream, so long and so loudly I often lose my voice for up to four days.

The sound of my screams, usually somewhere between 1am and 4am, would wake my father up with a chilling fright. He has often marvelled that our neighbours have never called the police to report a potential crime. He's explained this as being due to us living on acreage or thanks to the Genovese Syndrome, the bystander effect where witnesses often tend to believe someone else will help. It is because of this that I even found myself in the uncomfortable situation of explaining to my new neighbours, who shared apartment walls with me in my new unit block, that if they were woken by my late night screaming I was simply having a panic attack. I actually had to promise my neighbours that if I was ever in danger I would scream real words such as, "help me, please!" so they would be able to assist me.

I don't remember much about these intense screaming panic attacks. My psychologist is even wary of calling them that, but I have no other word for them. I've been told I scream 'What if I'm wrong?' This alludes to my Buddhist beliefs but obviously, if I am wrong, what is there? Is there nothing? And that is ultimately my base fear. Ceasing to exist. And then I scream.

I do not have these panic attacks in daylight hours – although I have come dangerously close in cinemas. I do however have the traditional panic attacks. I will feel as if everything is closing in on me, the sheer inevitability and overwhelming desperation at my lack of control of death renders me unable to function. I will gasp for breath, my heart will race, I will sweat and I will need to call someone to talk. I often choke down the phone, “talk to me! About anything!” My network of friends and family know not to ask questions and to just start rambling about the first thing that comes to mind – their job, football scores, traffic, the weather, anything to distract my mind. I focus on their voice and their words until I feel it’s safe to open my mouth without a blood-curdling scream escaping.

Miss SAMawdsley xx

PS: For help with Thanatophobia, please join my Facebook support group: Thanatophobia / Fear of death

  • Have you ever had a panic attack?
  • Have you ever perhaps lost control and started screaming?
  • What are your thoughts on thanatophobia or anxiety?


  1. it never occurred to me to bother looking up this fear. Also, I only started realizing what was "wrong" with me a few years ago. I did not understand what a panic attack was and that I was having them nearly every night. I too have OCD and Thanatophobia.

    I was going to share my experience of what its like but you know one of my adjunct fears? that if I tell anyone what its like, they will start doing it too. The fear seems reasonable and practical - we ARE going to die, right? Even though I know how its expressed is not normal.

    When I first started talking about it at all, I was surprised to learn that other people do not, in fact, spend much time at all thinking about their death and they most definitely did not go through anything close to the experience I was having nearly every night. At some point, I realized I was having panic attacks. Every. Single. Night.

    Why only in the last few years? Why did this get worse? I figured that out too; my husband.

    Before I got married to him I always did two things: I would stay up until I was so exhausted I could not think and I would sleep with a nightlight and music. For some reason certain types of music would distract my brain enough to where if was obsessing over my death-thoughts it wasn't noticeable enough to turn into a panic attack.
    But my husband wanted total darkness and absolute quiet to sleep. He is Bipolar and sleep is a very big deal for him. For four years I let it be his way. Eventually we had enough fights about my sleep deprivation that I finally told him I could no longer sleep in the same room if he was going to insist upon no light and no sound. He decided we would try things my way.
    Some nights, just the night light is enough, but there are times I miss the music. I know my husband would let me have it if I needed but I'm trying to get by without it.

    I have never had screaming attacks although I must confess there's been plenty of times I've been screaming in my head. Usually, I burst into tears or I start moving. I can't stand the dis-associated feelings and I often pace while rubbing my arms. I need to know where my body begins and ends. I need to feel like my body belongs to me. Lord, that sounds crazy, doesn't it? But during a panic attack, for me, that's how it is.

    I did once, I think only once, have a panic attack that was so bad I had to have my husband come home for me. That was an instance of medication going awry though. We sorted that one out.

    You know what's interesting? The phobia and anxiety is horribly worse if I smoke marijuana. I've tried and tried because so many people say its good for relaxing and lessening anxiety. Well not me. It makes my anxiety skyrocket. Its the body numbness I think. I can't stand it. Terrifies me. Brings back Thanatophobia.

    Thank you for writing this.

    1. Hi Smibbo,
      I have had that same fear of being unable to talk about it lest I ruin someone else's life since I was 11. I wouldn't tell my friend because I was sure that doing so would debilitate her, like it does me. Many people on my thanatophobia support page on Facebook have said the same thing. Nobody wants to be the first to speak about it in case they upset everybody else.
      I also understand the feeling of needing to be grounded. "Speak to me. Touch me. Remind me that I am real, and I am here."
      I've never tried drugs but someone heavily suggested LSD or something. I couldn't bring myself to do it
      I mentioned my Facebook support page and you are more than welcome to join:
      I hope you find peace. xx

  2. Thank you for sharing your experience - it's nice to not be the only one who doesn't seem at peace with the idea that death is far off because I'm fairly young. I have panic attacks when I think about death (since I was about 17), which can be triggered by anything from watching the Golden Girls to simply thinking about history and how fast life goes by. I can't stand the idea of not existing. I am not religious and I often wish I believed in an afterlife. Writing this, I'm getting stressed out, and if I really start to let my mind think about not existing I can't take it. It really scares me and I cry out and have to try to distract myself and I'm not okay until I am able to think about something else. I wish I could be at peace with the idea, because you can't live life if you're stressing out about death. I also wish that I could live forever, despite what people say about boredom.

    1. Thank you for sharing yours. I am also triggered by events such as birthdays, new year's eve and Christmas. Even something as innocuous as a movie ending can bring me to the border of hysteria.
      I have found comfort in Buddhism but I am not a very religious person either.
      The attitude we share has been summed up perfectly in a line from The Rose - Better Midler.
      "It's the soul afraid of dying that never learns to live..." xx

  3. Hi Samantha, What a relief to find such a well written description of whatI am feeling. Unfortunately this has overwhelmed every part of my existence at the moment. I'm wondering if youhave had any joy with therapies. I really feel like this condition is robbing me of my life. I struggle to explain it to others,and worry that they too will suffer if I talk too much about it. I'm desperate for any positive ways to improve. It feels as if once this has been unlocked there is no going back...Apologies for the negativity of this...Good luck on your journey.

  4. Hi Sam,

    I found great comfort reading that other people suffer from this. It's like reading my life, and knowing you feel this way too makes me feel less bad about it. I get so frustrated that other people don't understand and don't feel the same that I become hurt and claim that they are emotionally intelligent enough to realise what is going on here; the end of life, beautiful and brilliant life. I am wondering the same as the person above, have you had any luck with therapies? I tried Psychoanalytic Psychotherapy but it didn't seem to help anything. I have heard hypnotherapy can be very good?