Fear Of Death And Mental Health: How Death Anxiety Can Cause Panic Disorder And More

Death anxiety refers to a persistent, excessive fear of death or the dying process. While uncertainty around death is a fundamental human experience, fear of it can be highly distressing for some, potentially impacting daily life and well-being. Here, we’ll explore the psychological roots of death anxiety and how it can affect mental health. We’ll also examine strategies for how to cope, signs you might benefit from professional support, and where to seek help. 

Death anxiety can interfere with daily functioning

Learn to cope in therapy

Types of death anxiety 

People’s death attitudes can differ according to past experiences, culture, religion, and family traditions. As such, the form of death anxiety a person might have can differ between individuals, too. Here are some examples of common types of death anxiety: 

• Fear of death (thanatophobia): Thanatophobia is often at the core of death anxiety. It refers to an overall fear of one’s own death and dying.
• Fear of dying: fear of the dying process, including pain, suffering, and loss of control
• Fear of the unknown: fears about what happens after death, such as the afterlife or lack thereof. 
• Fear of the death of a loved one: fear and distress associated with the potential death of family members, friends, or other significant people in one's life

The psychological roots of death anxiety: key theories 

From evolution to existential awareness, psychologists studying death and dying have identified several underlying factors that may contribute to death anxiety. For example, different cultural perspectives and religious beliefs can heighten or lessen an individual’s fears of death depending on their interpretation. Evolutionarily, one may interpret the fear of death as a survival mechanism. 

In his psychoanalytic theory, Sigmund Freud hypothesized that the fear of death may stem from several sources, including unresolved childhood conflict, guilt, castration anxiety, abandonment, and thanatos (or the “death drive”). The existential psychologist Irvin Yalom posits that death anxiety arises from the fundamental human awareness of mortality and the inevitable end of life. 

Terror management theory (TMT) 

One of the most recent theories about death anxiety is the terror management theory (TMT). TMT suggests that humans’ unique awareness of mortality influences how our fears of death manifest and how we cope with them, either consciously or unconsciously. TMT cites cultural worldviews and self-esteem as two of the most fundamental unconscious influencers of death anxiety. 

Fear of death and the role of past experiences 

Experiences like the loss of a loved one, witnessing traumatic events, or personal near-death experiences can significantly heighten death anxiety. Similarly, experiencing a serious illness or witnessing the suffering of others can cause fears about mortality and the prospect of dying. In other words, fear of death can be a learned behavior where one develops death anxiety after observing or being exposed to other people's adverse reactions toward death or dying. Anxious or overprotective parenting can also contribute to anxiety of many types in childhood and later in life, potentially including death anxiety. 

Mental health conditions associated with death anxiety 

People with certain pre-existing mental health conditions may be more prone to experiencing death anxiety. For example, individuals with an anxiety disorder may experience heightened levels of death anxiety, which can manifest as panic attacks, rumination, obsessions, or compulsions related to death. 

Depression can also be associated with a sense of hopelessness and a diminished appreciation for life, potentially leading to increased death anxiety. Death anxiety may also be associated with eating disorders as well as trauma-related disorders, other mood disorders, and psychotic disorders. 

The impact of death anxiety on health and well-being  

Like many mental health challenges and conditions, death anxiety tends to exist on a spectrum from mild to severe. At its mildest, fear of death might cause preoccupied thoughts or compulsive behaviors that only arise occasionally and don’t hinder the individual’s overall well-being or daily functioning. At its most severe, anxiety about death can cause significant psychological, social, and physical challenges that impact an individual's ability to function in daily life. 

Panic disorder, OCD, and other mental health challenges related to death anxiety 

Death anxiety often shares a relationship with mental health anxiety types, depressive disorders, panic disorder, and obsessive-compulsive disorder (OCD). Some research points to death anxiety as “a strong predictor of psychopathology.” On the other hand, some studies cite "depression, anxiety, stress, fear of aging, and reduced life satisfaction as predictors of death anxiety.” There are likely many factors that may contribute to this mental health experience.

Physical health impacts of anxiety 

Research suggests that there is often a bidirectional relationship between anxiety and physical health. Individuals with chronic anxiety, including death anxiety, may experience symptoms like fatigue, muscle tension, sleep disturbances, and digestive issues. Chronic anxiety can lead to increased inflammation in the body and may contribute to conditions like heart disease, obesity, diabetes, and asthma. Conversely, people with life-threatening physical conditions may be more likely to experience death anxiety. 

Behavioral responses

People experiencing severe death anxiety might withdraw socially, avoiding contact with others. They might also develop anxiety around being in public or interacting with large groups and may experience a lack of motivation to do things that they used to find pleasurable. 

A person might become excessively health-conscious or go out of their way to avoid reminders of death, which can have a significant impact on daily life and functioning. They may also experience increased irritability and difficulty concentrating, and they could potentially engage in unhealthy coping mechanisms like substance use or risky behaviors. 

Coping strategies to manage a fear of death 

There are many ways one may be able to address, process, and ultimately manage death anxiety. These strategies range from using cognitive techniques to applying existential perspectives to practicing self-care daily. In cases of intense fear related to death, a person may benefit from seeking support from a mental health professional skilled in treating death anxiety. 

Cognitive behavioral approaches to death anxiety 

Techniques like cognitive behavioral therapy (CBT) and cognitive restructuring may help individuals acknowledge the reality of death and dying more comfortably. Such techniques can also help people recognize and challenge irrational thoughts associated with death and dying. A therapist might also implement other modalities depending on the person’s unique situation.

Practical strategies for managing death anxiety  

Some find that mindfulness methods such as breathing exercises, meditation, and grounding exercises can help them effectively cope with the fear of death and dying, offering an outlet for learning acceptance around death. Such techniques may also cultivate greater emotional resilience. Other practical strategies for managing death anxiety may include:

• Strengthen social relationships and nurture meaningful connections with loved ones
• Leave a legacy by writing an ethical will, contributing to a charity, or engaging in activities that create a lasting impact 
• Express yourself creatively through writing, art, music, or other mediums
• Focus on the present and cultivate appreciation for your life experiences
• Care for your body with quality sleep, exercise, and nutrition
• Engage in activities that can help relieve stress, such as a beloved hobby or body-focused mindfulness activities like yoga and tai chi

When to speak to a mental health professional

Anxiety isn’t always easy to recognize, particularly in the early stages. Even some people with life-long anxiety might not realize they have it until they speak with a therapist who can help point out the symptoms. Here are some potential signs of anxiety disorders to look for: 

• Physical symptoms such as shortness of breath, chest pain or tightness, rapid heartbeat or palpitations, sweating, tremors or shaking, nausea, diarrhea, or stomach upset, tension, muscle aches, and headaches 
• Emotional symptoms like excessive worry or fear, feeling tense, restless, overwhelmed, or out of control, irritability, and mood swings 
• Cognitive symptoms such as difficulty concentrating or making decisions and a preoccupation with or intrusive thoughts of death 
• Behavioral symptoms such as avoidant behaviors, using unhealthy coping mechanisms, and excessively seeking reassurance from others to cope with anxiety
• Coexisting mental health conditions like depression, trauma, OCD, and others, which could increase death anxiety

Finding support for anxiety, panic disorder, and other mental health difficulties

Though they can be intense and distressing, conditions like anxiety, phobias, and panic disorders are typically considered treatable. The type of approach a provider might use depends on the person’s situation and any diagnosable conditions they may be experiencing. Cognitive behavioral therapy (CBT) is a common approach. A therapist might also draw on resources like the Death Anxiety Handbook for information on measuring, assessing, and treating death anxiety and related mental health difficulties.

Seeking support online  

Online therapy may be a good match for individuals with anxiety who face challenges leaving the house or engaging with others in a face-to-face environment. It offers individuals a therapeutic alternative where they can speak to a licensed mental health professional remotely, from the comfort of home, on a schedule that fits their individual needs. Additionally, online therapy platforms like BetterHelp offer users the opportunity to message their therapist at any time and they’ll respond when they’re able—a feature that may be useful for those experiencing intense symptoms between sessions. 

Research suggests that internet-delivered CBT, or iCBT, can often be effective in treating specific phobias (such as thanatophobia), panic disorders, and more. For example, consider a clinical psychology review published in the National Library of Medicine that surveyed 373 randomised controlled trials and meta-analyses. Its findings suggest that, overall, “iCBT is effective in the treatment and management of various psychiatric disorders such as depression, GAD and social anxiety, panic disorders, phobias, addiction and substance use disorders, adjustment disorder, bipolar disorder, and OCD.”  The review also indicates that iCBT is often more cost-effective than in-person therapy and offers greater availability of treatment for people in areas with limited healthcare options. 

Takeaway

Fear of death and dying is a shared experience as old as humanity. However, when thoughts about death and dying become overwhelming to the point where they disrupt your daily activities, relationships, or work, it could indicate an anxiety disorder. In addition to leaning on social support, finding a creative outlet, and thinking about your legacy, it may be helpful to reach out to a mental health professional. They may help you identify the key underlying reasons you fear death and develop healthy coping skills.