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If you’re a self-proclaimed extrovert, you likely enjoy the company of others. But, there are times when you—and a majority of people— would still probably prefer to be alone.
While it’s common for someone to have a preference for how much they enjoy being around others, if they find themselves dreading alone time so much that just the thought of being alone causes intense anxiety, a healthcare provider may want to dive deeper to see if they have a specific phobia called autophobia—the fear of being alone.
What is autophobia?
We all feel lonely from time to time, but autophobia is different than wanting company.
Autophobia is a chronic and intense fear of being by yourself. There are several fears similar to autophobia associated with spending time alone. Monophobia causes people to fear for their safety when alone or without specific people, and eremophobia is a pervasive fear of solitude (Barber, 2018).
Autophobia is a type of anxiety disorder known as specific phobia. There are five different kinds of specific phobias: animal, natural environment, blood-injection-injury, situational, and other (American Psychiatric Association, 2013). Autophobia is a situational phobia because it arises in response to a specific situation—being alone.
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What causes autophobia?
Specific phobias, like autophobia, are some of the most common mental health conditions. Estimates suggest around 7.4% of people will experience a phobia within their lifetimes. That rate is higher for women; about 10% of women develop a specific phobia (Wardenaar, 2017).
What causes a phobia varies from person to person and phobia to phobia. Many specific phobias develop due to past traumatic events. In the case of autophobia, you may fear being alone after being by yourself during a traumatic event. Some phobias develop during childhood, but you can experience a phobia at any point in your life (American Psychiatric Association, 2013).
Your risk of developing a phobia also increases if you have a parent or a sibling who also has a specific phobia. However, you may not have the same phobia as your relatives (Fyer, 1990). You might be afraid of being alone, while your sister has a fear of clowns.
Signs and symptoms of autophobia
People with autophobia often go to extreme lengths to avoid being isolated. Like other anxiety disorders, autophobia can present with both physical and psychological symptoms.
Physical symptoms of autophobia may include (LeBeau, 2010):
- Panic attacks
- Increased blood pressure
- Increased heart rate
Other symptoms of autophobia can include having racing thoughts or feelings of dread (LeBeau, 2010). These symptoms may occur when you’re alone, anticipate being alone, or feel secluded. You may also feel anxious when you are with others but feel excluded (Barber, 2018).
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Because preferring to be around others may seem normal, it might be hard for you to see your fear of being alone as a solvable problem. A mental health professional can help you differentiate between run-of-the-mill loneliness and autophobia. One thing to be on the lookout for is how much autophobia disrupts your life and well-being. Therapists look for several key features when diagnosing a specific phobia (American Psychiatric Association, 2013):
- Fear-based symptoms that affect your work, personal, or social life
- Significant distress when faced with your triggers
- Symptoms that cannot be explained by another mental health condition.
Phobias often come with a dual diagnosis of other anxiety conditions such as agoraphobia, a fear of being out in public or crowds; generalized anxiety disorder; social anxiety; and panic disorder. Having one phobia also makes you more likely to have other phobias (Kessler, 2005).
Some situational phobias that are relatively easy to avoid, like flying, might not require treatment. However, since being alone is an often necessary part of life, recovering from autophobia typically necessitates treatment.
The best treatment option depends on the type of phobia you have: phobias tied to specific, occasional activities or phobias experienced daily.
Medications for autophobia
For phobias tied to specific, occasional activities, your doctor might prescribe benzodiazepines for short-term use. Benzodiazepines are a type of sedative medication that can help you feel calm in the face of your trigger (Rickels,1999).
Since autophobia is more likely to be experienced daily, these medications might not be as helpful due to their risk of addiction, dependence, and withdrawal after long-term treatment. They can also make it harder to work or engage in tasks such as driving because of their effect on your physical and cognitive functioning (Rickels,1999).
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Therapy for autophobia
A better option for autophobia is cognitive behavioral therapy with exposure. CBT with exposure is considered the most effective psychotherapy for specific phobias (Thng, 2020).
Working with a therapist, you’ll learn skills that can help you cope when alone. Your therapist will also expose you to scenarios designed to increase your severe anxiety. While that might sound like a bad thing, these exposures start small and work their way up to help you build a tolerance. For example, you may start by being alone for just a few minutes, followed by being alone for more extended periods.
Treatment generally includes up to eight 90-minute sessions or one longer session, depending on your symptoms. Research shows the benefits of exposure therapy last for at least one year. Maintaining your skills through self-exposure can help them last even longer (Koch, 2004).
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Don’t let the normalization of loneliness keep you from living your life if you think you may have autophobia. Without treatment, phobias tend to be lifelong conditions, but with help, they’re one of the most treatable mental health conditions (Wolitzky-Taylor, 2008).
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), American Psychiatric Association. Retrieved from https://www.appi.org/Diagnostic_and_Statistical_Manual_of_Mental_Disorders_DSM-5_Fifth_Edition
- Barber, C. (2018). Loneliness and mental health. British Journal of Mental Health Nursing, 7(5), 209-214. doi: 10.12968/bjmh.2018.7.5.209 Retrieved from https://www.magonlinelibrary.com/doi/full/10.12968/bjmh.2018.7.5.209
- Fyer, A. J., Mannuzza, S., Gallops, M. S., Martin, L. Y., Aaronson, C., Gorman, J. M., et al. (1990). Familial transmission of simple phobias and fears: a preliminary report. Archives of General Psychiatry, 47(3), 252-256. doi: 10.1001/archpsyc.1990.01810150052009. Retrieved from https://pubmed.ncbi.nlm.nih.gov/2306167/
- Kessler, R. C., Chiu, W. T., Demler, O., Merikangas, K. R., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 617–627. doi: 10.1001/archpsyc.62.6.617. Retrieved from https://pubmed.ncbi.nlm.nih.gov/15939839/
- Koch, E. I., Spates, C. R., & Himle, J. A. (2004). Comparison of behavioral and cognitive-behavioral one-session exposure treatments for small animal phobias. Behaviour Research and Therapy, 42(12), 1483–1504. doi: 10.1016/j.brat.2003.10.005. Retrieved from https://pubmed.ncbi.nlm.nih.gov/15500817/
- LeBeau, R. T., Glenn, D., Liao, B., Wittchen, H. U., Beesdo‐Baum, K., Ollendick, T., & Craske, M. G. (2010). Specific phobia: a review of DSM‐IV specific phobia and preliminary recommendations for DSM‐V. Depression and Anxiety, 27(2), 148-167. doi: 10.1002/da.20655 Retrieved from https://pubmed.ncbi.nlm.nih.gov/20099272/
- Rickels, K., Lucki, I., Schweizer, E., García-España, F., & Case, W. G. (1999). Psychomotor performance of long-term benzodiazepine users before, during, and after benzodiazepine discontinuation. Journal of Clinical Psychopharmacology, 19(2), 107–113. doi: 10.1097/00004714-199904000-00003. Retrieved from https://pubmed.ncbi.nlm.nih.gov/10211911/
- Thng, C., Lim-Ashworth, N., Poh, B., & Lim, C. G. (2020). Recent developments in the intervention of specific phobia among adults: A rapid review. F1000Research, 9, 195. doi: 10.12688/f1000research.20082.1. Retrieved from https://www.ncbi.nlm.nih.gov/pmc /articles/PMC7096216/
- Wardenaar, K. J., Lim, C. C. W., Al-Hamzawi, A. O., & Alonso, J. (2017). The cross-national epidemiology of specific phobia in the world mental health surveys. Psychological Medicine, 48(5), 878–878. doi: 10.1017/s0033291717002975. retrieved from https://pubmed.ncbi.nlm.nih.gov/28994357/
- Wolitzky-Taylor, K. B., Horowitz, J. D., Powers, M. B., & Telch, M. J. (2008). Psychological approaches in the treatment of specific phobias: A meta-analysis. Clinical Psychology Review, 28(6), 1021-1037. doi: 10.1016/j.cpr.2008.02.007. Retrieved from https://pubmed.ncbi.nlm.nih.gov/18410984/
Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.