Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Could you have dementophobia? How experts make a diagnosis

By Jessica Migala

Dec 20, 20237 minute read

Reviewed byApril Kilduff, MA, LCPC

Do you worry that you’re losing your mind, or could go crazy at any time? Or that you might lose control of your mind in the future? 

People often make “I’m going nuts!” comments rather flippantly. Like if you misplaced your keys and found them in your fridge, you might think, Wow! I’m totally losing my mind! Or if you’re dating someone and they ghost you, you might say, Didn’t they tell me that they were into me? Am I crazy?

But for some people, a fear of losing their mind isn’t a passing thought—it’s something that consumes their thoughts and actions every day and affects their ability to live their life fully. And there’s a name for this: dementophobia. 

“As a therapist, I’ve helped people understand what this fear means for them, and why it’s important not to jump to conclusions,” says Nicholas Farrell, PhD, a licensed clinical psychologist and Regional Clinical Director at NOCD. Read on to find out what it means if you fear going insane and the steps you can take to find help.

What is dementophobia?

The definition of a phobia is “an intense, irrational fear of something that poses little or no actual danger,” according to the National Institute of Mental Health (NIMH). Specifically, dementophobia is a fear of going insane. While we don’t have an exact number for how many people experience dementophobia, the NIMH points out that about 9% of adults in the U.S. have a specific phobia each year.

Dementophobia is an extreme fear that’s very different from those throw-away comments about going nuts. “Flippant comments like, Thank heavens I’m not going crazy, are not reflective of genuine concerns about losing one’s mind. This differs from folks who have a clinically significant fear of experiencing a life-altering cognitive deficit,” says Dr. Farrell. You might forget where your keys are, but then accept that the human brain, by nature, is imperfect. 

But if you have a real fear of losing your mind, you take this small, everyday mental blip as one sign—of many—that insanity is coming for you. In other words, you view or interpret the incident differently, namely as an impending warning sign of likely cognitive demise, Dr. Farrell explains.

Signs and symptoms of dementophobia

The clinical signs and symptoms of any specific phobia, such as dementophobia, include:

  • A persistent fear of or anxiety about a specific situation or object lasting for at least 6 months.
  • The situation/object nearly always triggers immediate fear or anxiety.
  • You actively avoid the situation or object.
  • The fear is out of proportion to the actual danger.
  • The fear causes significant distress or impairs social or occupational function. 

What’s especially challenging is that having dementophobia can trap you in your own mind. “There is often a lot of excess monitoring of cognitive processes,” says Dr. Farrell. “It’s a kind of meta-cognitive tracking.” In other words, you can get stuck in a cycle of thinking about thinking.

All this means is that you may try to take a step back in your own mind and ask yourself if your thinking processes are, in fact, staying “on the tracks” or “going off the rails.” You may constantly ask yourself: “Is the content of my thoughts logical or reasonable–or is it slowly slipping into the unreal?” he explains. Unfortunately, this fear takes on a life of its own, and so you will find you can’t assess that logically or properly or be 100% sure that something isn’t amiss with your mental clarity.

When the fear of losing your mind is a sign of OCD

Phobias like dementophobia can sometimes be linked to obsessive-compulsive disorder, or OCD. This is a mental health disorder with obsessions (unwanted, intrusive thoughts, images, feelings, sensations, or urges that trigger distress) and compulsions (mental or physical behaviors done to get rid of the obsessions), according to the International OCD Foundation.

OCD is an opportunistic disorder that latches onto things that are most important to you, which is why there are so many themes and core fears associated with OCD. One subtype of OCD is a fear of psychosis or schizophrenia, and this often falls into the category of Health OCD

However, there are many ways a fear of losing your mind can show up in OCD. “OCD involves an almost endless array of difficult, unpleasant thoughts. It’s one’s interpretation that the presence of these thoughts must mean that they are actually experiencing a loss of control over their mind. Even obsessions around pedophilia, another subtype of OCD, may be caused by a fear of a loss of cognitive control that would make someone sexually abuse children, says Dr. Farrell. In other words, you could even interpret thoughts of sexual attraction as indicating that you’re losing it. This is just one example, but any OCD fears can make you worry that you’ve lost your mind or will lose your mind.  

Obsessions related to this fear of losing your mind may include:

  • Am I going crazy?
  • Will I have a psychotic break?
  • What if I need to be institutionalized?
  • Do I have psychosis and not know it?
  • What if I have no control over myself and I harm someone?

In turn, you may perform compulsions, mental or physical, to neutralize these distressing obsessions, doing things like:

  • Excessively researching the symptoms of psychosis or schizophrenia and testing and checking yourself to see if you have them. 
  • Seeking reassurance from others that you are not losing your mind or experiencing cognitive decline. (One example of reassurance seeking might be a teacher who tests themself to see if they can remember all the names of their students. If they cannot, or they misname a student, “it’s catastrophic evidence that they’re losing it,” says Dr. Farrell.) 
  • Mentally reviewing past situations to see if you’ve displayed any sign that you’re losing your mind or attempting to prove to yourself that you didn’t have a psychotic break without realizing it.
  • Avoiding stressful or stimulating situations.

How can you know for sure whether it’s dementophobia, OCD, or something else?

Truthfully, it’s unlikely you’ll be able to make this distinction on your own. “Dementophobia is a fear that, while certainly characteristic in OCD, is also common in other anxiety- and fear-based problems,” Dr. Farrell says. But a qualified professional can help determine if you have a phobia, OCD, or something else. 

For example, a clinician may also screen for panic disorder. “The most common expression of panic disorder is the misinterpretation of physical arousal as an indication of a catastrophe,” says Dr. Farrell. A racing heart means a heart attack; difficulty breathing means impending suffocation. However, you may also attach cognitive consequences to these physical symptoms. “Dizziness or lightheadedness may be misinterpreted as a bodily indication that you’re losing your mind or slipping into psychosis,” he explains.

The bottom line is that it’s crucial to seek a diagnosis from a licensed mental health professional to accurately determine the source of these fears of losing your mind. It’s then that you can take the first step to feeling well—and feeling confident in your mental capacities—again.

When should you seek help for your fears?

You don’t need to suffer with the thoughts that you’re developing psychosis or schizophrenia. That can be a very scary and isolating place to be, and there are things you can do to work through these fears.

So how do you know when it’s time to reach out to a professional? The answer is that any time you feel worried or concerned about your mental state, you can and should find help. You deserve support and resources to break you from fears that keep you trapped in your own head. More specifically, though, it’s when these fears have taken some control over your life. “When that worry becomes so consuming that it clearly impacts your function or is responsible for a consistent level of emotional distress that feels unsettling, that’s a time to get evaluated by a mental health professional,” Dr. Farrell says. A clinic or agency that specializes in anxiety and fear-based mental health problems is your best option for receiving a thorough evaluation and an accurate diagnosis. 

Both specific phobias and OCD can successfully be treated with a form of behavioral therapy called exposure and response prevention (ERP). Unlike traditional talk therapy, which can backfire and make OCD worse, ERP has been proven highly effective in the majority of patients with OCD.

OCD and specific phobias frequently involve avoidance of things that trigger obsessions or distress. However, ERP asks you to do the opposite: To confront those fears head-on. In ERP therapy, you will experience repeated exposure to fearful thoughts related to losing your mind without giving into the short-term relief experienced by performing compulsions. 

For OCD symptoms to go away, you have to confront them. In time and with practice, you come to realize there is nothing to fear, and that you can actually live with confidence—despite the occasional uncertainty about your mental faculties. 

The best part about ERP is that evidence shows that virtual therapy is as effective as in-person therapy. Research has also found that ERP delivered in live teletherapy sessions can bring results in under half the time, on average, of traditional outpatient ERP therapy. The key is to work with a therapist who has received special training in ERP.

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