Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Fear of water (Aquaphobia): Common causes and treatment

By Jenna Demmer

May 31, 202411 minute read

Reviewed byPatrick McGrath, PhD

Even beyond the obvious ways—say, drinking, cooking, and showering—water is essential to life. You may need to cross a bridge to get to work, or drive in the rain to pick up medication. Needless to say, if you’re afraid of water, it will impact your life every single day.

Your fear might be mild and fully manageable, or it might be a mental health issue that holds you back from important parts of your life. Either way, you’re in the company of millions—even if your fear is severe. Up to 3% of Americans have aquaphobia: a severe fear or anxiety about water or situations involving water, causing significant distress and interfering with one’s life (to paraphrase the DSM-5).

These fears can also be a central component of obsessive-compulsive disorder (OCD), especially in cases that involve fear of harm (harm OCD) and concerns with health and contamination (health and contamination OCD). “There are many people who have a fear of water out of a fear of drowning,” explains Dr. Patrick McGrath, therapist at NOCD. “Then there are others whose fear of water because maybe it’s contaminated and it hasn’t been purified enough.”

In any case, you don’t have to live your life guided by fear, and trained professionals can teach you the skills you need to get better. Let’s explore fear of water, when to know if yours is a mental health concern, and what you can do if it is.

Whether you’re living with aquaphobia or OCD, our specialized therapists can help. Book a free call to get started.

Is my fear of water a mental health issue?

These fears can become completely debilitating, considering water is so central to our lives, but many fears involving water involve very rational concerns, to a degree. For instance, it’s natural to feel a bit nervous diving into the ocean—or to want to be sure that the water you’re using is clean. Sometimes, though, these fears can cross a line and indicate possible mental health issues.

To mental health professionals, people cross that line “when the concern starts to impair one’s daily functioning or create a degree of distress that impacts one’s quality of life,” explains Kimberley Quinlan, LMFT, who specializes in OCD and anxiety disorders. “If the person experiencing this fear begins to notice that they cannot carry out daily tasks such as bathing, drinking, and brushing teeth, they should reach out to a mental health professional.”

If the person experiencing this fear begins to notice that they cannot carry out daily tasks such as bathing, drinking, and brushing teeth, they should reach out to a mental health professional.

Kimberley Quinlan, LMFT

Symptoms of Aquaphobia

If you’re struggling with aquaphobia, you’ll notice symptoms when you’re around water or in a situation that involves water in some way. For some people, certain scenarios are especially distressing, while other situations are more tolerable. In any case, for your fears to be diagnosed as aquaphobia, they must cause you significant distress or interfere with your ability to function in everyday life.

Another major factor when determining whether you have a phobia is whether your fear is proportionate to any actual risk—for instance, you don’t necessarily have a phobia if you’re frightened by a hurricane warning in your area.

If you have aquaphobia, then water almost always causes immediate fear or anxiety. You avoid water whenever possible, and when you can’t, you experience a lot of distress. You may also suffer anticipatory anxiety in the days leading up to an encounter with water.

Here are some other symptoms you may experience when you’re around water, or when thinking about a future encounter with water:

  • Dizziness
  • Fast breathing and heart rate
  • Intense sweating
  • Nausea
  • Pale skin
  • Panic attacks
  • Shaking
  • Sleep problems
  • Tense muscles

You should seek out professional help if you develop symptoms like panic attacks, depression, and feelings of dread or hopelessness, says Quinlan.

Triggers for a fear of water

Water can be present in many different settings, so your fears can be triggered in a variety of situations. Here are some things that may bring you anxiety if you have a fear of water:

  • Baths or showers
  • Being around water (oceans, pools, fountains, etc)
  • Being splashed or sprayed by water
  • Drinking water from restaurants
  • Drinking or using tap water
  • Swimming
  • Seeing impurities in water
  • Hearing about contaminated water
  • Feeling like you are full or have drunk too much water
  • Traveling over the ocean in a plane

Sometimes, even just seeing or thinking about water can be triggering.

OCD and a fear of water

When you think about your fear of water, OCD may not be the first culprit that comes to mind. After all, many people tend to associate the condition with excessive handwashing, which tends to involve more water, not less. 

But the truth is, OCD is often rooted in anxiety and uncertainty, so it’s not at all surprising that obsessions—unwanted and distressing thoughts that return frequently—may involve fears and worries about water: “What if I drown?” “What if my water is contaminated?”

At the surface, OCD involving fears of water can appear pretty similar to aquaphobia. People with a fear of water related to either of these disorders are likely to avoid water whenever they can. The biggest difference is the presence of compulsions—a key component of OCD.

Compulsions are behaviors or mental actions that people do to relieve the distress that comes from their obsessions. This may work for a little while, but it does nothing to ease their fears in the long run. Instead, they reinforce the OCD cycle, making obsessions more likely to return in the future, and creating greater distress.  

A fear of water is most likely to be associated with two common types of OCD: health and contamination OCD and harm OCD.

Health and contamination OCD

Health and contamination OCD revolves around fears that you might get sick or make others sick. This can often involve worries that drinking or bathing water contains contaminants—fears about spit/saliva, fears about urine, fears about semen, and a fear of blood are common. If you have health and contamination OCD and fear of water, you might experience other obsessions, such as:

  • What if I am drinking too much water?
  • How do I know if I am hydrating properly?
  • What if I drink too much and die?
  • What if I swallow salt water?
  • What if the water is contaminated?
  • What if I’ll be contaminated since the water isn’t purified enough?
  • What if I get sick from swimming in water?

Notice that many of the above obsessions involve a fear of drinking water. Drinking water is a big concern for some people with health and contamination OCD. They may worry that water is contaminated with metals, toxins, chemicals, waste, pollutants, or other substances. In some cases, they may also be afraid of “magically” getting an illness.

To cope with water-related fears, people with health and contamination OCD might do compulsions like the following:

  • Avoiding water
  • Boiling all water before using it
  • Covering all cups between drinks
  • Drinking only from a specific source of water that they trust
  • Excessively checking levels of chemicals in their water
  • Excessively checking labels of water bottles
  • Excessively filtering water
  • Excessively researching potential contaminants in water
  • Not drinking water outside the home
  • Only drinking bottled water
  • Seeking reassurance from other people that water is clean
  • Disposing of water that’s been out for a short period of time

Harm OCD

As the name suggests, people with harm OCD are concerned about causing or experiencing harm, whether to themselves or others. When it comes to water, “maybe you’re afraid of drowning, afraid you’re going to drown somebody, or that your kids are going to drown,” says Tracie Zinman-Ibrahim, LMFT, CST, Chief Compliance Officer of NOCD.

Here are some other examples that clinicians often hear from people with harm OCD: 

  • What if I drown?
  • What if someone I love drowns?
  • What if I drown someone I love?
  • What if I see someone drown?
  • What if there is a flood?
  • What if I get lost in the sea?
  • What if I leave the faucet running and cause a flood, my pets drown, someone gets electrocuted, etc?

Because of the anxiety that comes from these fears, you might respond with compulsions to feel safe and in control. Here are some common responses that clinicians see:

  • Avoiding water
  • Avoiding bridges that run over water
  • Seeking reassurance from other people that water is safe
  • Asking someone to stay in the bathroom while you shower
  • Only drinking bottled water, or even a specific brand
  • Boiling water before using it for any purpose
  • Avoiding going outside in the rain
  • Refusing to travel in wet conditions
  • Staying away from oceans, rivers, or lakes

Dr. McGrath provides an example of how a parent with harm OCD might react to a fear related to water: “As a new parent, it’s always good to watch your children in the bathtub, but I’ve worked with someone who felt the urge to constantly check their baby’s pulse to make sure they were still okay, even though they could clearly see that they weren’t drowning,” he says. “Their fears made them doubt their own senses and worry that something could be gravely wrong, even though they couldn’t see it.”

How can a fear of water affect your life?

Plenty of people get reasonably nervous about swimming or driving in the rain, but their worries don’t keep them from living life on their own terms. For some people, though, these fears can make a severe impact. Perhaps you can’t go to the pool with friends, or maybe you even avoid drinking fluids altogether when you’re home alone.

At the more severe end of the spectrum, “if you don’t drink water, you could become dehydrated and very sick,” says Dr. McGrath. “Or it could take hours and hours of your day just to purify the water that you use.”

You may also become anxious about bathing or using water from the sink to wash your face or brush your teeth. And if you only drink bottled water, it can come at a high cost. So, to varying degrees, a fear of water can interfere with your health, hygiene, finances, and social life.

You deserve to live life on your own terms—not OCD’s. Book a free call to get matched with a specialist today.

Do I have OCD or aquaphobia?

“Commonly, someone with aquaphobia is afraid of situations that involve exposure to water,” explains Quinlan. Meanwhile, people whose fears are the result of OCD may not necessarily be afraid of water itself, but rather of situations (think “worst-case scenarios”) that could happen around water. These fears will often correspond with the overall theme of a person’s OCD. For instance, someone with contamination OCD may be afraid of drinking from the tap, while a person with harm OCD may never venture outside when the ground is wet.

Another major difference between the two conditions is how people respond to their fears. People with aquaphobia are generally satisfied as long as they can avoid water or the specific situations they’re afraid of. OCD is more pervasive, and can be triggered by situations or thoughts that have only an indirect relationship with their fears themselves.

“If you have OCD, you are filled with doubt. You try to solve it all the time but can’t seem to find relief. Instead, you feel worse and more confused, and you find yourself doing compulsions trying to make yourself feel better,” says Zinman-Ibrahim.

If you have OCD, you are filled with doubt. You try to solve it all the time but can’t seem to find relief.

Tracie Zinman-Ibrahim, LMFT, CST

How can I overcome my fear of water?

While your fear of water can impact almost any area of your life, the good news is that no matter how severe it gets, it’s very treatable. If your fear of water causes you distress or gets in the way of your life, it’s important to reach out to a mental health professional. Even if you’ve had these fears for your whole life, you can get better.

Whether you’re struggling with OCD or aquaphobia, the treatment of choice for both is exposure and response prevention (ERP) therapy. Decades of clinical research have shown ERP to be effective for up to 80% of people with OCD and 80-90% of people with phobias. Be sure to find a therapist who specializes in your specific mental health condition. This is especially important if you have OCD, as treatments that work for other conditions can actually backfire for OCD. 

In ERP, you’ll gradually, safely, and collaboratively confront the thoughts and situations that trigger your fears about water. With your therapist’s guidance and support, you’ll learn to accept the distress and discomfort that you feel, simply allowing it to pass instead of avoiding it or responding with a compulsion. For example, if you only drink a specific brand of bottled water, you and your therapist would gradually disobey the strict demands of OCD. Maybe you’d start by trying a different brand, and eventually move on to using a home filter for your drinking water.

Dr. McGrath emphasizes that the goal of treatment won’t be the same for everyone. It’s fine if you don’t generally want to drink out of the faucet in your daily life, and you’d rather opt for water from a filter or fridge instead. What matters most is the freedom you’ll gain from changing your relationship with worry and uncertainty. “You could go to a nice restaurant and somebody could pour a glass of water for you, and you won’t interrogate them about where it came from. You’ll just be able to drink the water and accept the little shred of uncertainty that used to feel so unbearable,” he explains.

“Let’s say you were spending five hours a day purifying all the water you were going to drink for that day. You could get four and a half hours per day of your life back,” Dr. McGrath continues. Not only that, but your fears will no longer stop you from, say, spending time with loved ones at the pool or taking care of your health and hygiene. Whether at the kitchen faucet or at the beach, you can take steps to live the life you want to live, rather than being guided by fear.

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