Fear of crowds (enochlophobia): causes and treatment


Enochlophobia is a phobia (irrational fear) of crowds that negatively affects your daily life. Although enochlophobia is not a true mental health disorder, this condition causes symptoms similar to other types of anxiety disorders.

This article discusses the symptoms and causes of enochlophobia, its identification and treatment.

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What is the fear of crowds?

A lot of people are uncomfortable in large groups of people. However, if this is true for you, it does not necessarily mean that you have enochlophobia. A phobia is an unrealistic, ongoing fear of something that causes a person to avoid the situation as much as possible, or to experience severe distress when the situation cannot be avoided.

People with enochlophobia may avoid traveling by train, bus, or plane due to overcrowded conditions. They may also avoid going to big cities, to events such as concerts or amusement parks, or even to a restaurant, movie theater or shopping mall.

Symptoms of enochlophobia

Enochlophobia can cause symptoms when you are in a crowd, or even just when you think you are in a crowd. The physical symptoms, which correspond to other types of anxiety disorders, include:

  • Sweat
  • Tremor
  • Nausea
  • Chest pain
  • Difficulty in breathing
  • Pounding / accelerated heartbeat
  • Hot flashes or chills
  • Dizziness
  • Feeling of impending doom
  • Fainting

Causes

The exact cause of enochlophobia is not known, but this condition can be affected by a chemical imbalance of neurotransmitters (such as dopamine and serotonin) in the brain. Phobias can also develop from traumatic experiences in your own life or from hearing about negative experiences from other people.

Genetics and certain cultural beliefs may play a role in your risk of developing enochlophobia. If you are an anxious person, your temperament may make you susceptible to enochlophobia.

It is possible for someone to have a phobia without going through a negative or traumatic event.

Diagnostic

Mental health problems are diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Enochlophobia is not included in DSM-5. However, it is similar to specific phobias, which DSM-5 describes as a persistent and irrational fear of a specific activity, person, object, or situation.

Specific phobias are diagnosed according to the following criteria:

  • Excessive or unreasonable fear of being in or thinking about a specific situation
  • Fear that has persisted, usually for at least six months
  • Disproportionate fear of actual threat of being in a crowd
  • Immediate anxiety response when exposed to crowds
  • Do everything possible to avoid being in a crowd or enduring crowds in extreme distress

Diagnose enochlophobia versus agoraphobia

Symptoms of enochlophobia may overlap with those of agoraphobia. However, with agoraphobia, the person may fear being alone outside their home or being in open spaces such as large shopping malls or parking lots. Additionally, agoraphobic people may avoid crowds because they fear that they will not be able to escape them.

People with agoraphobia may worry that help may not be available if they experience panic attacks or other debilitating or embarrassing symptoms, while people with enochlophobia may actually be afraid of being hurt. in the crowd.

Treat enochlophobia

A variety of treatments are available for enochlophobia, including psychotherapy, relaxation / mindfulness training, and sometimes medication.

Psychotherapy

Psychotherapy, or talk therapy, is an effective treatment for enochlophobia. A commonly used method of psychotherapy to treat phobias is cognitive behavioral therapy (CBT). This type of therapy focuses on identifying the thought patterns that are causing your irrational fears. Your therapist will teach you how to challenge your thoughts and reduce your symptoms when facing your fears.

CBT can include exposure therapy. This treatment helps you cope with your fear of crowds in small steps. You might start by thinking about being in a crowd or looking at photos of a crowd, while using coping strategies to reduce your anxiety. Eventually, with the help of your therapist, you will work your way through a crowd of people.

Relaxation and mindfulness

Relaxation and mindfulness techniques can help reduce symptoms of anxiety. These can include deep breathing, visualization, guided imagery, and mindfulness training.

  • Deep breathing: Anxiety often causes rapid, shallow breathing. Deep breathing (diaphragmatic breathing) reduces symptoms of anxiety by focusing on your breathing.

Deep breathing exercise

  1. Sit or lie down in a comfortable position.
  2. Place one hand on your chest and the other on your stomach.
  3. Inhale slowly, filling your stomach with air. Try not to let your chest rise.
  4. Fold your lips and breathe out slowly, as if you were suffering from the candles.
  5. Repeat for several breaths.
  • Visualization: This technique involves imagining yourself in a crowd of people, without feeling your anxiety symptoms.
  • Guided imagery: This relaxation activity involves voice prompts, either from another person or using a recorded voice. Guided imagery helps you imagine calm images, such as relaxing on a beach, to reduce symptoms of anxiety.
  • mindfulness: Enochlophobia is based on irrational thoughts and fears. The whole point of mindfulness is to redirect your thoughts to the present, rather than focusing on all the things that could go wrong when you are in a crowd of people.

Medications

Medication is usually not the first step in treating phobias. However, if your fear of crowds prevents you from participating in important daily activities, you may need medical intervention.

Benzodiazepines such as Klonopin (clonazepam), Xanax (alprazolam), Valium (diazepam), and Ativan (lorazepam) are a common type of medicine used to treat phobias. These medicines are taken when you first experience your symptoms or just before you are exposed to the situation that is causing your symptoms. These drugs are short-lived.

Benzodiazepines should be used with caution. They frequently cause drowsiness and poor coordination, and people who take them should not drive or perform other potentially dangerous activities for several hours afterward.

Additionally, benzodiazepines can cause drug tolerance (when a drug no longer works as well as it did), dependence, and substance use disorder. It can be difficult to stop them even if you’ve been taking them for only a few days, and you may experience unpleasant withdrawal symptoms if you stop them abruptly.

In some cases, your doctor may prescribe other types of medicines that treat anxiety disorders by working on neurotransmitters in your brain, such as selective serotonin reuptake inhibitors (SSRIs). Common SSRIs are Prozac (fluoxetine), Zoloft (sertraline), Lexapro (escitalopram), Celexa (citalopram), and Paxil (paroxetine).

Summary

Enochlophobia is an irrational fear of crowds that can interfere with your ability to perform daily tasks such as traveling on public transport, running errands, or going out with friends. This condition causes symptoms of anxiety, such as a fast heartbeat, sweating, and dizziness. A mental health professional such as a psychiatrist can work with you to help you cope with, or even overcome, your phobia using psychotherapy, coping strategies, and in some cases, medication.

A word from Verywell

It can be embarrassing to admit that your fear of crowds is preventing you from seeing loved ones or doing everyday tasks. But the help and support is there for you. Consider joining a virtual support group if you are uncomfortable in a crowd and talk to your health care provider or therapist about treatment options.


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