I wrote about my journey with emetophobia a few years ago during covid, and as we enter another mental health awareness week I wanted to speak about it again. There is still a fair bit of stigma and misunderstanding when it comes to mental health, and I want to be a part of changing that. We can’t see what’s going on in someone’s mind, so unless someone tells you otherwise it can seem like they don’t struggle, and that can make us feel more alone when we do. I also believe sharing honestly with each other can be a powerful tool for increasing awareness and understanding, which ultimately leads to more people being able to access the support they need.
For those of you that may not know, I have struggled with emetophobia for pretty much as long as I can remember - at least the age of 4. Emetophobia is an intense, all-encompassing fear of vomit. Exactly how this manifests can vary between people, but for me it includes a fear of both myself and other people vomiting in almost equal measure. It’s difficult to explain just how much of an impact this can have on daily life, but most people with emetophobia will passionately say they would rather die than be sick, and at it’s worst it literally takes over every aspect of a person’s life.
When you have emetophobia, the threat of illness is everywhere, all the time. Any person you’re in contact with COULD hypothetically be sick. Any food you eat COULD potentially make you ill. Anything you touch COULD potentially be contaminated. On any given day you COULD become unwell. And that feels really overwhelming when it’s the thing you are afraid of the most. When you add to this all the hundreds of every day scenarios where that risk can feel even higher - close contact with people or crowds, eating food prepared by someone else or that might be past its best, using public facilities, attending social events with alcohol, going to schools/workplaces/events where illnesses might be spread around, even eating more than normal and having bodily sensations such as fullness can feel scary. Just trying to go about a normal life with emetophobia can feel pretty terrifying.
Younger me was entirely controlled by this fear, feeling that nothing at all was worth the risk of vomiting and I needed to avoid these situations at all costs. I absolutely, un-ironically felt that I would rather die than be sick, and I often felt quite suicidal from the reality of vomiting being a part of life and not feeling able to cope with that. I know that might sound ridiculous, but for me the fear of vomit was far stronger than any fear of dying, and it felt utterly miserable and hopeless to live with such extreme and relentless anxiety around something that I knew I could never fully escape from for as long as I was alive. Emetophobia became like a constant feeling of existential dread and terror. Living for me meant my worst nightmare could come true around any corner, and I struggled to find any purpose for getting through that suffering.
There were years during my teens in particular where it got so bad that I required medical intervention. I felt so physically sick from anxiety and was so worried about being ill that I stopped eating. I couldn’t stomach anything except plain rich tea biscuits. I felt physically sick constantly, and I had almost daily panic attacks. I withdrew from the world, struggled to attend school, couldn’t engage in the hobbies I once enjoyed, lost friends who didn’t understand, and physically became very underweight, tired and frail. It took 3 years, several medications, and a multidisciplinary team from Great Ormond Street hospital to help me escape this hole, and the effects of the malnutrition at that age have impacted my body ever since.
My life looks completely different now, and has for many years. The past year and a half in particular I have been travelling and doing all sorts of things I never would have thought I could. I’ve exposed myself to countless situations where the risk of vomiting or becoming unwell are high: crowded public transport, the constant use of shared/public toilets, boat trips and ferry crossings with people being seasick, food and water I don’t quite trust, a general lack of control over my environment and the cleanliness of things, and many more. The fact I have been doing all these things and am able to ‘live my best life’ despite my phobia is the result of many years of hard work and therapy, but I can’t deny that alongside all these incredible moments I have still experienced a lot of anxiety and had some really hard moments.
When we first arrived in Thailand, I really struggled with food. I’d heard so many stories of people getting food poisoning or sick while travelling southeast Asia and I was really anxious about eating or drinking anything that might make me ill - even before we left the UK. The only things that felt safe were bottled water and pre-packaged, non-perishable food, but unfortunately a diet of crisps, biscuits and dried mango for 3 months does not a healthy person make, and knew I couldn’t fall back into that hole. I decided that a vegetarian pad thai was my safest option, and that was pretty much all I ate for the first couple of weeks along with my pre-packaged snacks and bottled water.
As our travels went on and I watched Patrick and Jack eating all sorts of food and drinking all sorts of drinks and never getting ill despite me being convinced they would, I got slightly more confident and would occasionally branch out to a vegetarian fried rice or even a soft drink (with no ice, of course). By the time we got to the Philippines, 2 weeks away from arriving in Australia, I was feeling even more adventurous and we went out to an Italian restaurant there for New Years Eve. The day after that, my worst nightmare happened and I’m not kidding when I say it was the most violently ill I have ever been in my life. It felt so traumatic that it was over a week before I would eat anything at all, and I reverted to eating only plain dry cereal pieces for the rest of the trip. Dramatic, I know.
Not only did I feel like all the progress of the last few weeks had been undone, but I also felt like all the progress of the years before had been undone too and the intensity of the fear came flooding back. The experience of me vomiting kept replaying vividly in my mind, over and over, like I could almost feel it happening again. It was so distressing and felt completely out of my control. It reinforced every anxious thought and reminded me why I took such extreme measures to avoid that happening, why I felt there really was nothing at all worth going through that for, and why living in a world where vomiting exists feels so overwhelmingly scary. I couldn’t escape it and I wanted to go home, shut myself off from the world and never eat again. Younger me probably would have done that, but older me gave it some time, and slowly eased herself back into the world.
In the time since that incident my life looks almost back to normal, but I can’t deny that it has been a setback to how I feel. I’m still having panic attacks on average once a month. I find I’m more on edge and easily triggered by small things such as someone coughing. Doing things I’m scared of feels harder. I am generally more preoccupied and worried about vomit than I was before we left. I occasionally still have vivid dreams where I or someone else is sick. The feeling of existential dread has somewhat returned. And yet, it has also been without a doubt the BEST year of my life. In many ways I’ve been the most relaxed and happy I have ever felt, the most excited I have been about life and the most confident and fulfilled I have been. My overriding feeling of this year is one of amazement and awe for the world and the life I get to live. Emetophobia just kind of coexists with it all, creeping in uninvited.
I’m still not sure exactly why the experience of vomiting, or witnessing someone else vomit, is so intensely distressing for me and not for other people. The way I experience it, I struggle to understand how other people AREN’T terrified of it. It genuinely feels traumatic for me, every time. I think the unpredictability of it is a big part - not knowing when, or if, it’s going to happen - but I also just find the sensations, sounds, smell, sight and everything about it all deeply distressing and disturbing. There is no one big event I can pinpoint to understand where it comes from, no obvious trauma in my infancy that my parents can identify, and no time in my life I can remember ever being without that fear. For me, emetophobia has always just kind of been there. I have never experienced life without it and I think that makes it really hard to figure out now.
Whilst I’ve got pretty good these days at not allowing my world to be made small by emetophobia, I still struggle a lot with the physical manifestations of it. I regularly find myself feeling anxious and unwell, usually triggered by something I wasn’t even consciously aware of worrying about at the time (seeing a health campaign sign earlier in the day about gastroenteritis, drinking some water that tasted a bit different, feeling a bit too full, overhearing a conversation of a random stranger being ill - tiny, trivial things), and by the time I do become aware of it, it’s usually too late. Even before I start to feel unwell, the panic is there. I become hyper-focused on my bodily sensations and convince myself that something feels off. I enter an excruciating cycle of nausea-induced anxiety and anxiety induced-nausea, both things making the other worse, and this spirals into a level of intense, real, physical nausea that mimics exactly the same feelings as the times I am actually unwell, until it becomes impossible to distinguish what is anxiety and what is not.
Since I can never really know for sure if I am going to be sick or if it’s just anxiety, I find myself in a losing battle with this almost every time. It usually ends with me sitting alone somewhere, with a sick bag in one hand and my bottle of water in the other, full-body trembling, convinced I am going to be sick any minute and just waiting for it to happen (or not happen, as the case may be 99.9% of the time). This cycle is more likely to happen when I’m tired, stressed, out of routine or more anxious than usual, but it can happen on any day seemingly out of the blue.
Going through this so regularly, not just the anxiety part but actually feeling so intensely unwell so regularly, affects my quality of life quite significantly. Feeling sick is unpleasant for most people, but for me it is completely debilitating. My body and brain totally shut down and I can’t function until I feel better. At my worst point I can’t speak or move, and every thought in my head and every slight noise, sight, sound, movement or smell around me can be enough to set me off again. It’s a really dark headspace to be in, and my inability to function when feeling ill often makes me doubt my ability to cope with the life I want in the future. Can I really live my whole life like this? Is it worth it? How could I ever possibly have children and show up for them? How could I cope with being pregnant and having morning sickness? How can I be an equal partner if I regularly fall into a state in which I can’t even do the bare minimum?
Along with those feelings of shame, the nausea also reinforces my fear by reminding me how it feels to feel sick, and that it can happen at any time. The anticipation feels terrifying and makes it a daily battle to keep living a normal life, especially when these panic attacks are often a frustrating consequence of me doing so. It’s hard to feel optimistic when I keep experiencing such intense feelings of sickness, anxiety and despair even when I’m not unwell. Since they are most often triggered subconsciously, I am yet to figure out any reliable way to make them stop. For now I can only try and get better at getting through them.
Reading all these words back, I’m aware how extreme and irrational this all sounds. But I think that’s kind of why I wanted to share it. This is my very real internal world, but for the most part on the outside I genuinely don’t think anyone would have had any idea. I think a lot of us can feel a bit crazy or ashamed for the thoughts/feelings/behaviours we experience at times, regardless of what they are, and end up feeling like we are the only ones. I guess I want to show you that farrrrrr more people than you realise are probably struggling with things and having experiences that make them feel a bit weird and ashamed as well, even if they aren’t exactly the same as yours.
We are all human beings with unique minds, environments and life experiences, and navigating life and ourselves and our relationships can be really hard. Maybe it’s actually normal to be abnormal. I genuinely believe every one of us is a constant work-in-progress, whether we are aware of it or not, and there’s no shame in that. We all have to work through hard stuff at one time or another, but adding shame to those feelings only makes it harder. Letting go of the idea that we should always have it figured out can be really liberating, but I also believe it is important to empower ourselves to take responsibility for our own mental health, and recognise that we CAN feel better and deserve to make our wellbeing a priority, even when it’s hard. It’s not always straightforward or linear, but it’s always worth sticking at it. You will always be stronger and braver by facing your problems than you will be by avoiding them.
I think it’s also important to note that the same way some physical health conditions don’t just ‘go away’, and require long-term management for some people, the same can be true for mental health difficulties. Sometimes being anxiety-free is possible, but oftentimes learning to live with the anxiety can be just as healing. My fear hasn’t fully gone away, but I now live a much more fulfilling life alongside it rather than being controlled by it, and the increase in fulfilling moments make my life feel worth living. I may still be learning to manage many aspects of emetophobia, and I may still have days where I struggle, but when I look at the year I’ve had and the life I now live, I can see how unbelievably far I’ve come and I hold out more hope for the future. Wherever we are in our journeys and however much further we hope to go, we deserve to be proud of the progress we have made.
Lastly I want to touch on this idea that our mental health is somehow a fully controllable thing, and that people can avoid mental health problems if they just do the right things and think the right thoughts. While it is true that there are many lifestyle choices we can make that have a big influence on helping to maintain good mental health (just as there are with physical health) and that’s important, it’s just not as simple as do X and you will feel Y in all cases. Sometimes you can try with all the knowledge and tools you have and be doing your very best, but the struggles will still come anyway (take it from someone with a masters degree in Clinical Psychology 🫠). The idea that we can always control our mental health or prevent mental illness is a misconception that can add even more shame for people who are most likely already trying their best and feeling like it’s their fault. The truth is that anyone can find themselves struggling at any time, with any number of different things, and you are not broken or ‘less than’ for that. How we respond to it is what makes the difference.
If you have made it this far, thank you for reading! I hope it’s helped you feel less alone or ashamed for any struggles you have had or might have in the future. Or at least a bit better able to understand those that do. Statistics show that 1 in 4 people will experience a mental health disorder every year in the UK, but I suspect the true number is far higher than that. Emetophobia is one of many hundreds of lesser-known mental health conditions that often go undiagnosed, untreated, and undisclosed for many years, and seeking help is a step that not everybody takes. If you are struggling with something that doesn’t seem to make sense to anyone else, I promise you are not the only one and you can still seek help. At the age of 16 I finally had a name for what I was experiencing, and I have since discovered there are many other people out there like me and there are also many trained professionals who understand it and are able to help, I just needed to know where to look. Every time I have shared my experiences more openly, people have came forward with their own stories and I have realised that these things are always so much more common than we think.
So my advice is to be kind to yourself and those around you, be brave to take the first step, and remember to keep the conversations going 🩵
