What is Decidophobia? (An Overview)

In this blog we will deliberate the symptoms, causes and treatment of Decidophobia. 

An intense fear of making decisions is called Decidophobia. It is a type of specific phobia which comes under the category of anxiety disorders in the DSM-V.

Someone suffering from it will experience extreme anxiety when they have to make decisions. 

A mere thought of making decisions can also give rise to anxiety. One might even experience full-blown panic attacks if left if the responsibility of making decisions. 

Therefore, one avoids a situation where they need to make decisions.

These acts of avoidance are repeated in order to eliminate unpleasant feelings.

One’s fear of decision making is validated by the fact that by avoiding their fear stimuli, they feel nice and safe. 

Someone suffering from Decidophobia can also develop OCD in the future because this avoidance can change into compulsions. 

According to the DSM-V, anxiety and avoidance affect one’s social and occupational functioning.

For example, one will be unable to decide or choose, let say what subjects they like to study.

Their parents/guardians might make decisions in their place which can turn out to be unfavorable for their futures. 

Someone suffering from Decidophobia lacks the ability to make quick decisions, which is required in a job.

Therefore, their professional lives may suffer. One will also be unable to decide his own life partner or the way he wants to live his life.

They might end up living with someone they don’t want to. 

All these instances depict how Decidophobia affects one’s life negatively. 

Decidophobia is the irrational fear of decision making. Someone suffering from this specific phobia might be afraid of making mistakes or getting into trouble because of his decisions. 

Symptoms of Decidophobia 

People with Decidophobia, like in all other specific phobias, experience intense anxiety about having an encounter with a situation where they need to make decisions.

They’re unable to control this anxiety and thus, end up feeling more anxious. This anxiety, in extreme cases, can give rise to full-blown panic attacks.

Sufferers go into flight or fight mode because of an adrenaline rush. In this state, the body’s physiological responses help one make decisions when in fear causing situations.

They either decide to escape the situation (flight) or stay and combat their fear (fight).

According to the DSM-V, one must suffer from anxiety lasting for at least 6-months.

Symptoms one suffers from in Decidophobia, including anxiety are as follows:

• Extreme anxiety upon encountering a situation where one needs to make decisions 
• Extreme anxiety when thinking of making decisions 
• Inability to manage anxiety
• Full-blown panic attacks
• Avoiding making decisions 
• Increased heart beat
• Breathlessness 
• Muscle tension
•  Nausea 
• Feelings of dizziness/fainting
•  Fear of an impending doom
• Excessive sweating 
• Tremors
• Hot/cold flashes 
• Butterflies in the stomach
• Drying up of the mouth 
• Migraine

Out of these, one should experience at least 3-5 symptoms, including anxiety, to be diagnosed with Decidophobia.  

Causes of Decidophobia 

Decidophobia, like all other phobias, has no known cause. In this phobia, one is fearful of making decisions because they fear they might make mistakes. 

These types of phobias can be a result of a number of factors such as biological (genetics) and or environmental (past experiences or social learning). 

Genetics refers to the genes and neurotransmitters in our body. Someone with a family history of a phobia/mental disorder has a higher chance of having the same or different disorder in the future.

This is because the genes of the parents are transferred to their children, thus any alteration in the genes of one’s parents is inherited by the child.

This genetic tendency to develop a mental disorder/specific phobia can also be referred to as a Diathesis-stress relationship.

According to this, one with a genetic predisposition will not develop symptoms of Decidophobia until and unless there is some trigger event.

This trigger event can be for example, in childhood one whose parents were strict was scolded upon making decisions related to his life.

In some houses, children are not allowed to decide or make their own decisions, therefore they develop Decidophobia. 

Someone who was highly criticized for the decisions he made in his childhood or teenage years is very likely to question his ability to make good decisions and therefore will develop this fear.

Individuals who belong to societies where they are judged by people on the way they spend their lives or the things they do, one will be afraid of making decisions because of the fear that other people might accuse him or taunt him. 

Therefore, these social factors, along with a genetic predisposition can develop Decidophobia. 

Treatment of Decidophobia 

Decidophobia, like all other specific phobias, has no exclusive type of treatment that is specifically designed to treat it.

Like all the other specific phobias, Decidophobia is treated by a number of different therapies including, Cognitive-behavioral Therapy (CBT) and or medications that lowers anxiety or other physical symptoms. 

• Cognitive-Behavioral Therapy (CBT) 

It is one of the most frequently used treatments for patients with almost all kinds of mental disorders.

Decidophobia is defined as the irrational fear of making decisions. Thus, the therapist helps the patient in replacing these irrational thoughts with more rational ones. 

The patients are helped out in analyzing and justifying the way they feel about their fear stimuli.

Therapists assist them in uncovering the reasons behind their fear and later they provide them with alternate, pleasant thoughts. 

The patient is told to maintain a thought diary (with ABCD column) which provides them a replacement for every irrational thought they have, when thinking about a particular situation.

The ABCD stands for: 

i. A (antecedents) a situation or triggering event.

ii. B (belief) the thought that comes to one’s mind when in that triggering situation.

iii. C (consequences) the symptoms/feelings caused by that event/thought 

iv. D (dispute) alternate, rational thoughts provided by the therapist in an attempt to        dispute/challenge those irrational beliefs.

This last section of the thought diary is what really plays a role in helping the person feel good/less anxious.  

• Mindfulness-Based Stress Reduction (MBSR) 

MBSR is a meditation therapy, used to manage stress or anxiety. It is an 8-week program which includes group sessions.

Mindfulness meditation and Hatha yoga are practiced in these sessions. Lectures and group discussions are also done to talk about mental health and increase interactivity.

In mindfulness meditation the person is told to, for example, focus on the sensations felt while breathing or the rhythm of the chest rising and falling during the process.

This distracts the person’s attention from something stressful to something which is neutral and soothing. 

For quick and effective treatment, patients are also given a set of home works, for example 45 minutes of yoga and meditation sessions for 6 days a week and to record their results/feelings in a book or diary for 15 minutes a day.

• Neuro-Linguistic programming (NLP) 

It is a psychological approach that includes ways of trying to reach a personal goal. It links language, thoughts and patterns of behavior learned through experience. 

The key elements of NLP are action, modeling and effective communication. It suggests that everyone has different ways of how they see the world.

By understanding a number of perspectives of others, patients who use NLP see the world through a combination of their personal views and that of others. 

NLP therapists treat patients with Decidophobia by making them understand their thoughts, behaviors and emotional state.

By having an insight of the patient’s own ‘personal’ view of reality, they assist them in forming new, positive thoughts. 

NLP helps the patient in improving his state of thoughts about other people by understanding their cognitive-behavioral patterns.

Like CBT, this form of therapy is also very effective. 

• Dialectical Behavior Therapy (DBT) 

This is another effective therapy used to treat Decidophobia. It is more commonly used with people suffering from personality disorders, but is also useful with patients suffering from this type of specific phobia.

Coping skills are taught in the DBT group which lasts for about 6-months and can have a number of people (depending on how many join the group). 

            i. Half-smiling is the first module of DBT. It is a technique that is used with patients who are distressed because of their irrational thoughts.

The technique is known as ‘Half-smiling’ because the person is first advised to think about the stimuli that fears or upsets them, and while doing so they are told to lift the corners of their mouths by subtly smiling.

Smiling is not that will help one get rid of these unpleasant thoughts, it is the person’s ability to constrain itself from thinking about those thoughts while half smiling.

          ii. Mindfulness, the second module, is another technique used in DBT groups which helps the individual in getting rid of those negative thoughts.

Individuals are told to focus on the present and be attentive to what is going on around them at the moment. This helps in breaking the link between their mind and any negative thought that might come to them then. 

For example, a person is told to focus on his breath or on the sound of the wind around them, making use of their auditory sense. 

         iii. The third technique or module of the DBT is distress tolerance skills. This module teaches people to calm themselves down in healthy ways when they are distressed or emotionally overwhelmed.

Individuals are allowed to make wise, rational decisions and take immediate action, rather than being captured by emotionally destructive thoughts that might make the situation worse.

Reality acceptance skills are also learnt under this model so that people fully accept reality and later make plans on how to address the problem.

• Yoga/Meditation 

They are not just one of the many treatment therapies used for Decidophobia, instead they are one of the most common ways of relaxation used by many people.

Yoga tends to stimulate the meditative state of one’s mind while the person is in a particular yoga posture.

Through yoga/meditation the mind is diverted towards something more productive and calm, allowing the person to escape the negative, distress causing thoughts.

Out of a number of yoga types, one can benefit from any yoga type/pose they like. Hatha yoga is one of the different types of yoga.

The breathing techniques or the imagery one creates while in a yoga posture are the real factors that makes the person feel less anxious and diverts their mind, away from the thoughts about their fear stimuli. 

• Drug Therapy 

Drugs are used to reduce the physical symptoms caused by Decidophobia.

Drugs are very quick in effectiveness, as they start showing progress in the patients’ health at least 2 weeks after the medicine is taken. 

This type of biological treatment is usually more effective if the cause of the phobia is only genetic.

However, these drugs/medicines are not to be taken without a doctor’s prescription or consultation. 

Two types of drugs are used in the treatment of this phobia:

                      i.  Antidepressant Drugs

These drugs, as the name suggests don’t only treat depression but are also very effective in treating phobias. Medicines like Paxil reduce the anxious feelings of a person and makes him feel calm.

They need to be taken on a daily basis but not without a doctor’s advice.

                       i. Anti-anxiety Drugs

Medicines like Klonopin are anti-anxiety drugs.

They are most commonly used with patients who experience panic attacks and also lowers their anxiety by binding to receptor cells of the brain that cause these unpleasant symptoms.

Whether the cause of Decidophobia, or any other type of specific phobia is genetics, environmental or both, the best and the most effective way of treating them is by using a combination of both biological treatments (drugs) with cognitive treatment (for example CBT/exposure therapy).

Frequently Asked Questions 

Citations 

• https://psychtimes.com/decidophobia-fear-of-making-decisions/
• https://common-phobias.com/Decido/phobia.htm
• https://www.tranceformpsychology.com/phobias/decidophobia.html/#:~:text=Decidophobia%20is%20the%20Fear%20of,making%20ANY%20decisions%20at%20all!
• www.apa.org