What is Kopophobia? (An Overview)

In this blog we will discuss the symptoms, causes and treatment of Kopophobia. 

Kopophobia is the fear of fatigue.

It is a type of specific phobia, which comes under the category of anxiety disorders in the DSM-V.

Someone suffering from this phobia will experience extreme anxiety when they encounter their fear stimuli, fatigue.  

Not just experiencing fatigue, but the very thought of it can instigate high levels of anxiety.

If this anxiety worsens, one can have full-blown panic attacks. 

In order to elude these unpleasant feelings, someone suffering from fatigue will take measures to avoid getting fatigued.

Because fatigue is something subjective, one feels it but cannot see or touch it, avoiding this can take a lot of efforts. 

In Kopophobia, this avoidance can help in maintaining one’s fear of fatigue because of the pleasant feelings it produces.

As the DSM-V suggests, this act of avoidance caused by anxiety affects the sufferers social and occupational functioning. 

For example, one will restrain themselves from doing work that requires energy and causes fatigue.

Such as, not going to school/office, not helping family members with household work.

In extreme cases, one will not leave his house at all because of the perception that it will cause fatigue.

Sufferers will spend most of their day on bed, avoiding any sort of work.

Actions like, dressing up, walking, eating can also be perceived to be tiring.

This social occupational dysfunction and avoidance can lead to the sufferer developing depression and or OCD in the future. 

Kopophobia is the irrational fear of fatigue.

The word derives from the Greek word ‘kopo’ meaning fatigue and phobia meaning fear. 

Symptoms of Kopophobia 

Like in the case of all other specific phobias, Kopophobia too has anxiety as its focal symptom.

Individuals suffering from an irrational fear of fatigue suffer from extreme anxiety which, as mentioned earlier, can result in one having panic attacks. 

When one undergoes extreme anxiety, the body experiences other physiological symptoms as well.

Such as increased heart rate or palpitations. 

When the sufferer thinks about fatigue or getting exhausted, he goes 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)-faint or suffer from panic attacks or stay and combat their fear (fight)-by taking counterproductive actions.

Sufferers of Kopophobia experience symptoms in different ways.

Someone may find going to school exhausting whereas someone else might find getting up from bed energy consuming. 

One might have more severe symptoms than the other, based on their past experiences and intensity of the phobia.

Though, as the DSM-5 suggest, one must experience anxiety lasting for at least 6-months.  

Symptoms one experiences in Kopophobia are: 

• Excessive anxiety when they think they’re experiencing fatigue 
• Excessive anxiety when thinking about fatigue 
• Inability to manage anxiety 
• Full-blown panic attacks 
• Avoiding energy consuming actions 
• Increased heart beat 
• Breathlessness 
• Muscle tension 
• Nausea 
• Feelings of dizziness/fainting 
• Feeling depressed 
• Fear of an impending doom 
• Excessive sweating 
• Tremors 
• Hot/cold flashes 
• Butterflies in the stomach 
• Drying up of the mouth 
• Disorientation 
• Migraine 
• Insomnia 

For one to be diagnosed with Kopophobia, a person should experience at least 3-5 of these symptoms (including anxiety). 

Causes of Kopophobia 

Like every other specific phobia, Kopophobia is a result of either genetics or a past traumatic experience. 

Someone who has a family history of anxiety disorders or specific phobias has a higher chance of developing Kopophobia than someone who doesn’t.

This is because they are genetically predisposed to develop it.  

Genes and neurotransmitters also play a significant role in this genetic predisposition. 

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 Kopophobia until and unless there is some trigger event, instigating anxiety or fear related to fatigue. 

An environmental trigger event can be for example; the sufferer might’ve gotten sick or suffered some physical injury due to strenuous activity which led to fatigue.

They can also develop Kopophobia if they have seen or heard of the health problems one suffered due to exhaustion. 

May be an individual is not physically healthy enough and therefore, any kind of strenuous activity can instigate their illness.

Also, one might fear fatigue because of the unpleasant feelings it produces and or the way our body responds to exhaustion. 

Thus, Kopophobia is caused by both genetics and environmental factors. 

Treatment of Kopophobia 

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

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

• Cognitive-Behavioral Therapy (CBT) 

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

Kopophobia is defined as the irrational fear of fatigue.

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, is 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 Kopophobia by making them understand their thoughts, behaviors and emotional state.

By having an insight of the patients 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. 

• EMDR 

This another form of treatment used with patients suffering from specific phobia or anxiety disorders. 

It is used with patients who know the cause of their phobia. 

First, the therapist collects the patients’ history of different fears.

They then identify the real cause of the particular fear/phobia the patient has. 

They then discuss any new/latest event that triggered their anxiety and fear in the past few weeks.

People coming with specific phobias are told to imagine their distress causing stimuli. 

The therapist then works with the individual in order for them to overcome their fear.

In the case of Kopophobia, the patient will be advised on how to overcome his fear of fatigue.

They do this by creating a positive imagery for the patients’ feared stimuli.

• Dialectical Behavior Therapy (DBT) 

This is another effective therapy used to treat Kopophobia.

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 Kopophobia, 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 Kopophobia.

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 suggest 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 Kopophobia, 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://common-phobias.com/Kopo/phobia.htm
• https://psychtimes.com/kopophobia-fear-of-fatigue/
• www.brain.org
• www.apa.org