What is Scotomaphobia? (A Summary)

In this blog we will discuss the symptoms, causes and treatments of Scotomaphobia. 

An intense fear of blindness is called Scotomaphobia. 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 exposed to a situation one feels they’ll get blind because of. 

Even the thought of getting blind can be enough to trigger anxiety and stress. One can undergo full-blown panic attacks if the condition worsens. 

Normally, people fear getting blind. They do so if they believe any situation or incident can lead them to lose their eyesight. However, someone who suffers from Scotomaphobia will have a constant fear of getting blind. They will be extremely stressed and terrified, even if they’re not exposed to a situation where one might get blind. 

A sufferer tries to evade the intrusive, negative thoughts one has in Scotomaphobia by avoiding getting exposed to a situation one fears they’ll get blind in. The acts of avoidance are repetitive because of pleasant feelings it produces. This repetition not only maintains one’s fear of blindness but can also lead to OCD. 

According to the DSM-V, anxiety and avoidance affects one’s social and occupational functioning. For example, one will avoid going out of the house for the fear of getting blind. Because of this, they’ll skip school and or the office. 

One will visit the doctor or an eye specialist very frequently. Even the slightest pain or discomfort in the eye can lead to extremely high levels of anxiety. 

All these actions can lead to depression. 

Scotomaphobia is an irrational fear of blindness in the visual spot. The name originates from the Greek word ‘scotoma’ meaning blindness and ‘phobos’ meaning fear.  

Symptoms of Scotomaphobia 

Like in the case of all other specific phobias, Scotomaphobia too has anxiety as its focal symptom. Individuals suffering from an irrational fear of blindness 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 he is around his fear stimuli, 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.

Scotomaphobia, being the fear of blindness is experienced by individuals in different ways. One might have more severe symptoms than the other, based on their past experiences and intensity of the phobia. 

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

Symptoms one experiences in Scotomaphobia are:

• Excessive anxiety when exposed to a situation where one might get blind 
• Excessive anxiety when thinking about blindness 
• Unavoidable anxiety 
• Inability to manage anxiety
• Full-blown panic attacks
• Avoiding places or situations where one might get blind 
• Recurrent need to visit a doctor 
• 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

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

Causes of Scotomaphobia 

Scotomaphobia, like all other phobias, has no known cause. In this phobia, one is fearful of blindness because of the unpleasant feelings and helplessness it causes. 

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 Scotomaphobia until and unless there is some trigger event.

A trigger event can be for example, a sufferer might’ve seen their loved ones getting blind. The difficulties they go through can be the reason why one fears getting blind. Also, hearing about individuals suffering badly due to blindness can be the reason for their fear. 

Additionally, news reports about blind people and their sufferings can be another reason for Scotomaphobia to develop. 

Therefore, Scotomaphobia is caused by both genetics and environmental factors. 

Treatment of Scotomaphobia 

Scotomaphobia, like all other specific phobias, has no exclusive type of treatment that is specifically designed to treat it. Like all the other specific phobias, Scotomaphobia is treated by a number of different therapies including, Cognitive-behavioral Therapy (CBT) and or medications that lowers the 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. Scotomaphobia is defined as the irrational fear of blindness. 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. 

• 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 Scotomaphobia, the patient will be advised on how to overcome his fear of blindness. 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 Scotomaphobia. 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 Scotomaphobia, 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 Scotomaphobia. 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 Scotomaphobia, 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).

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Frequently Asked Questions 

Q1) How is Scotomaphobia treated?

Psychotherapies like CBT, NLP and or medicinal drugs are very effective ways of treating Scotomaphobia.

Q2) What causes Scotomaphobia?

A genetic predisposition and environmental factors are the reasons why one develops Scotomaphobia.

Q3) How is Scotomaphobia diagnosed?

Scotomaphobia is diagnosed by the help of DSM-V. According to it, one must experience anxiety lasting for at least 6 months accompanied by at least 3-5 physiological symptoms of specific phobias. 

Citations 

• https://psychtimes.com/scotomaphobia-fear-of-blindness/
• https://fearof.org/scotomaphobia/
• https://common-phobias.com/scotoma/phobia.htm
• www.apa.org