When I was a kid, I remember channel surfing and stumbling upon a news special about phobias. The man on my screen was sticking his hands in a garbage can, sweating and hysterically crying as if he were dipping his fingers in a barrel of battery acid. A reporter explained that the man had a phobia of germs, and with the help of a therapist, he was facing his fear and exposing himself to the thing that scared him most.
Click. I’d rather watch cartoons.
But as I watched TV that night, and for several years after, I would remember that man. I would remember the sick, embarrassed feeling I felt watching him be so raw and vulnerable and exposed. I wondered how a fear of something as common as garbage could send someone spiraling, allowing this adult to devolve into a broken, malfunctioning person.
When I was diagnosed with a emetophobia at age 24, this man was the first person I thought of.
Emetophobia is the irrational fear of vomit, and before the moment my doctor uttered my diagnosis, I was completely unaware that I had a phobia at all.
I have always had a fear of vomit — seeing a puddle of puke on the sidewalk or an impromptu vomit scene in a movie could send me into panic attack that would derail my entire day — but what I feared more than anything was feeling nauseated myself. I went above and beyond to avoid the mere chance that I might get nauseous. In doing this, ironically, I made myself sick — allowing the immense amounts of stress to leave me feeling ill and, yes, on the verge of vomiting, nearly every day.
I would stuff towels under my bedroom door when my mom made dinner, because the smell of food would nauseate me. I would wear “motion sickness wristbands” every day, even if I was just going to school. If I had to get my throat swabbed at the doctor’s office, I would beg for a blood test instead.
My biggest triggers, though, were restaurants and car rides. Seriously, I’ve had a panic attack in nearly every restaurant bathroom stall on the south shore of Long Island. Upon entering a restaurant, my eyes would immediately scan the space for bathrooms and exits. If I went out to eat with family or friends, I’d spend most of my time pacing outside the restaurant, trying desperately to lower my heart rate and steady my breathing. I would usually order something but ask the waitstaff to wrap it up as soon as it came out to the table, without ever daring to take a bite first.
My car habits were just as strange. Over time, my (incredibly patient) friends knew not even to suggest I take the back seat, learning that the only way I would get into a car is if I sat in the passenger seat with the window open and one hand hanging out. It became a ritual — a constant that I could depend on that allowed me, in some small way, to feel like I was in control of my unruly gut. It didn’t matter if it was the dead of winter or the hottest day of the year — everyone else in the car was at the mercy of my bizarre coping mechanisms.
Now, you may be thinking, “Well, who likes vomit? Who likes feeling nauseated?”
Sure, most people aren’t exactly fans, but this thinking is what allowed me to rationalize my fear for so many years. The lengths I went to to avoid feeling nauseated were definitely extreme, but it was easy for me and those around me to dismiss it, because, you know, puke is gross.
First of all, I told everyone I had a sensitive stomach. And I believed it! I said I was extremely prone to car sickness. I even convinced myself (and others) that I had an unlucky amount of food poisoning. I secretly wondered if I had an eating disorder. Anorexia I had heard of, emetophobia I had not.
After a while, it just seemed logical to cut out the aspects of my life that caused me stress. I stopped joining friends at the diner or taking car rides with my eager pals who had just become newly licensed drivers. I wanted to join my friends for road trips and half-price appetizers and trips to the “good mall” a few towns over, but I figured I’d rather play introvert than put myself through the inevitable physical anguish.
The thought that I had a phobia never crossed my mind, but other mental illnesses did. When I was around 16, I started taking medication for anxiety and depression. Around the same time, I was also seeing doctors to help me with my stomach, never considering that these two things could be related. After all, my depression could make me feel hopeless and upset, but I thought the physical symptoms I was experiencing with my stomach were too tangible to be mental.
With college looming in the near future and my stomach issues worsening by the day, I spent much of my senior year trying to cope with my gut problems. I took probiotics and fiber pills. I ate Activia yogurt. I tracked all the food that entered (and exited) my body. I limited my calorie intake, because less food equals less vomit, right? In a last-ditch effort, I got a biopsy. It came back normal. I felt hopeless.
By the time I was 24, I had basically gotten used to playing off my debilitating stomach problems as an adorable quirk — like playing the ukulele while wearing glasses or collecting novelty salt-and-pepper shakers. On one hand, I felt very much like an adult for the first time in my life; I had graduated, gotten a job, and moved into an apartment with my partner. But on the other, I was still struggling to do mundane things like sit through a meal at a restaurant and get into cars.
Everything changed when I made an appointment with a new doctor who was closer to my apartment to get a refill of my depression medication. Little did I know that this simple act, done for convenience, would change my life. During my consultation, I mentioned my long history of stomach issues. Within 15 minutes of talking, the doctor told me I had emetophobia.
I immediately started cognitive behavioral therapy, a type of a psychosocial intervention that makes you confront your fears and unlearn your bad habits. My therapist told me that I deserved to be able to eat in restaurants and go on car rides and enjoy life—things that I thought were simply not afforded to me. It finally dawned on me that my quality of life was diminished due to my phobia, and that I had the power to change things.
It has been more than two years since I learned I had emetophobia, and I can’t help but look back and wonder why I seemed to consider every other diagnosis for my stomach issues besides a phobia. I partly blame the plethora of doctors, therapists, and counselors for not properly diagnosing me. But more than that, I blame the lack of public knowledge about emetophobia, and all phobias. Even now, a quick Google search of the word “emetophobia” yields few results, although, according to Alison Lenet, MD, of Columbia University Medical Center, emetophobia is one of the most common phobias, especially among young women.
More than that, mental illnesses of all kinds are still extremely stigmatized, and we are taught that our mental symptoms and our physical symptoms are two different things. It was hard enough to seek help for anxiety and depression as a teen, and speaking about something abstract like my specific fears didn’t seem productive. For years, I experienced pain and discomfort in my stomach. Why aren’t doctors talking more about physical symptoms that manifest due to mental illness? This is not a phenomenon exclusive to phobias — many people have reported physical symptoms that correlate to mental illness like anxiety, depression, and OCD, but the American Psychiatric Association only lists things like “withdrawal,” “apathy,” and “mood changes” on the Warning Signs of Mental Illness page of its website.
There is evidence, however, linking mental illness with physical pain. This 2008 study in the journal Depression and Anxiety states that “primary care patients who endorse symptoms of muscle pain, headache, or stomach pain are approximately 2.5–10 times more likely to screen positively for panic disorder, generalized anxiety disorder, or major depressive disorder.” So why aren’t we talking about this more?
I try not to harp on my years of suffering too much. Instead, I am enjoying life in new ways that would probably seem boring to most. I have been riding in cars, eating in restaurants — hell, I’ve even eaten while riding in a car! A mundane task for most still feels like a giant victory for me. It took months of hard work on top of years of frustration, but I finally understand why it’s worth it to stick your hands in the garbage.