What is emetophobia and why is it getting so much attention on TikTok?

It all started when Alicia Mitas was 7 years old and got sick on Easter.

"Ever since then, I started worrying about it every single day to my parents," she explains. "I would ask them a lot of questions about being sick or if I looked sick or why my stomach felt a certain way. And my parents knew after a while, 'OK, this is not normal.'"

Mitas, now 18, suffers from emetophobia, the fear of vomiting or other people vomiting.

Tiktok user @lacey.bibbee describes her experience with emetophobia as being "deathly afraid of throw up." Like others who share the same fear, she's using the social media platform to spread awareness about emetophobia and its impact on her life. The hashtag #emetophobia has garnered more than 70 million views on TikTok.

In a video, @lacey.bibbee says she started experiencing it after listening to her father throw up all night before he had a stroke, which she says was "so traumatizing."

"I don't know why I get so panicked by (vomit), I don't know if I'm worried about getting thrown up on, getting sick myself or whatever," she says. "If someone's coughing, gagging, feels sick, looks sick, is sick and they're around me, it totally puts me on full-on panic mode."

With emetophobia, there's typically a predisposition to anxiety, explains Ken Goodman, a licensed clinical social worker, board member for the Anxiety and Depression Association of America and author of “The Emetophobia Manual." It can also be triggered by a certain event, whether traumatic or not, that could happen as early as childhood.

"It's not just seeing someone throw up – everyone sees someone throw up in their childhood... But when it's filled with anxiety on top of it, now there's disgust and anxiety – then a phobia begins to develop, where the mind begins to amplify the situation and people start to worry, 'What if it happens again?' and 'What if it happens to me?'"

In addition to anxiety, obsessive compulsive disorder may also be a comorbidity for someone who experiences emetophobia, he says.

Emetophobia's impact on daily life

Those who suffer from emetophobia may try to avoid situations that could trigger their fear, Goodman says.

"Sometimes patients haven't thrown up in 15 years, but they rearrange their life because of the fear," he says. 

This might include being careful with what types of food you eat, compulsively checking expiration dates, limiting alcohol consumption or avoiding places that might cause motion sickness like cars, planes or boats.

"I've had patients who would not drive in the car unless two or three hours had gone by after they ate," he says. "You couldn't go necessarily to eat at people's homes, because you never know how they cooked the food and where it came from."

The International OCD Foundation describes the symptoms of emetophobia as "debilitating," adding that people may also avoid certain medications that list nausea as a possible side effect and others may forgo pregnancy for fear of morning sickness.

"Struggles with all of these issues often result in depression, shame, secrecy and lies," the foundation's website reads.

For Mitas, school was hard.

"I really did not have a social life in high school, because I was so afraid of going out and then getting sick when I was out with my friends," she says. "Whenever I started to feel anxious or sick (in class), I would always ask to either go to the guidance counselor or the nurse's office. That was my safety."

Emetophobia doesn't only affect people mentally but also physically.

"When you keep worrying, 'what if I get sick, what if I get sick,' ...it makes you actually feel sick... it makes you feel nauseous, and it's just this horrible cycle," Mitas explains. "My brain always tricks me into thinking that I'm sick when I'm actually not, and it's just my anxiety making my stomach hurt."

Goodman says it's normal for people to experience anxiety physiologically, including sweating, rapid heartbeat or stomach distress.

"Oftentimes people with emetophobia will feel nauseous. And that nausea will then lead them to believing it's going to happen even though it never happens," he says, explaining the physical sensation can then worsen their anxiety and trigger the emetophobia.

It's more than just being disgusted by vomit

Most people find throwing up unpleasant, of course, but there are two main distinctions between an average dislike of throwing up and emetopohbia.

"Everyone thinks of (vomit) as disgusting, but with someone with emetophobia, that disgust is amplified," Goodman says. "It's (also) associated with anxiety... Someone with emetophobia experiences intense anxiety prior to or in anticipation of it happening. So it's not just throwing up, it's throwing up and having intense fear over it."

If you've never heard of emetophobia, you're not alone. Goodman says even some therapists aren't familiar with it, highlighting the importance of finding a therapist that specializes in anxiety, OCD or the condition itself.

"This is not something that people have to live with for the rest of their life, but it takes a lot of determination, effort and patience," he says. "It's not something that will go away unless you're committed to the treatment and getting better, but it's definitely something that people can overcome."

For those unfamiliar with emetophobia, Mitas asks people not to tease and "just be nice."

"Don't make fun," she says. "I remember one time my dad jokingly pretended he was going to throw up when I was younger. He learned never to do that again."

Mitas says exposure therapy for her has been her "saving grace" and encourages others suffering to seek professional help. 

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