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Knowledge Base » Mental Health » What is Aquaphobia?

What is Aquaphobia?

Last updated on 4th May 2023

Aquaphobia, an extreme fear of water, is a type of specific phobia that is highly individualised, as it varies significantly in the way it manifests. It can encompass a fear of many different types and amounts of water and different actions you perform in relation to water.

Aquaphobia is often related to the fear of drowning, with up to 46% of adults reporting that they are scared of drowning. A phobia of water can include being fearful of swimming in water, bathing in water, being close to water and even being outside in the rain.

We are going to look at aquaphobia in more detail, including the common causes, triggers, symptoms and treatments.

What is Aquaphobia?

Aquaphobia is an extreme, irrational and overwhelming fear of water. Someone with this phobia may perceive water to be dangerous, scary or harmful. This means they are likely to experience intense fear, anxiety or panic when they see, hear or touch water or when they think about or talk about water.

Aquaphobia is a highly individualised phobia, in that it can manifest very differently from person to person, with people feeling fear and anxiety in relation to different types and amounts of water. Someone with aquaphobia may experience negative thoughts, feelings and behaviours in relation to all types of water or only when faced with specific types of water, for example, they may be comfortable with fountains but fear lakes.

Other people only experience fear, anxiety or panic when they are performing certain actions concerning water, for example, they may be comfortable showering but experience high levels of fear when swimming. Alternatively, their fear may be related to water moving in a certain way, for example, they may experience lower levels of fear in relation to still water (such as a pond) compared to moving water (such as waves in the sea).

Someone with aquaphobia may experience fear, anxiety or panic relating to all or some of the following types of water:

Different bodies of water:

For example:

  • Large bodies of water, such as oceans, seas and lakes.
  • Deep bodies of water where drowning may be more likely.
  • Man-made bodies of water, such as swimming pools, fountains and ponds.
  • Water with waves, such as the ocean or sea.
  • Water with currents, such as rivers and seas.
  • Bodies of water that may be murky, may not be clean or are untreated, such as puddles, ponds and rivers.
  • Moving water, such as waterfalls and rivers.
Causes of Aquaphobia

Different actions in relation to water:

For example:

  • Swimming or floating in the water.
  • Walking or standing in water.
  • Sitting or lying down in water (for example, in the bath).
  • Water splashing on you.
  • Drinking water.
  • Water moving close to you.
  • When it’s raining, hailing or snowing outside and puddles gather on the ground.
  • Submerging your face in water.
  • Being in a boat on water.
  • Running water, such as from a shower or tap.

Aquaphobia is a type of specific phobia – an enduring, overwhelming and irrational fear of a specific object, situation, place or person; in this case, an extreme fear of water. Someone with this phobia may experience difficulties functioning normally or concentrating in certain places or situations because of the fear that they could encounter water. They could become consumed with the thought of water and find themselves constantly checking that there is no water around them. The fear, anxiety and panic that they feel can have a significant impact on their mental and emotional well-being and their behaviour.

This can cause them to go to extreme lengths to try and prevent encounters with water, specifically the type of water that triggers their phobia. They may begin to avoid certain places or situations to reduce the risk of them encountering water, for example, they may refuse to go to the beach, a park or the countryside in case they encounter a body of water. However, because the UK has a high amount of rainfall and is an island, there are many naturally occurring bodies of water, including the sea, lakes, reservoirs and rivers. This can make it difficult to avoid water.

Although avoidance behaviours are designed to help someone avoid water and other triggers and reduce the likelihood that they will experience negative thoughts and feelings, avoidance behaviours can actually have a paradoxical effect, whereby they instead reinforce your fear and result in more severe symptoms in the future. Avoidance behaviours can also have a negative impact on your social life, your relationships and your ability to perform everyday tasks.

Because aquaphobia is an individualised phobia, it can occur in many different ways and your fear may be connected to one or more specific fears related to water, for example:

The fear of drowning:

The fear of water often stems from the fear of drowning. According to the World Health Organisation (WHO), drowning is the third leading cause of unintentional death worldwide, accounting for more than 200,000 deaths every year. Add to that the fact that many people consider drowning to be a particularly painful and traumatic way to die, then it is no surprise that 46% of adults say that they are afraid of drowning. A fear of drowning can become so intense that it develops into a fear of water.

The fear of the vastness and depth of water:

Large bodies of water, such as oceans, seas and lakes, and water that is dark or murky, such as ponds and swamps, can seem dangerous or scary as you cannot see what it is under the water. This fear can also be connected to the evolutionary fear of darkness and the fear of being unable to see predators that are close to you or that are about to attack you. Because water usually gets darker as it gets deeper, people with this specific fear are more likely to experience symptoms in relation to large bodies of water.

The fear of the unknown:

Nearly three-quarters of the Earth’s surface is water. However, more than 80% of the world’s oceans have never been explored, mapped or discovered by humans. In fact, humans have explored more of Mars and the moon than they have of the ocean floor. The fear of the unknown is responsible for many people’s fear of water, particularly large bodies of water. This could be related to the fear of mythical creatures such as the Loch Ness Monster or the Kraken or real creatures that may be undiscovered in the oceans.

The fear that water could be dirty or contaminated:

Contaminated water and dirty water can cause many different health concerns and is responsible for the transmission of many different diseases and illnesses, including cholera, hepatitis A and typhoid. Diseases and illnesses can spread from drinking or bathing in contaminated water or breathing in mist from contaminated water. Although drinking water is usually extremely safe in the UK, it is still possible to be exposed to bacteria and diseases in other bodies of water, such as swamps, ponds, puddles and polluted rivers, which could cause skin irritations, infections and illnesses.

Disliking being wet:

Some people, particularly people who have sensory difficulties, may dislike the feeling of being wet or wearing wet clothing so strongly that they then develop a phobia of water. Their dislike of being wet can result in them avoiding showering, swimming and being out in the rain. Avoidance behaviours and negatively skewed memories of the feeling of being wet can result in aquaphobia.

Aquaphobia can occur on a spectrum, with some people experiencing more mild symptoms than others and some people finding that their phobia is less easily triggered, and they only feel fear and anxiety in relation to certain types of water or in certain situations.

To be classified as aquaphobia, your fear of water will include:

  • Feelings of intense fear, panic or anxiety that are difficult to manage.
  • Fear or anxiety that is out of proportion to the true risk.
  • A fear of water that has lasted for at least six months.
  • Engaging in avoidance behaviours to prevent encounters with water.
  • A fear of water that interferes with your day-to-day life, overall well-being or sense of safety.

Someone with aquaphobia will likely experience negative thoughts or feelings such as anxiety, fear or panic even when the risk of danger is negligible. Feeling fear or panic in potentially dangerous situations is normal, for example, if you are floating out to sea or in deep water and cannot swim. However, someone with aquaphobia will experience fear and anxiety even when there is no real risk to them. Even if you are aware your fear is disproportionate to the danger, you will likely be unable to control your negative patterns of thought, your emotions and your behaviours.

Aquaphobia can be connected to and occur in conjunction with other phobias, including:

  • Ablutophobia: An extreme fear of bathing or washing.
  • Thalassophobia: An extreme fear of the ocean and other large bodies of water.
  • Cymophobia: An extreme fear of waves, sea swells and wave-like motions.
  • Ombrophobia: An extreme fear of rain.
  • Mysophobia (germaphobia): An extreme fear of germs, dirt or contamination.
  • Astraphobia: An extreme fear of weather, particularly thunderstorms.

Although rare, in some people, the fear of water can become so extreme that it can extend to a fear of drinking water. Some people who fear drinking water may be comfortable drinking other fluids, such as juice, cordial and tea, which can prevent their fear from having a significant adverse effect on their health. However, in some unusual cases, the individual could begin to fear any liquid that contains water or reminds them of water. Because water is crucial to our health and survival, this could result in dehydration and other serious health concerns.

How does Aquaphobia differ from Hydrophobia?

Although sometimes confused with hydrophobia, aquaphobia and hydrophobia differ in multiple ways. Whilst aquaphobia is a type of specific phobia that falls under the anxiety disorder umbrella, hydrophobia is a clinical characteristic of the rabies virus (a type of viral infection that attacks the brain and nerves) and is a physiological condition, rather than a psychological one. Hydrophobia occurs during the later stages of rabies and is almost always fatal.

Although aquaphobia and hydrophobia may initially appear to manifest in similar ways, hydrophobia is the result of involuntary and extremely painful spasms in the throat that occur when you drink water or even come into contact with water. This can result in difficulties swallowing or extreme pain when swallowing, which can result in someone refusing to drink water, no matter how thirsty they are.

The symptoms of hydrophobia may manifest as a refusal to drink water and can also appear as fear, dread or panic when faced with water. This is why it can sometimes be confused with aquaphobia. However, they are very different medical conditions that doctors can easily differentiate between. They both have different causes, prognoses and treatments.

How Common is Aquaphobia?

As mentioned earlier, approximately 46% of adults report having a fear of drowning. However, this does not mean that all of these people have a phobia of water. Negative thoughts and feelings regarding water usually occur on a spectrum, ranging from mild fear and anxiety or anxiety only in specific situations (such as if you are in deep water and are worried you will drown) to severe fear, panic and anxiety that occurs even if there is no real risk and can impact your day-to-day life, affect your decision-making and result in avoidance behaviours of certain places and situations. It can sometimes be difficult to determine how many people are truly experiencing aquaphobia.

Because aquaphobia is a type of specific phobia, its diagnosis must comply with the diagnostic criteria for specific phobias. This means there are no individual statistics available that show how many people have a phobia of water.

Similarly to other specific phobias, aquaphobia is thought to be an underdiagnosed phobia, with the number of people experiencing this phobia thought to be much higher than the diagnostic rates.

There are several reasons why aquaphobia may be underdiagnosed, for example:

  • People have not heard of aquaphobia so may not realise they are experiencing a diagnosable medical condition.
  • People aren’t aware that there are effective phobia treatments available.
  • Someone who is scared of water may not discuss their fear with others so may not be aware that their thoughts, feelings and behaviours are extreme and irrational.
  • Someone with aquaphobia may implement avoidance behaviours that reduce or eliminate their contact with water.
  • They may be aware that their fear is irrational and may be experiencing feelings of embarrassment or shame.
The people at risk of aquaphobia

Who is at Risk of Aquaphobia?

Although people of all ages, backgrounds and demographics can develop aquaphobia, certain risk factors can increase the risk of someone developing a phobia of water.

These can include:

  • Having a previous traumatic, negative or scary experience involving water.
  • Having another related phobia, such as thalassophobia or ombrophobia.
  • Having a close family member, for example, a parent or sibling, with aquaphobia.
  • Having a close family member, for example, a parent or sibling, with another phobia.
  • Being exposed to the fear of water during childhood or adolescence.
  • Being an intrinsically more anxious or nervous person.
  • Having a sensory processing disorder or sensory difficulties.
  • Having a condition such as aquagenic urticaria (AU), an allergic condition where contact with water causes swelling, rashes, hives or breathing difficulties.
  • Having a history of anxiety disorders or other mental health difficulties.
  • Going through a significant life stressor, having higher than usual stress levels or being in a heightened mental state (particularly if you are exposed to a fear of water or have a negative experience involving water during this time).
  • Having a substance use disorder, such as an addiction to drugs or alcohol.

Unlike many other types of phobias, such as masklophobia, which are often more prevalent in children compared to adults, aquaphobia is more likely to occur in adults, who may be more aware of the possible dangers of water. However, aquaphobia can also develop in children, particularly if they have a scary or traumatic experience involving water or are exposed to a fear of water at an early age.

However, it is important to note that although the above risk factors can increase the likelihood of you developing aquaphobia, they do not guarantee this. An individual with none of the above risk factors may develop a phobia of water unexpectedly, whereas someone with several risk factors may never develop the condition and may enjoy spending time in and around water throughout their life.

How to Deal with Aquaphobia?

As well as official treatment options, there are multiple ways you can deal with your phobia, specifically by implementing effective coping and calming strategies that can help you to deal with your phobia and successfully manage and reduce your symptoms. Coping and calming strategies can be combined with lifestyle changes to help you to alleviate your symptoms and reduce the impact your phobia has on your day-to-day life and overall well-being.

You can engage in successful coping and calming strategies habitually over time to help you reduce the frequency and severity of your phobia symptoms long term and reduce the likelihood that encountering water will trigger negative thoughts, feelings and behaviours. Other coping and calming strategies can be implemented short term when you are faced with your triggers. Short-term strategies are designed to minimise or prevent any physiological, psychological or behavioural symptoms in the moment and to prevent a triggering situation from worsening.

Some long-term and short-term coping and calming strategies you can implement to help you deal with your aquaphobia include:

Desensitisation

Desensitising yourself so that water doesn’t trigger a reaction or results in a less severe reaction can help to reduce the impact your phobia has on your everyday life and your well-being. Desensitisation should happen gradually to ensure you feel calm and safe throughout and are not overwhelmed. Some ways you can desensitise yourself are by running your hands under water, viewing a body of water from a distance and watching positive videos involving water. Gradually desensitising yourself can help you to slowly reduce your fear response.

Learn about your fear

By understanding what initially caused your fear of water and the situation surrounding it, you can gain a deeper understanding of your phobia. You can then deal with your fear’s root cause, as well as any negative thoughts, emotions and behaviours connected to it. By rationalising and understanding your phobia, you can reduce your automatic fear response, and reduce the frequency and severity of your symptoms.

Create a fear ladder

A fear ladder can help you to analyse and understand your fear of water. It can also help you to identify which of your triggers creates more severe fear, anxiety and panic than others. When creating your fear ladder, you will organise your triggers from least severe to most severe. Because phobias are highly individualised, everyone’s fear ladder is different.

However, an example fear ladder is shown below:

1 = Swimming in the water.
2 = Taking a bath.
3 = Standing in the sea.
4 = Being close to a waterfall.
5 = Being on a boat.
6 = Walking in or standing in puddles.

Once you have created your fear ladder, you can then confront your fears one at a time, starting at the bottom of the ladder (the trigger that results in the least phobic response). This can help you to build up your tolerance of your triggers gradually and reduce your fear of water long term.

Challenge negative thoughts and feelings

Those with aquaphobia may experience increased distress when thinking about or talking about water, or when recalling negative experiences with water. Avoid escalating your fear by disrupting and challenging negative thoughts and memories. Remember that water is not a danger to you and that your fear is unfounded. Remind yourself that your fears are disproportionate and that the feeling will soon pass.

Avoid negative portrayals of water

Being exposed to negative portrayals of water in TV shows, films or news stories can validate and reinforce any negative connotations you might already have. As a result, you may experience more anxiety and fear. To prevent your phobia from escalating, avoid triggering or negative depictions of water. Being exposed to these negative depictions can intensify your fear and result in more severe symptoms.

Join a support group

A support group enables you to connect with other people who currently or have previously experienced a phobia. You can connect with people who have had similar experiences to you and have an understanding of your fear and the ways it impacts your life. A phobia support group can provide you with education, emotional support and a safe place to discuss your fears without judgement. A support group can help to reduce stress and anxiety and can help you to reduce your symptoms and manage your fear.

Practise mindfulness

Mindfulness can treat anxiety disorders as well as phobias. With mindfulness, you learn how to focus your breathing and attention and reduce your chances of experiencing a panic attack when faced with your triggers. In addition to managing stress and anxiety, mindfulness can help you explore the connection between mind and body, as well as manage phobia symptoms.

Practice yoga or meditation

Yoga and meditation can be long-term strategies that can help you manage or reduce the impact your fear has on your life. They can help you to control your breathing and control your body’s automatic reaction to encountering water, helping you to feel calmer and more in control. You should practise yoga and meditation on a daily basis to help you reduce the negative thoughts, feelings and reactions you may have when faced with water in the future and help you improve your phobia’s symptoms over time and reduce the impact it has on your life.

Learn deep breathing exercises

Deep breathing exercises can help you to manage the symptoms of your phobia if you encounter a trigger by prompting your brain to relax and calm down and helping you to manage your anxiety. You can also practise deep breathing in the long term. If you engage in deep breathing exercises every day, this can help you to effectively reduce your stress levels, relieve tension in your body and reduce your anxiety long term.

Utilise visualisation techniques

Visualisation is a strategy you can implement when faced with your triggers in the future. Visualisation involves picturing a place, person or memory that elicits positive feelings or calms you down. This can help to alleviate your symptoms and prevent your fear and anxiety from escalating.

Make lifestyle changes

Lifestyle factors such as lack of sleep and high levels of stress can worsen the symptoms of your phobia. By making lifestyle changes, you can reduce the impact your phobia has on your life.

Some lifestyle changes you can make include:

  • Implement a successful sleep routine.
  • Reduce your daily stress.
  • Eat a healthy, balanced diet.
  • Implement an exercise routine.
  • Avoid caffeine, sugar and other stimulants.
The triggers of aquaphobia

What Triggers Aquaphobia?

Because aquaphobia is an individualised phobia, there are many different potential triggers. The types of things, places and situations that trigger your phobia can vary from person to person, with some people’s aquaphobia having only one trigger and other people’s having multiple triggers.

The types of triggers and the number of triggers experienced by different people can vary depending on what initially caused their phobia to develop, their perception of the potential risk, the severity of their symptoms and their current mindset and mental health.

The most common triggers for aquaphobia are:

  • Seeing a body of water, such as an ocean, the sea, a lake, a river or a pond.
  • Being close to water (as you may fear you could fall in, be pushed in or be dragged in by the current or tide).
  • Walking, standing or paddling in the water.
  • Sitting or lying in water (such as in the bath).
  • Hearing moving water, such as waves or a waterfall.
  • Hearing running water or the splashing or plopping of water, such as from a shower or tap.
  • Feeling water directly on your skin or wet clothing on your skin.
  • Feeling water in your face or going up your nose or in your mouth.
  • Water hitting you or being splashed or sprayed with water, such as from a water balloon or a car splashing into a puddle.
  • Seeing animals you typically associate with water, such as ducks, fish, sharks and whales.
  • When it’s currently raining.
  • Seeing puddles on the ground.
  • Seeing dirty water.
  • Drinking water.

What are the Symptoms of Aquaphobia?

Because aquaphobia is an individualised phobia that occurs on a spectrum, the symptoms can differ significantly between different people. Differences can occur in the way the symptoms manifest, how frequently they occur and their severity, with some people experiencing much more severe symptoms than others.

The differences in the severity and frequency of symptoms can occur for multiple reasons, such as the acuteness of your phobia, the initial cause of your phobia, your triggers, your perceived risk of the threat of danger in the situation and your current mental and emotional well-being.

The symptoms of aquaphobia can occur at any time, including when you encounter water or another trigger or when you think or talk about water or remember a previous encounter with water. In more severe cases of aquaphobia, symptoms can be similar to the symptoms of anxiety and panic attacks and some people with a phobia do experience panic attacks when they encounter water. The symptoms of a phobia are often automatic and uncontrollable. It may feel like you are unable to control or manage your thoughts or feelings and that your phobia is taking over your body.

The symptoms of aquaphobia can be physiological (related to your body), psychological (related to your mind) and behavioural (related to your behaviour) and may include:

Psychological Symptoms:

  • Intense, overwhelming persistent, excessive and unreasonable fear, anxiety or panic when faced with water.
  • Intense feelings of dread or terror when close to water.
  • Feelings of fear, anxiety or panic that are out of proportion to the risks.
  • Being unable to control your fear, anxiety or panic even if you are aware that they are out of proportion to the risk.
  • Anticipatory anxiety in the lead-up to a potential encounter with water.
  • Feeling immobilised by your fear or feeling like you are unable to move.
  • Difficulties concentrating or functioning normally around water or when in triggering situations.
  • Feeling defenceless or vulnerable.
  • Experiencing frequent or distressing nightmares about water.
  • Feeling like you are in danger or having an impending sense of doom.
  • Feeling like you are losing control or fearing losing control.
  • Feeling like you could die.

Physiological Symptoms:

  • Feeling dizzy, light-headed or faint.
  • Unusual or extreme sweating or clamminess.
  • Pale or flushed skin, particularly in the face.
  • Nausea, vomiting, an upset stomach or feeling like you have butterflies in your stomach.
  • Difficulties breathing, such as rapid breathing, shallow breathing, hyperventilating or feeling like you cannot catch your breath.
  • Heart palpitations, increased heart rate or feeling like your heart is pounding.
  • Increased blood pressure.
  • Trembling or shaking.
  • Unusual muscle tension or stiffness.
  • Tightness in your chest or chest pain.
  • Experiencing a choking sensation, finding it difficult to swallow or feeling like something is stuck in your throat.
  • A dry or sticky mouth.
  • Having chills.
  • Having an unusual sensitivity to hot or cold temperatures.
  • Confusion or disorientation.
  • Unusual tiredness or fatigue.
  • Pins and needles or a prickling sensation, particularly in your extremities.

Behavioural Symptoms:

  • Avoiding water or any places or situations where you could encounter water.
  • Refusing to shower, bathe or wash your hands.
  • Refusing to go outside in the rain or when it has recently rained.
  • Refusing to drink water.
  • Being unable to eat or having a lack of appetite during or in the lead-up to triggering situations.
  • Difficulties sleeping or insomnia in the lead-up to triggering situations.
  • Refusal or avoidance to think about or talk about water.
  • Refusing to watch a TV show or film about water.
  • Feeling like you want to run away or hide when faced with water.
  • Withdrawing from social situations that could potentially involve water.
  • Refusing to leave your home in case you encounter water.

You may only experience a few of the above symptoms or may experience a lot of them. Some people find that they don’t experience symptoms from all three categories, for example, they may only experience physiological and psychological symptoms and may not experience behavioural symptoms. It could also be that you experience different types of symptoms at different times, depending on the trigger. For example, you may only experience physiological symptoms, such as a racing heart, shaking, breathing difficulties and panic attacks if you are submerged in water.

What causes Aquaphobia?

There are many possible causes of aquaphobia, and different people’s phobias can be caused by different things. For some people, their phobia has one clear cause, whereas for other people, multiple factors contributed to them developing a phobia of water. It could also be that you cannot identify the initial cause of your phobia, particularly if your fear began during childhood or developed a long time ago.

Determining the root cause of your water phobia and what initially triggered your symptoms can be extremely helpful, as it can help you to address your initial trigger or triggers and any negative patterns of thought or negative feelings that are attached to the original onset of your phobia, which can make it easier for you to deal with your phobia and manage your symptoms.

The causes of a water phobia can be environmental, psychological, genetic or evolutionary.

The most common causes of aquaphobia are:

  • A negative, traumatic or scary experience involving water – This is the most common cause of aquaphobia and is also known as a direct learning experience or traumatic conditioning. The traumatic experience may or may not have involved real danger or risk. However, as long as the individual experiences significant fear, distress or trauma, this can lead to the development of a phobia. The most common types of experiences that result in someone developing aquaphobia usually involve feeling like you were going to drown, struggling to breathe, being unable to swim to safety or being caught in a riptide or a strong current. Following the traumatic experience, you may begin to have intrusive and negative thoughts or memories of the trauma and begin to avoid trauma-related triggers, for example, by avoiding places and situations where you are required to swim or could encounter water. This can cause the fear or anxiety you felt at the time of the experience to linger or worsen and can lead to you developing a phobia.
  • Multiple smaller, less serious, negative experiences involving water – In some situations, you can develop a phobia of water because of multiple smaller experiences that if they occurred alone, may not have triggered a phobia. For example, being repeatedly scolded or embarrassed during a swimming lesson, falling into a muddy puddle and feeling humiliated or being bitten by a fish while swimming. These are more likely to result in a phobia if these negative experiences happen within a similar timeframe and if the individual is a child or adolescent at the time.
  • Fear rumination – Usually, fear rumination is triggered by and occurs following a negative or traumatic experience involving water. Repetitive and negative thought processes and the recapitulation of traumatic, frightening, negative or painful experiences involving water can become increasingly disturbing and intrusive over time, making you recall the experience as more frightening than it was in reality. Fear rumination reinforces your natural fear responses, creates additional anxiety and can result in you developing aquaphobia.
  • An informational learning experience – You may develop aquaphobia if you are exposed to information about water that scares you. For example, you may be exposed to information about the dangers of riptides, the types of illnesses and infections that can be transmitted through water or the number of people that die from drowning every year. This information can lead to you viewing water as dangerous or scary and can result in you avoiding contact with water, which can then develop into aquaphobia.
  • Negative depictions or portrayals of water – Exposure to negative portrayals of water could result in a phobia, particularly if the exposure occurred during childhood or during a vulnerable or stressful time in your life. This exposure can come from popular culture, such as a TV show or film. For example, watching films such as Jaws, where people were attacked and killed by a shark, and Titanic where people died by drowning, can cause you to develop a fear of bodies of water that develops into a fear of water itself. Exposure to negative portrayals can cause someone to view water as being dangerous and result in them being afraid that something bad could happen to them in water. This can then result in them developing a phobia.
  • Having an allergy to water – An allergy to water, aquagenic urticaria (AU), is most often characterised by a rash or red, itchy hives following skin contact with water. Someone with AU can also experience headaches, dizziness, fainting, wheezing and shortness of breath if they touch or ingest water. Although this condition is rare, it can occur in conjunction with aquaphobia, as you begin to fear that contact with water will result in an allergic reaction. You are more likely to also develop aquaphobia if your allergy is severe or if you were previously embarrassed following an allergic reaction.
  • A learned phobia – An observational learning experience can result in the development of a phobia because you observed another person’s fear of water and learned to be afraid of it yourself. If you are exposed to phobias during childhood or adolescence, you are more likely to develop them yourself. A child who grows up with a parent or sibling who suffers from aquaphobia is more likely to develop the condition themselves. Adults can also develop learned phobias.
  • Evolutionary factors – There is thought to be an evolutionary basis for aquaphobia, particularly because humans evolved to avoid predators to maximise survival. The water posed multiple risks to our ancestors, particularly because of the risk of drowning and the risk from predators. Fear is designed to promote survival, meaning in the course of human evolution, those who feared water and were more cautious in bodies of water may have been more likely to survive. Humans may have then evolved to be predisposed to a fear of water. In some people, this fear can become excessive and develop into a phobia.
  • Experiencing significant or higher-than-usual stress levels – Significant, long-term stress can result in a disproportionate fear response or an inability to manage intense situations. This can make it more likely that you will develop a phobia, such as aquaphobia, particularly if you have a negative experience involving water or are exposed to the fear of water while experiencing higher levels of stress. A stressful or distressing event, such as a death, can also trigger a phobia, as someone may be less able to manage their emotions and thought processes when experiencing grief, and this can result in a disproportionate fear response.
Diagnosing aquaphobia

How is Aquaphobia Diagnosed?

If you think you may be experiencing aquaphobia, your first step will be to visit your GP. Your GP, while assessing your symptoms, will also refer you to a psychologist or phobia specialist. During your appointments, both your GP and the psychologist will ask you detailed questions about your symptoms and your fear of water.

They will likely request information about:

  • The symptoms you experience, including what your symptoms are, how frequently they occur and how severe they are.
  • The initial onset of your fear, including when your symptoms first began and what initially triggered your fear of water.
  • Your medical history, including whether you are currently or have previously had any anxiety disorders, panic disorders, phobias or other mental health conditions.
  • Any medication or supplements you take (to ensure that your symptoms cannot be attributed to another source).
  • Whether you have a family history of phobias.
  • How much your fear interferes with your day-to-day life, your well-being and your behaviour.

The psychologist will also conduct a phobia questionnaire to gain more insight into your fear. Because aquaphobia is a type of specific phobia, to make a diagnosis, your symptoms will be compared to the diagnostic criteria for specific phobias.

Your symptoms will need to correspond with the seven key criteria listed below:

1. The fear must be persistent, excessive and unreasonable. It can occur either when water is present or when it is not present.
2. Exposure to water or another trigger leads to an immediate anxiety response in the majority of situations.
3. The fear is excessive and disproportionate to the threat, and this is recognised by the individual.
4. The individual avoids places or situations where water could be present. If water is present, the individual will experience extreme fear, anxiety or distress.
5. The anticipation of encountering water and the avoidance behaviours associated with avoiding their triggers can have a significant impact on the individual’s day-to-day life.
6. The fear has lasted for a minimum of six months.
7. The phobia is not associated with another disorder or mental health condition.

If your symptoms fit the diagnostic criteria above, you will receive a diagnosis of aquaphobia. Depending on the severity of your phobia, treatment may be recommended.

How is Aquaphobia Treated?

There are multiple effective treatment options for phobias, including aquaphobia. However, not everyone with aquaphobia requires treatment. If your symptoms are mild, your phobia doesn’t impact your daily life or well-being or you have already implemented successful coping strategies, then formal treatment may not be required. However, you should always consult your doctor before making any decisions about treatment.

For people whose phobia is triggered frequently or results in avoidance behaviours, whose symptoms are severe and whose phobia impacts on their daily life or well-being, treatment will likely be recommended. Aquaphobia is a highly treatable condition and there are several types of treatment that have been proven to effectively treat a phobia of water.

Because multiple treatment options are available, your psychologist will create a personalised treatment plan that is designed to effectively treat the root cause of your phobia, your symptoms and any negative thought patterns, feelings and behaviours that are connected to your phobia.

Your treatment plan will be based on several factors, for example:

  • The severity of your symptoms.
  • The frequency of your symptoms.
  • The root cause of your phobia.
  • How significantly your phobia impacts your life.
  • Your overall health and well-being, including your mental health.

The most common types of treatment for aquaphobia are:

Exposure Therapy:

Exposure therapy, also known as systematic desensitisation, can help to alter your fear response by repeatedly exposing you to your triggers in a safe and controlled environment. To effectively treat your phobia, the exposure must take place over multiple sessions, with the number of sessions required depending on the severity of the phobia. The aim is to desensitise you so that being exposed to water no longer triggers a fear response.

Exposure therapy will involve both visualising your fear and experiencing your triggers in real life. You will be exposed to your fears in escalating phases. Initially, you will be exposed to triggers that create the least amount of anxiety, for example, looking at photos of water. Then, once you are comfortable with this level of exposure, you can move on to the next trigger, for example, turning a tap on and off. The psychologist will analyse and record your reactions, thoughts and feelings throughout.

You will gradually build up to the most anxiety-provoking situations, with the aim of being able to be in or around water without experiencing a negative response. With each exposure, you should experience progressively lower anxiety. If a trigger results in a severe reaction, the psychologist may return to a less intense type of exposure.

By creating realistic thoughts and beliefs surrounding water, unlearning negative associations and patterns of thought, decreasing negative reactions and feelings towards water long term, and learning relaxation techniques and coping and calming strategies, exposure therapy can help you overcome your phobia.

Cognitive Behavioural Therapy (CBT):

CBT is a type of psychotherapy also known as talk therapy. This type of therapy aims to help you understand your phobia and any negative or damaging thoughts and patterns of behaviour that are contributing to or worsening your phobia. The psychologist will work with you to alter your thoughts, feelings and patterns of behaviour.

CBT also helps you to identify the underlying cause or causes of your fear and any existing negative thought patterns. You will try to deconstruct negative thoughts surrounding water into smaller fragments, which can then be worked on individually. This can help you to reduce or eliminate any negative connotations you have attached to your fear and reduce your psychological, physiological and behavioural responses to water.

During the sessions you will:

  • Discuss your triggers and symptoms.
  • Explore what caused your fear of water.
  • Learn how to recognise your negative thoughts and change the way you are thinking.
  • Learn coping strategies and calming strategies, such as deep breathing exercises, distraction techniques and coping statements.

Clinical Hypnotherapy:

A hypnotherapist can help you gain a better understanding and repattern your thoughts regarding your fear of water. You will learn how to overcome negative thoughts and feelings about water through guided relaxation techniques and focused attention.

While you discuss your fears, you will be placed into a deeply relaxed state. Hypnotherapy will assist you in identifying any negative thought patterns, memories, feelings or behaviours that contribute to your phobia. To reduce and manage your symptoms more effectively, you will also learn calming strategies.

Medication:

Medication is not usually used as the sole treatment option for aquaphobia. However, medication may be recommended if you are also experiencing another mental health difficulty, such as anxiety or depression, alongside your phobia. Medication may also be recommended if your phobia is severe and is having a significant impact on your life, for example, if you are unable to leave your house or cannot shower or wash your hands. In this situation, medication will likely be recommended alongside a type of psychotherapy, such as CBT.

The types of medication you could be prescribed may include:

  • Beta-blockers.
  • Selective serotonin reuptake inhibitors (SSRIs).
  • Sedatives.
  • Anti-anxiety medication.
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About the author

Nicole Murphy

Nicole Murphy

Nicole graduated with a First-Class Honours degree in Psychology in 2013. She works as a writer and editor and tries to combine all her passions - writing, education, and psychology. Outside of work, Nicole loves to travel, go to the beach, and drink a lot of coffee! She is currently training to climb Machu Picchu in Peru.



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