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Mental Health (Expert Forum)
emetophobia ?
Answered by
Roger Gould, M.D. - Mental Health, Wellness
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD), bipolar disorder, dementia, electroconvulsive therapy (ECT), learning disabilities, memory, obsessive compulsive disorder (OCD), panic, personality disorders, phobias, post-traumatic stress disorder (PTSD), schizophrenia, stress, transitions, and work problems.
emetophobia ?
by KenBC, Jul 30, 2005 12:00AM
Hello,
We have a 16 year old daughter who has seen many physicians,
psychologists and psychiatrists over the years. We can't seem to pinpoint the
problem. There are some days we think she is suffering from something in
the abdomen, then there are other days we think she is suffering from
something in the head (something like emetophobia). But she always
complains of chronic nausea. Even though she does eat, we can't get her to
eat a balanced diet.
She had blood tests where the only parameter that was abnormal was total
bilirubin was 2.2 mg/dL (the correct range should be 0.2 thru 1.3
mg/dL) otherwise all tests negative.
Ultrasound results of the abdomen are also negative (there's no
abnormality seen in the liver, portal vein, gallbladder, bile duct,
pancreas, spleen, kidneys and no gallstones or ascites).
She was treated for depression with Zoloft (50 mg) for 5 months then
with Paxil (25 mg) for 3 years under the care of a psychiatrist. Her
greatest fear is either vomiting or seeing someone else vomiting. The
paxil did help, but since she was (gradually) taken off of it, her
condition got worse. We are reluctant to put her back on psychtropics
like paxil because of the (now) known suicides related to the "black box"
drugs.
Her phobia (and/or nausea / stomach ache) is now so great that she can't
leave the house.. even to see a doctor!
How do we break out of the endless loop?
We have a 16 year old daughter who has seen many physicians,
psychologists and psychiatrists over the years. We can't seem to pinpoint the
problem. There are some days we think she is suffering from something in
the abdomen, then there are other days we think she is suffering from
something in the head (something like emetophobia). But she always
complains of chronic nausea. Even though she does eat, we can't get her to
eat a balanced diet.
She had blood tests where the only parameter that was abnormal was total
bilirubin was 2.2 mg/dL (the correct range should be 0.2 thru 1.3
mg/dL) otherwise all tests negative.
Ultrasound results of the abdomen are also negative (there's no
abnormality seen in the liver, portal vein, gallbladder, bile duct,
pancreas, spleen, kidneys and no gallstones or ascites).
She was treated for depression with Zoloft (50 mg) for 5 months then
with Paxil (25 mg) for 3 years under the care of a psychiatrist. Her
greatest fear is either vomiting or seeing someone else vomiting. The
paxil did help, but since she was (gradually) taken off of it, her
condition got worse. We are reluctant to put her back on psychtropics
like paxil because of the (now) known suicides related to the "black box"
drugs.
Her phobia (and/or nausea / stomach ache) is now so great that she can't
leave the house.. even to see a doctor!
How do we break out of the endless loop?
Doctor's Answer
by Roger Gould, M.D., Aug 02, 2005 12:00AM
, Aug 02, 2005 12:00AM
You mentioned medications, but have you tried psychotherapy. That is what is called for, and especially if she won't leave the house, you will have to act fast before not leaving the house becomes an even bigger problem than it already is. She needs someone who understands eating disorders and phobias.. Don't rely on medications for this...its insight into her developmental stuckedness that she needs to get moving again.
-Spencer
I am 37 years old and the last time I vomited was when I was about 6 or 7...I don't remember having a tramatic experience with it, it was just a flu or something and I can remeber a total of three times prior and including that one (two were in a car).
Since then, slowly over the years, the fear has grown. It controls every aspect of anxiety in my life. I still function more or less normally, but I do take xanax every day for 12 years (.25 a day, and .5 or 1mg on cerain occasions, which would be instances when I am in some of the following situations).
Let me tell you how this snowballs for someone who is emetophobic. You freak out when you hear someone has a flu, you avoid them like the plague...you wash your hands with anti-bacterial wash like crazy...you do so much investing on how you catch stomach flu's of food poisining, knowing it has to be ingested...so you avoid eating out at restaurants and when you do you like to make sure they are wearing gloves and you see them prepare the food (not that will alway's matter).
You have down to a tee when a vomit scend is about to happen on TV...like a scene while people are drinking excessivly, or something might grosse them out), so you have your face covered to avoid the scene ahead of time.
You panick when a car in front of you opens their door at a stop light (they might be getting sick), you are afraid to ever get any surgery because the anestesia will make you sick and God help you if you ever have Cancer