Hydrophobia (fear of water): what is it, causes and symptoms

Do you know hydrophobia? It is about the phobia of water. Like all phobia, it consists of an irrational, disproportionate and intense fear of a stimulus; in this case, the water.

In this article we will know what this disorder consists of, in which populations it appears more frequently (detailing each of them: autism, intellectual disability and Fragile X Syndrome) and what are its symptoms, causes and treatments.

Hydrophobia: the irrational fear of water

Hydrophobia is a specific phobia (an anxiety disorder), classified as such in diagnostic reference manuals (the current DSM-5). It is about the intense fear of water (I already know pool water, drinking water, the sea, etc.).

The fear and anxiety associated with water cause the person to avoid situations where they must be in contact with water (for example, the shower, swimming pools, etc.). Specifically, hydrophobia is a subtype of environmental or natural phobia (Remember that in DSM-5 there are five types of phobias: animals, blood / injection / wound, situations, the environment and “other types”).

Environmental or natural phobias

Environmental or natural phobias are characterized because the phobic stimulus (that is, the object or situation that causes fear and / or excessive anxiety) is an element of the natural environment, such as: storms, lightning, water, land, wind, etc.

Thus, other types of environmental phobias will soon: astraphobia (phobia of storms and / or lightning), acrophobia (phobia of heights), nyctophobia (phobia of the dark) and ancrophobia (or anemophobia) (phobia of wind). However, there are many more.

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Who is usually hydrophobic?

Hydrophobia is a very common phobia in children with a neurodevelopmental disorder, such as an autism spectrum disorder (autism). It is also common in some syndromes (for example, the Fragile X Syndrome) and in intellectual disability (especially in childhood).

Hydrophobia, however, can appear in anyone, although in these groups it is more frequent.

1. Autism spectrum disorders (ASD)

Autism spectrum disorders are neurodevelopmental disorders that affect different areas of the individual: communication, social interactions and interests.

Thus, although they are very heterogeneous people, we generally find the following symptoms in cases of ASD: alterations in language (even its absence), difficulties in social interactions, in communication and in the use of gestures, as well as in non-verbal language, restrictive patterns of interests, stereotypies, motor disturbances, rigid patterns of behavior, obsessions, etc.

Among its symptoms, hydrophobia is frequently found, although it is not known very well why.

2. X fragile syndrome

Fragile X Syndrome is considered the first cause of inherited intellectual disability. It is a genetic alteration caused by a mutation in the FMR1 gene, a gene highly involved in the development of brain functions.

Its main symptoms include intellectual disability (of varying severity), autistic symptoms, and symptoms of hyperactivity with or without attention deficit. On the other hand, the appearance of hydrophobia in these children is also frequent (the reason is unknown).

3. Intellectual disability

Intellectual disability is a condition of the person, which can be caused by multiple causes and factors (e.g. autism spectrum disorder, syndrome, anoxia at birth, cerebral palsy, etc.).

A) Yes, when we talk about intellectual disability, we actually include other cases of neurodevelopmental disorders, where the appearance of hydrophobia (along with other types of phobia) is frequent.

Symptoms

The symptoms of hydrophobia are related to the intense fear of the water itself. Generally, people with hydrophobia feel an inherent fear of water due to the possibility of drowning in it (for example in the pool).

On the other hand, it can also happen that these people simply do not want to bathe or shower, to avoid contact with water, and even in other cases it happens that they do not want to drink liquids. As we have seen, these symptoms are typical of children with an autism spectrum disorder (ASD), as well as of children with some other neurodevelopmental disorder or intellectual disability.

Along with the intense fear of water, cognitive, behavioral and psychophysiological symptoms appear, as in any specific phobia.

1. Cognitive symptoms

At a cognitive level, in hydrophobia symptoms such as: lack of concentration, attentional difficulties, irrational thoughts such as "I'm going to die by drowning", etc. can appear.

2. Behavioral symptoms

Regarding the behavioral symptoms of hydrophobia, the main one is an avoidance of situations that involve contact with water (or resistance to such situations with high anxiety; that is, rather, these situations are “supported”).

3. Psychophysiological symptoms

In relation to the psychophysiological symptoms, these can be several, and they appear in the presence or imagination of the phobic stimulus, for example a swimming pool, a glass of water, the sea, etc. (depending on the case). The most common are those associated with a panic attack, such as:

• Palpitations
• Dizziness
• Sickness
• Vomiting
• Hypereventilation
• Hyperarousal
• Tension
• Sweating
• Etc.

Causes

The main cause of hydrophobia, as with the vast majority of phobias, is a traumatic experience lived, in this case, related to water. It could be, for example: having drowned in a swimming pool, having swallowed a lot of water, having choked on water, having been injured in the sea by the waves, etc.

It can also happen that the person has not lived a traumatic experience, but has witnessed, seen or heard it in other people (for example friends, family ...). This is extrapolated to certain images or videos (for example news of drowning people).

On the other hand, the fact of seeing how a very close person (for example a mother) is terrified of water, can make us also end up “inheriting” it (by vicarious learning).

Finally, there is a certain biological vulnerability / predisposition in some people to suffer a anxiety disorder, which can join other causes and increase the possibility of hydrophobia.

Treatment

The treatment of choice for phobias, at a psychological level, is exposure therapy (expose the patient to the phobic stimulus, gradually). Sometimes coping strategies are also included, or that help reduce the patient's anxiety (for example breathing techniques, relaxation techniques, etc.).

The objective, however, will always be that the patient resists the situation as long as possible, so that his body and her mind get used to it. In other words, “the body” has to learn that the negative consequences that are feared (for example, drowning) do not have to happen. It is about breaking this chain of classical conditioning, with which the patient has associated that "water = damage, drowning, anxiety", and so on.

On the other hand, cognitive behavioral therapy is also used, where it is tried, through psychotherapy, refute the irrational beliefs of the patient associated with water. It is about changing these dysfunctional and unrealistic thinking patterns, to replace them with more realistic and positive ones.

As for psychotropic drugs, anxiolytics are sometimes administered, although the ideal is a multidisciplinary treatment where psychological therapy is the backbone.

Bibliographic references

• American Psychiatric Association -APA- (2014). DSM-5. Diagnostic and Statistical Manual of Mental Disorders. Madrid: Panamericana.

• Bados, A. and Vallejo, M.A. (ed.). (2005). Specific phobias. Behavior therapy manual.

• Molina, MPR, Juste, J.P. and Fuentes, FJR. (2010). Fragile X syndrome. Protocol diagnost ter pediatr, 85-90.

• Muñoz, M. (2017). Fear of aquatic fear. Miguel Hernández University.