Do you know hydrophobia? It is the phobia of water. Like any phobia, it consists of an irrational, disproportionate and intense fear of a stimulus; in this case, water..
In this article we will learn what this disorder consists of, in which populations it appears most 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 the reference diagnostic manuals (the current DSM-5). It is an intense fear of water (whether it is swimming pool water, drinking water, the sea, etc.).
The fear and anxiety associated with water cause the person to avoid situations where he/she must be in contact with water (e.g. shower, swimming pools, etc.). Specifically, hydrophobia is a subtype of environmental or natural phobia (recall that in the DSM-5 there are five types of phobias: animal, blood/injection/fluid, situational, environmental and “other types”).
Environmental or natural phobias
Environmental or natural phobias are characterized by the fact that the phobic stimulus (i.e. the object or situation that causes fear and/or excessive anxiety) is an element of the natural environment, such as: storms, lightning, water, earth, wind, etc.
Thus, other types of environmental phobias are astraphobia (phobia of storms and/or lightning), acrophobia (phobia of heights), nyctophobia (phobia of darkness) and anemophobia (phobia of wind). However, there are many more.
- Recommended article: “Differences between syndrome, disorder and disease”.
Who usually presents hydrophobia?
Hydrophobia is a very frequent phobia in children with a neurodevelopmental disorder, such as a neurodevelopmental spectrum disorder.such as autism spectrum disorder (autism). It is also common in some syndromes (e.g. Fragile X Syndrome) and in intellectual disability (especially in childhood).
Hydrophobia, however, can appear in any person, although it is more frequent in these groups.
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 these are very heterogeneous individuals, we generally find the following symptoms in cases of ASD: language disorders (even absence of language), difficulties in social interactions, communication and gestures, as well as in non-verbal language, restrictive patterns of interests, stereotypies, motor disorders, rigid patterns of behavior, obsessions, etc.
Among its symptoms, hydrophobia is frequently found, although it is not well known why.although it is not well known why.
2. Fragile X Syndrome
Fragile X syndrome is considered the leading cause of hereditary intellectual disability.. It is a genetic disorder caused by a mutation in the FMR1 gene, a gene heavily 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 is also frequent in these children (the reason for this is unknown).
3. Intellectual disability
Intellectual disability is a condition of the person, which can be originated by multiple causes and factors (e.g. an autism spectrum disorder, a syndrome, anoxia at birth, cerebral palsy, etc.).
Thus, when we speak of intellectual disability, we are in fact including other cases of neurodevelopmental disorderswhere the occurrence of hydrophobia (along with other types of phobia) is frequent.
The symptoms of hydrophobia relate to an intense fear of water itself. Generally people with hydrophobia have an inherent fear of water because of the possibility of drowning in it (e.g. in the swimming 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 ingest liquids. As we have seen, these symptoms are typical of children with autism spectrum disorder (ASD), as well as children with other neurodevelopmental disorders or intellectual disabilities.
Along with the intense fear of water, cognitive, behavioral and psychophysiological symptoms appear, as in any specific phobia.
At the cognitive level, hydrophobia may present symptoms such as: lack of concentration, attentional difficulties, irrational thoughts such as “I am going to die by drowning”, etc.
2. Behavioral symptoms
As for the behavioral symptoms of hydrophobia, the main one is an avoidance of situations involving contact with water (or resistance to such situations with high anxiety, i.e., rather “putting up with” these situations).
3. Psychophysiological symptoms
In relation to the psychophysiological symptoms, these can be several, and 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:
The main cause of hydrophobia, as with most phobias, is a traumatic experience, in this case, related to water. a traumatic experience, in this case, related to water.. It can be, for example: having drowned in a swimming pool, having swallowed a lot of water, having choked on water, having been hurt 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, relatives…). This is extrapolated to certain images or videos (e.g. news of drowning).
On the other hand, the fact of seeing how a very close person (e.g. 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 from an anxiety disorder, which can be combined with other causes and increase the possibility of suffering from hydrophobia.
The treatment of choice for phobias, at the psychological level, is the therapy by exposure (exposing the patient to the phobic stimulus, gradually). Sometimes coping strategies are also included, or strategies that help to reduce the patient’s anxiety (e.g. breathing techniques, relaxation techniques, etc.).
The objective, however, will always be for the patient to resist the situation for as long as possible, so that his or her body and mind become accustomed to it. In other words, “the body” has to learn that the negative consequences that are feared (e.g. drowning) do not have to happen. The aim is to break this chain of classical conditioning, with which the patient has associated that “water = harm, drowning, anxiety”, etc.
On the other hand, cognitive behavioral therapy is also used, where we try, through psychotherapy, to refute the patient’s irrational beliefs associated with water. The aim is to change these dysfunctional and unrealistic thought patterns and replace them with more realistic and positive ones.
As for psychotropic drugs, sometimes anxiolytics are administered, although the ideal is a multidisciplinary treatment where psychological therapy is the backbone.