What Is the Fear of Crowds? (Enochlophobia)

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Enochlophobia is a phobia (irrational fear) of crowds that negatively affects your daily life. While enochlophobia isn't an actual mental health disorder, this condition causes symptoms similar to other types of anxiety disorders.

This article discusses the symptoms and causes of enochlophobia, how it is identified, and how this condition is treated.

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What Is Fear of Crowds?

Many people are uncomfortable in large groups of people. However, if this is true for you, it doesn't necessarily mean that you have enochlophobia. A phobia is an unrealistic, ongoing fear of something that causes a person to avoid the situation as much as possible, or to have severe distress when the situation can't be avoided.

People with enochlophobia may avoid traveling by train, bus, or airplane due to crowded conditions. They may also avoid going to big cities, events such as concerts or amusement parks, or even out to a restaurant, the movie theater, or the mall.

Symptoms of Enochlophobia

Enochlophobia can cause symptoms when you're in a crowd of people, or even just when you're thinking about being in a crowd. Physical symptoms, which are consistent with other types of anxiety disorders, include:

  • Sweating
  • Shaking
  • Nausea
  • Chest pain
  • Difficulty breathing
  • Pounding/racing heartbeat
  • Hot flashes or chills
  • Dizziness
  • Feeling of impending doom
  • Fainting

Causes

The exact cause of enochlophobia is not known, but this condition can be impacted by a chemical imbalance of neurotransmitters (such as dopamine and serotonin) in the brain. Phobias can also develop from traumatic experiences in your own life or from hearing about other people's negative experiences.

Genetics and certain cultural beliefs may play a role in your risk of developing enochlophobia. If you are an anxious person, your temperament may make you susceptible to enochlophobia.

It is possible for someone to have a phobia without experiencing a negative or traumatic event.

Diagnosis

Mental health conditions are diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Enochlophobia is not included in the DSM-5. However, it is similar to specific phobias, which the DSM-5 describes as persistent, irrational fear of an activity, person, specific object, or situation.

Specific phobias are diagnosed using the following criteria:

  • Excessive, or unreasonable fear related to being in, or thinking about, a specific situation
  • Fear that has persisted, typically for at least six months
  • Fear that is out of proportion to the actual threat of being in a crowd
  • Immediate anxiety response when exposed to crowds
  • Going out of your way to avoid being in crowds, or enduring crowds with extreme distress

Diagnosing Enochlophobia vs. Agoraphobia

Enochlophobia symptoms may overlap with those of agoraphobia. However, with agoraphobia, the person may be afraid of being alone outside their home or being in open spaces such as large shopping centers or parking lots. Also, people with agoraphobia may avoid crowds because they fear they may not be able to escape them.

Those with agoraphobia may worry that help might not be available if they experience panic attacks or other incapacitating or embarrassing symptoms, whereas people with enochlophobia may actually be afraid of being hurt in the crowd.

Treating Enochlophobia

A variety of treatments are available for enochlophobia, including psychotherapy, relaxation/mindfulness training, and sometimes medications.

Psychotherapy

Psychotherapy, or talk therapy, is an effective treatment for enochlophobia. One common psychotherapy method used to treat phobias is cognitive behavioral therapy (CBT). This type of therapy focuses on identifying the thinking patterns that are causing your irrational fears. Your therapist will teach you how to challenge your thoughts and reduce your symptoms when you confront your fears.

CBT might include exposure therapy. This treatment helps you face your fear of crowds in small steps. You might begin with thinking about being in a crowd, or looking at pictures of a crowd of people, while using coping strategies to reduce your anxiety. Eventually, with the help of your therapist, you'll work your way up to being in a crowd of people.

Relaxation and Mindfulness

Relaxation and mindfulness techniques can help reduce symptoms of anxiety. These can include deep breathing, visualization, guided imagery, and mindfulness training.

  • Deep breathing: Anxiety often causes fast, shallow breathing. Deep breathing (diaphragmatic breathing) reduces symptoms of anxiety by focusing on your breath.

Deep Breathing Exercise

  1. Sit or lie down in a comfortable position.
  2. Place one hand on your chest and the other on your belly.
  3. Breathe in slowly, filling your belly with air. Try not to let your chest rise.
  4. Pucker your lips and breathe out slowly, as if you are blowing out candles.
  5. Repeat for several breaths.
  • Visualization: This technique involves picturing yourself in a crowd of people, without experiencing your anxiety symptoms.
  • Guided imagery: This relaxation activity involves voice prompts—either from another person or using a recorded voice. Guided imagery helps you imagine calm images, such as relaxing on a beach, to reduce anxiety symptoms.
  • Mindfulness: Enochlophobia is based on irrational thoughts and fears. The purpose of mindfulness is to redirect your thoughts to the present, rather than focusing on all the things that could go wrong when you're in a crowd of people.

Medications

Medications aren't usually the first step in treating phobias. However, if your fear of crowds is keeping you from participating in important daily activities, you might need medical intervention.

Benzodiazepines such as Klonopin (clonazepam), Xanax (alprazolam), Valium (diazepam), and Ativan (lorazepam) are one common type of medication used to treat phobias. These medications are taken when you are experiencing your symptoms, or right before you will be exposed to the situation that causes your symptoms. These medications are short lasting.

Benzodiazepines should be used cautiously. They frequently cause drowsiness and impaired coordination, and people who take them should not drive or perform other potentially hazardous activities for several hours afterward.

Also, benzodiazepines can cause drug tolerance (when a medication no longer works as well as it did), dependence, and a substance use disorder. It may be difficult to stop them even if you have been taking them for just a few days, and you may experience unpleasant withdrawal symptoms if you abruptly stop them.

In some cases, your doctor might prescribe other types of medications that treat anxiety disorders by acting on the neurotransmitters in your brain, such as selective serotonin reuptake inhibitors (SSRIs). Common SSRIs are Prozac (fluoxetine), Zoloft (sertraline), Lexapro (escitalopram), Celexa (citalopram), and Paxil (paroxetine).

Summary

Enochlophobia is an irrational fear of crowds that can interfere with your ability to perform daily tasks such as travel on public transportation, run errands, or hang out with friends. This condition causes symptoms of anxiety, such as a racing heartbeat, sweating, and dizziness. A mental health professional such as a psychiatrist can work with you to help you cope with, or even overcome, your phobia using psychotherapy, coping strategies, and, in some cases, medications.

A Word From Verywell

It can be embarrassing to admit that your fear of crowds may be keeping you from seeing loved ones or completing daily tasks. But help and support is out there for you. Consider joining a virtual support group if you are not comfortable in crowds and talk to your healthcare provider or therapist about treatment options.

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