My Fear of Vomit: The Nightmare of Living with Emetophobia

The one thought that completely invades my brain when I'm awake (and even, at times, in my sleep) is: "Will I vomit today?"

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May 1 2015, 7:00pm

It was the carrot that really pissed me off. Among all of the joyous fruit and vegetable paintings was a scrawled, childlike "keep the community healthy" banner. There were loads of other dated primary school paintings on the wall, but the carrot felt like a punch in the stomach—it had a smiling face, like it was goading me.

I was standing in front of the doors to the psychiatric clinic.

I had done everything "right" that morning, yet it still took me over an hour (it should take 30 minutes at most) to get there. I ate my bland, inoffensive porridge. I filled up a bottle of water. I packed a neatly-folded emergency plastic bag in case I got sick. I had the chewing gum I rely on every day to remove any tastes from my mouth that might prompt throwing up. Yet I still felt a familiar dread wash over me the minute I opened the door to leave my house.

I see myself as a maverick vomit warrior. I have had severe emetophobia for almost three years now, but I have suffered from it in varying degrees for more than a decade. The thought that completely takes over my brain when I'm awake (and even, at times, in my sleep) is: Will I vomit today? To which the immediate answer is: Yes, I will.

This has been my primary thought every day for three years. The nausea is real and sickening. The sudden rising temperature, the cold sweats and the trembling all indicate that I will vomit.

This is the moment when I will vomit. It's my body. I can't escape it. I'm trapped here. I'm going to vomit. I'm going to vomit. I'm going to vomit.

I am 24. I have vomited four times in my life.

I follow a strict diet of safe, bland foods because I don't want to risk getting food poisoning. I'm hypersensitive about hygiene, washing my hands more than necessary. When the other people in the house are out I run antibacterial wipes across door handles and taps. Every winter is like living through some apocalyptic nightmare when news reports begin telling us that norovirus is spreading. For me, these reports are like saying to a normal person, "Hey! There's a man with a machete hiding in your back garden, covered in the blood of his other victims, and guess what? You're next!"

I know it's weird and I know it's irrational, and last year I went through several months of fantasizing about killing myself because I couldn't cope with the constant, unrelenting fear and nausea. I'm not afraid to die because when you die, you don't vomit. Even if you do, you're dead, so you don't have to live through it. I had it all meticulously planned down to a tee—the idea of death was, and to a much lesser extent now still is, more tolerable to me than vomiting. The only thing that got me through this period was a close group of unbelievably supportive friends, therapists, and psychiatrists.

It was at this point, too, that my brain also decided to check out. I learned, quickly, that my brain currently has only two settings: persistently overworked or not functioning at all. Apparently, it couldn't put up with all of this vomit phobia bullshit and decided to go on a solo holiday. I began to experience intense depersonalization.

I wandered around like some sort of alien, able to see people but not connect. I could barely manage to keep a conversation going, struggling to look anyone in the eye. I remember walking down a convenience store aisle thinking that nothing around me was real, that I wasn't a person. This wasn't the first time I had experienced depersonalization, but whereas before it would last for a few minutes a time at most, here, it was a constant. I was eventually diagnosed with depression, but I couldn't quite believe it. I wasn't sitting in my room all day crying—to me, naively, that's what depression was. I didn't feel sad. I just felt nothing, like I was existing rather than living. Even in the depths of this depression, though, the fear and anticipation of vomiting never waned. The danger still felt very real.

It took me a couple of months after this episode to take antidepressants and stick with them. I had several months of lying flat on my bed, not moving an inch lest some vomit somehow leak out of my mouth. I cried silently as I anticipated medication-induced vomiting after taking each tablet. The antidepressant I was prescribed not-so-hilariously had nausea listed as a "very common" side effect, so I spent the entire night after taking the first one shaking and crying in my room, in the dark—in case something brightly-colored might somehow further exacerbate my already horrific nausea—desperately willing my body not to give in.

The idea of death was, and to a much lesser extent now still is, more tolerable to me than vomiting.

Some of my friends noticed there was something wrong when I got depressed—one said that my complexion had changed, that I just "didn't look well"—but previous to this very few people had any insight into my mental health. Those who know mostly found out because they happened to be around me while I was in the middle of a panic attack, at which point I believe I'm on the brink of filling the entire place with torrents of vomit and have run out of fucks to give.

At these moments, when I'm trying to explain myself, everything comes out at lightning speed. I tell them I can't eat outside, that I limit my food, don't travel any more and that my life has been destroyed by my obsessions. While I'm babbling away, my eyes are fixed on the exit the entire time, weighing up whether it would be better to vomit in the room, in the toilet nearby or outside. If I go outside I might not make it in time, but if I stay here other people might see me vomit. Every eventuality is nightmarish. As my mind races, I'll continue telling them about the panic out of desperation, somehow hoping that, in telling them, the fear will melt away. That I will look less insane if I just explain myself. Then, once the panic has subsided, I get swept up in the immediate regret of letting someone else know about my phobia.

Traveling really is a perennial struggle—my psychosomatic motion sickness sees to that. It takes me double the time to get anywhere I need to be because I constantly battle with the desire to run back home in case the nausea is a vomit warning. Eating in a restaurant is like being asked to walk across a tightrope suspended above circling sharks. I have stopped drinking alcohol and don't go out at night. I won't eat a cooked meal until I know that I won't have to leave the house for the rest of the day, in case I give myself food poisoning. I am forever getting off buses early, walking the longer way to avoid crowds of people I may vomit in front of—or who may vomit in front of me—and doing things that people who don't know about the phobia think are just me being unbelievably awkward.

I've missed so many important moments and events because of this fucking ridiculous phobia.

But at least my brain is "back" now. I was prescribed new antidepressants that help to prevent nausea and encourage sleep, so now I only wake up once or twice a week in the middle of the night gripped with the fear that I will vomit—compared to that being an almost nightly occurrence, it's a miracle. I've been on the medication for nearly a year now and, despite still feeling trapped by thoughts sometimes, I do feel like a living person. That, to me, is progress.

Right now I'm doing exposure therapy for the vomit phobia, too. I can now look at pictures of people vomiting without wincing, and watch videos of people vomiting without wanting to jump out of a window. Do I think I could actually be around someone while they're vomiting? Not yet, but I believe I'll get there eventually. I still feel nauseous everyday, but I'm coping. It's slowly starting to seem like there is light at the end of the tunnel.

If you are concerned about the mental health of you or someone you know, visit the Mental Health America website.