Understanding Death Anxiety

Worries about dying or losing a loved one are a normal part of life, but if your thoughts about death (or dying) are extremely distressing, time-consuming, or stop you from doing important things, you might be experiencing death anxiety.

Death anxiety (or ‘thanatophobia’) is a common fear that anyone can experience. Research suggests that up to 10% of people experience death anxiety, and around 3% have an intense fear of death. These concerns might relate to your own death, someone else’s death, the process of dying, or what happens after death.

Death anxiety can lead to difficulties with your mental health and can affect how you function in your daily life. It can also play a role in other problems including anxiety disorders (such as health anxiety or obsessive compulsive disorder), depression, and eating disorders. The good news is that cognitive behavioral therapy (CBT) is an effective treatment for death anxiety.

This guide will help you to understand:

• What death anxiety is.
• Why death anxiety might not get better by itself.
• Treatments for death anxiety.

Our ‘Understanding…’ series is designed to support your clients:

• Scaffold knowledge. The guides are perfect during early stages of therapy to help your clients understand how their symptoms fit together and make sense.
• Reassure and encourage optimism. Many clients find it hugely reassuring to know there is a name for what they are experiencing, and that there are evidence-based psychological models and treatments specifically designed to help.
• De-mystify the therapy process. To increase your client’s knowledge of the therapy process and the ingredients that it is likely to involve. If you can help your clients to understand why an intervention is important (think exposure!) it can help encourage them to engage.
• Signposting. If you’re just seeing a client briefly for assessment, or you have a curious client who wants to know more, these resources can be a helpful part of guiding them to the right service.
• Waiting time not wasted time. When you’ve assessed someone but their treatment can’t begin right away, psychoeducation can help them learn about how therapy can help while they’re waiting.

Each guide includes:

• Case examples to help your clients relate to the condition, and to normalize their experiences.
• Jargon-free descriptions of symptoms, and descriptions of how they might affect your thoughts, feelings, and actions.
• A symptom questionnaire for screening assessment.
• An accessible cognitive-behavioral account of what keeps the problem going, or what stops it from getting better.
• A description of evidence-based treatments for that condition, including an overview of the ‘ingredients’ of a good cognitive behavioral approach.

• Noyes Jr, R., Hartz, A. J., Doebbeling, C. C., Malis, R. W., Happel, R. L., Werner, L. A., & Yagla, S. J. (2000). Illness fears in the general population. Psychosomatic Medicine, 62, 318-325.
• Agras, S., Sylvester, D., & Oliveau, D. (1969). The epidemiology of common fears and phobia. Comprehensive Psychiatry, 10, 151-156. DOI: 10.1016/0010-440X(69)90022-4.
• White, J. (1980). A practical guide to death and dying. Quest.
• Greenberg, J., Pyszczynski, T., & Solomon, S. (1986). The causes and consequences of a need for self-esteem: A terror management theory. In R. F. Baumeister (Ed.), Public self and private self (pp. 189-212). Springer.
• Yalom, I. D. (2008). Staring at the sun: Overcoming the terror of death. Jossey-Bass.
• Pyszczynski, T., Solomon, S., & Greenberg, J. (2015). Thirty years of terror management theory: From genesis to revelation. Advances in Experimental Social Psychology, 52, 1-70. DOI: /10.1016/ bs.aesp.2015.03.001. 
• Iverach, L., Menzies, R. G., & Menzies, R. E. (2014). Death anxiety and its role in psychopathology: Reviewing the status of a transdiagnostic construct. Clinical Psychology Review, 34, 580-593. DOI: 10.1016/j.cpr.2014.09.002.
• Iverach, L. (2018). Death anxiety and psychopathology. In R. E. Menzies, R. G. Menzies, & L. Iverach (Eds.), Curing the dread of death: Theory, research, and practice. Australian Academic Press.
• Pyszczynski, T., Greenberg, J., & Solomon, S. (1997). Why do we need what we need? A terror management perspective on the roots of human social motivation. Psychological Inquiry, 8, 1-20. DOI: 10.1207/s15327965pli0801_1.
• Kirkpatrick, L. A., & Navarrete, C. D. (2006). Reports of my death anxiety have been greatly exaggerated: A critique of terror management theory from an evolutionary perspective. Psychological Inquiry, 17, 288-298. DOI: 10.1080/10478400701366969.
• Menzies, R. E., & Veale, D. (2022). Free yourself from death anxiety: A CBT self-help guide for a fear of death and dying. Jessica Kingsley Publishers. 
• Tomer, A. (1994). Death anxiety in adult life – theoretical perspectives. In R. A. Neimeyer (Ed), Death anxiety handbook: Research, instrumentation, and application (pp. 3-28). Taylor and Francis. 
• Jong, J., Ross, R., Philip, T., Chang, S. H., Simons, N., & Halberstadt, J. (2018). The religious correlates of death anxiety: A systematic review and meta-analysis. Religion, Brain, and Behavior, 8, 4-20. DOI: 10.1080/2153599X.2016.1238844.
• Howard, A., & Scott, R. (1965). Cultural values and attitudes toward death. Journal of Existentialism, 6, 161-171.
• Schumaker, J. F., Barraclough, R. A., & Vagg, L. M. (1988). Death anxiety in Malaysian and Australian university students. Journal of Social Psychology, 128, 41-47. DOI: 10.1080/00224545.1988.9711682.
• Menzies, R. E., Zuccala, M., Sharpe, L., & Dar-Nimrod, I. (2018). The effects of psychosocial interventions on death anxiety: A meta-analysis and systematic review of randomised controlled trials. Journal of Anxiety Disorders, 59, 64-73. DOI: 10.1016/j.janxdis.2018.09.004.
• Furer, P., & Walker, J. R. (2008). Death anxiety: A cognitive-behavioral approach. Journal of Cognitive Psychotherapy, 22, 167-182. DOI: 10.1891/0889-8391.22.2.167
• Menzies, R. G. (2018). Cognitive and behavioural procedures for the treatment of death anxiety. In R. E. Menzies, R. G. Menzies, & L. Iverach (Eds.), Curing the dread of death: Theory, research, and practice. Australian Academic Press.
• McEvoy, P. M., Hyett, M. P., Shihata, S., Price, J. E., & Strachan, L. (2019). The impact of methodological and measurement factors on transdiagnostic associations with intolerance of uncertainty: A meta-analysis. Clinical Psychology Review, 73, 101778. DOI: 10.1016/j.cpr.2019.101778.
• Linkovski, O., Kalanthroff, E., Henik, A., & Anholt, G. E. (2016). Stop checking: Repeated checking and its effects on response inhibition and doubt. Journal of Behavior Therapy and Experimental Psychiatry, 53, 84-91. DOI: 10.1016/j.jbtep.2014.12.007.