Thalassophobia: What Is It, Symptoms, Causes & Treatment

Created by: Tua Saude editing team

Thalassophobia is a specific phobia characterized by an intense and persistent fear of deep bodies of water such as oceans, seas, and large lakes. This fear often stems from the vastness, darkness, and perceived unknown dangers lurking beneath the surface.

Individuals with thalassophobia may experience significant anxiety when thinking about, seeing images of, or being near deep water, even if there is no immediate threat.

The condition is categorized under natural environment phobias within the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

Imagem ilustrativa número 1

Symptoms and manifestations

People with thalassophobia can present with both physical and psychological symptoms. These manifestations may occur in anticipation of, during, or after exposure to deep water environments. Common symptoms include:

  • Rapid heartbeat or palpitations
  • Shortness of breath
  • Nausea or stomach distress
  • Sweating or chills
  • Shaking or trembling
  • Dizziness or feeling faint
  • Chest tightness
  • Feelings of dread or panic
  • Strong desire to escape or avoid water-related situations

Emotional responses may include overwhelming fear, helplessness, or terror. Cognitive patterns often involve catastrophic thinking, such as imagining drowning or encountering unseen dangers. The symptoms must cause significant distress or interfere with daily functioning to meet the clinical threshold for a specific phobia diagnosis.

Causes and risk factors

Thalassophobia can result from a complex interplay of biological, psychological, and environmental factors:

  • Evolutionary influences: Fear of deep and dark environments may have developed as a survival mechanism to avoid potential dangers in unknown terrain.

  • Childhood experiences: Negative encounters with water or vicarious learning (e.g., hearing about drownings) can contribute to fear development.

  • Family history: Having relatives with anxiety disorders or phobias may increase risk.

  • Personality traits: High sensitivity to uncertainty and increased tendency toward rumination and catastrophizing are associated with specific phobias.

Prevalence of thalassophobia

While specific prevalence rates for thalassophobia are limited, it is considered a subtype of specific phobias, which affect a significant portion of the population. Key data include:

  • Lifetime prevalence of specific phobias: Approximately 7.4% globally
  • 12-month prevalence: About 5.5%
  • Gender differences: Females are more likely to be affected (9.8%) than males (4.9%)
  • Age of onset: Median onset is around 8 years of age

Phobias related to natural environments, such as deep water, are among the most commonly reported categories.

Diagnosis and differential considerations

According to the DSM-5, the diagnostic criteria for specific phobia require:

  1. Marked fear or anxiety about a specific object or situation (e.g., deep water)

  2. The phobic stimulus almost always provokes immediate fear or anxiety

  3. The fear or anxiety is out of proportion to the actual danger

  4. The phobia is persistent, typically lasting for 6 months or more

  5. The fear causes clinically significant distress or impairment

  6. The disturbance is not better explained by another mental disorder

Differential diagnosis may include:

  • Aquaphobia: Generalized fear of water, not limited to deep bodies

  • Panic disorder: Sudden attacks not necessarily tied to specific triggers

  • Post-traumatic stress disorder (PTSD): Water-related trauma history

  • Generalized anxiety disorder (GAD): Persistent and widespread anxiety not confined to specific stimuli

Assessment tools such as the Fear of Water Assessment Questionnaire (FWAQ) can aid in identifying and quantifying water-related fears.

Treatment and coping strategies

Evidence-based treatments for thalassophobia are highly effective. Common approaches include:

1. Cognitive behavioral therapy (CBT)

CBT helps individuals challenge irrational beliefs and develop adaptive thinking patterns. Techniques may involve:

  • Cognitive restructuring

  • Psychoeducation

  • Exposure planning

2. Exposure therapy

This involves gradual and controlled exposure to feared stimuli to reduce anxiety over time. It can take the form of:

  • In vivo exposure (real-life situations)

  • Imaginal exposure

  • Virtual reality exposure therapy (VRET), which has shown comparable efficacy with improved tolerability

3. Systematic desensitization

Combines relaxation techniques with graduated exposure, often used in adolescent and pediatric populations.

4. Technology-assisted interventions

Digital platforms and mobile apps offer accessible and effective options for individuals who may not engage in traditional therapy.

5. Pharmacological approaches

While not a first-line treatment, medications such as beta-blockers (e.g., propranolol) may be used adjunctively to manage acute symptoms.

6. Coping strategies

Research indicates individuals may use a range of coping styles:

  • Emotion-focused coping: Attempting to regulate emotional responses

  • Avoidance-based strategies: Actively avoiding water-related environments

  • Relaxation training and mindfulness: Supporting emotion regulation

Thalassophobia may co-occur with or resemble other specific phobias, such as:

  • Nyctophobia: Fear of darkness

  • Bathophobia: Fear of depths

  • Aquaphobia: Generalized water fear

  • Submechanophobia: Fear of submerged man-made objects

  • Megalohydrothalassophobia: Fear of large underwater creatures or structures

Proper assessment is essential to distinguish thalassophobia from overlapping or comorbid fears.

Frequently asked questions (FAQ)

What causes thalassophobia?

Thalassophobia may arise from evolutionary fears, traumatic water experiences, or genetic and psychological factors. Uncertainty and lack of visual control in deep water contribute to heightened fear responses.

How common is thalassophobia?

While exact data for thalassophobia are limited, it is part of the broader category of specific phobias, which affect up to 7.4% of the global population in their lifetime, with higher prevalence in women.

Can thalassophobia be cured?

Yes, thalassophobia is treatable. Cognitive behavioral therapy and exposure-based methods are the most effective interventions, often resulting in significant symptom reduction.

What is the difference between thalassophobia and aquaphobia?

Thalassophobia is a fear of deep, vast bodies of water, particularly the ocean, while aquaphobia refers to a more generalized fear of water, including shallow or enclosed water.

Is virtual reality therapy effective for thalassophobia?

Yes. Studies have shown that virtual reality exposure therapy is nearly as effective as traditional in vivo exposure and is more accessible and tolerable for many individuals.

Update History
We regularly update our content with the latest scientific information to maintain an exceptional level of quality.
  • 12 June, 2025 (Current version)
    Updated by Daisy Oliveira - Registered Nurse
  • 28 May, 2024
    Updated by Daisy Oliveira - Registered Nurse
  • 27 May, 2024
  • Created on May, 2024

References
  • . Eaton WW, Bienvenu OJ, Miloyan B. Specific fears and phobias: epidemiology and classification. Br J Psychiatry. 2018;173(3):212-217. ;():.
  • . Miloyan B, Eaton WW, Bienvenu OJ. Key factors behind various specific phobia subtypes. Sci Rep. 2023;13:22164. ;():.
  • . Fernandez-Aranda F, Munguía L, Steward T, et al. Two decades of digital interventions for anxiety disorders: a systematic review and meta-analysis. Psychol Med. 2023;53(4):1478-1490. . ;():.
  • . Mousavi SF, Rahimipour M, Amiri M, et al. Fear of drowning (thalassophobia) and its coping strategies in nurses working in public hospitals. J Nurs Res. 2022;30(2):145-152. ;():.
  • . Otte C, Gold SM, Penninx BW, et al. Recent developments in the intervention of specific phobia among adults: a rapid review. F1000Research. 2020;9:195. ;():.
  • . Kampmann IL, Emmelkamp PMG, Morina N. Inferiority or even superiority of virtual reality exposure therapy in phobias? A systematic review and meta-analysis. Front Psychol. 2019;10:1758. . ;():.
  • . Wolitzky-Taylor KB, Horowitz JD, Powers MB, Telch MJ. Psychological approaches in the treatment of specific phobias: a meta-analysis. Clin Psychol Rev. 2008;28(6):1021-1037. . ;():.
  • . Prayetno A, Sukmawati S. Effectiveness of systematic desensitization for decreasing anxiety in individuals with specific phobia. Int Res J Adv Eng Sci. 2020;5(3):124-126. ;():.
  • . Mujica-Parodi LR, Almonte ML, Foss-Feig JH, et al. Update on neurobiological mechanisms of fear. Front Behav Neurosci. 2023;17:1167199. ;():.
  • . Kapus J, Bajwa RS, Rahman A, et al. Development and validity of the Fear of Water Assessment Questionnaire (FWAQ). Front Psychol. 2020;11:1598. ;():.
  • . American Psychiatric Association. Diagnostic criteria for specific phobia. Anxiety Disorders Clinical Practice Guidelines. 2022. ;():.
  • . Wardenaar KJ, Lim CCW, Al-Hamzawi A, et al. The cross-national epidemiology of specific phobia in the World Health Organization World Mental Health Surveys. Psychol Med. 2017;47(10):1744-1760. . ;():.
  • Anxiety. StatPearls. 2022. Accessed 18 Oct 2022 https://www.ncbi.nlm.nih.gov/books/NBK470361/
  • EATON, William W; BIENVENU, O. J; MILOYAN, Beyon. Specific phobias. Lancet Psychiatry. 2018;Vol.5, n.8():678–686.
  • PAN, Dandan et al. The impact of fear of the sea on working memory performance: a research based on virtual reality. VRST '18: Proceedings of the 24th ACM Symposium on Virtual Reality Software and Technology. 2018;Vol.24, n.38():1-9.
  • American Psychistric Association. Manual Diagnóstico e Estatístico de transtornos mentais - DSM-V. 5 ed ed. Porto Alegre: Artmed; 2014.
  • Specific Phobia. StatPearls. 2022. Accessed 18 Oct 2022 https://www.ncbi.nlm.nih.gov/books/NBK499923/
  • FASHTAMI, Shiva M; DARVISHPOUR, Azar. Fear of drowning (thalassophobia) and its coping strategies in nurses working in public hospitals in Eastern Guilan. J Inj Violence Res. 2022;Vol.14, n.1():8.