Fear Of Being Alone: How To Identify And Address Autophobia

As human beings, we’re wired to pursue social connection, community, and belonging. When we lack a sense of connection with other people, we may feel anxious about the experience of being alone. Aloneness is not an inherently negative state. However, for people with autophobia, the fear of being alone can interfere with their ability to function and thrive, causing intense anxiety. 

In this guide, we’ll explore the meaning, symptoms, and potential causes of autophobia as a specific situational phobia. From there, we’ll explain how physicians diagnose and treat this condition with the goal of empowering patients to improve their mental health and lead socially fulfilling lives.

What is autophobia? 

Autophobia, or the fear of being alone, is a type of specific phobia. Other terms for autophobia include monophobia, isolophobia, and eremophobia. The Cleveland Clinic describes autophobia as having an “irrational, extreme fear of being alone.” What may be called autophobia may manifest in different ways, depending on the person. For example, a person may fear developing a medical condition when left alone, going home alone, or experiencing symptoms of another phobia or condition that makes them fear being alone, such as panic disorder. 

According to the National Institute of Mental Health, a specific phobia describes “an intense, irrational fear of something that poses little or no actual danger.” Compared to complex phobias, which are often associated with a general situation or circumstance and usually develop in adulthood, specific phobias often develop during childhood and may become less severe with age.

How autophobia feels emotionally and physically

Many people with autophobia feel both psychological symptoms and physical symptoms, such as chest pain, a sense of impending doom, and other symptoms. However, the severity of phobia symptoms can vary; for some, their symptoms may significantly interfere with functioning. 

A fear of being alone (autophobia) may be a symptom of an anxiety disorder

The symptoms of autophobia might be similar to those of other anxiety disorders. For people with autophobia, these physical symptoms typically coincide with feelings of sadness, dread, or anxiety in response to being alone. However, a person may not necessarily be feeling lonely to experience autophobia, as autophobia differs from loneliness. Autophobia is associated with extreme anxiety about situations where one is alone or thinks about being alone. The symptoms can vary depending on an individual’s circumstances and coexisting health conditions.

Cognitive and emotional symptoms of autophobia

A person with an anxiety disorder may experience emotional and cognitive symptoms, such as a sense of impending doom, intense fear, heightened alertness, and trouble sleeping. While autophobia can look different for each person, someone with autophobia may have a fear of abandonment or worry about being alone even when they are surrounded by loved ones. Another person may feel unsafe or helpless when thinking about being alone. Typically, a person’s negative thoughts can lead to certain avoidance behaviors that can reinforce their fear and anxiety. 

Behavioral symptoms

Since a person with autophobia can experience intense anxiety and fear about being left alone, even if they know they aren’t in physical danger, they may go to extreme lengths to be with others, even when social interactions or relationships might have become unhealthy. Some possible behaviors associated with autophobia may include: 

• Staying in an abusive or unhealthy relationship out of fear of being alone
• Insisting that friends or family stay when they would rather leave
• Becoming overly reliant on a specific person

 Physical signs of an anxiety disorder or fear of being alone

An anxiety disorder may present many common symptoms. Physical symptoms may include:

• Shortness of breath
• Heart palpitations
• Dizziness and lightheadedness
• Nausea, upset stomach, and other digestive issues
• Excessive sweating and chills
• Trembling and shaking
• Panic attacks
• Chest pain

Diagnosing autophobia and anxiety disorders

Although autophobia is not an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a mental health professional may diagnose autophobia as a specific phobia. 

Understanding autophobia within anxiety disorders in the DSM-5

Specific phobias are listed as a class of anxiety disorders in the DSM-5. To be diagnosed with a specific phobia rooted in the fear of being alone, a person must: 

• Experience a persistent fear of being alone, lasting for at least six months
• Display intense feelings of fear or anxiety when alone, out of proportion to the actual danger posed by the situation or context
• Display symptoms almost immediately when alone or when asked to think about being alone
• Have difficulty functioning in daily life due to the severity of their symptoms

Once you receive a diagnosis of a specific phobia, you can begin working with a mental health professional to develop a treatment plan that best reflects your current needs and medical history. 

To ensure a thorough and comprehensive treatment plan, you can work with a psychologist to better understand the potential contributors to your autophobia. For example, there may be a root cause associated with your symptoms, such as an early-life traumatic experience, that you may wish to explore in a safe, nonjudgmental space.

Contributing factors that may increase anxiety and the fear of being alone:

Learning about the contributing factors that might have influenced the development of a phobia can be one helpful step in the healing process. These factors may include:

• Genetic risk factors, sometimes indicated by a family history of anxiety disorders

• A coexisting diagnosis of dependent personality disorder (DPD) or borderline personality disorder (BPD), both of which are often associated with a fear of being alone

• Childhood trauma or adverse early life experiences, such as parental divorce

• People with dependent personality disorder typically have a long-term pattern of allowing others to take responsibility for their personal needs. DPD may be partly attributed to a lack of self-confidence and self-dependence. 

• People with BPD often have long-term patterns of unstable mood, relationships, and self-image, which may contribute to fears of being alone or abandoned. 

• A diagnosis of panic disorder, which can cause someone to fear being alone in the event of a panic attack

• Learned fear from others

• Other phobias that may amplify the symptoms of autophobia. For example, if you also have claustrophobia (the fear of confined spaces), you may hesitate to enter small or unknown spaces without a companion.

As with other mental disorders, the causes of autophobia tend to be complex and can vary by individual. Still, exploring potential contributors may help people feel more informed about their diagnosis and the trajectory of their treatment plan. 

How autophobia affects daily life and relationships

Mental health treatment options for autophobia and anxiety disorders 

If you are living with autophobia, you may be searching for ways to manage and treat your symptoms. In the early stages, learning about your condition and the potential ways of treating autophobia can feel overwhelming. A mental health specialist may be equipped to guide you through the process and streamline your treatment. When you seek professional help, you will also likely learn effective tools and coping mechanisms to manage your particular symptoms and situation, which can be empowering. Some people may also benefit from consulting with a healthcare provider, who may prescribe anti-anxiety medication like beta-blockers or selective serotonin reuptake inhibitors (SSRIs), to help you cope with symptoms as you work with a therapist. 

Because autophobia is generally diagnosed as a specific phobia, treatment options are often based on psychologists’ current understanding of specific phobias. Drawing from this diagnosis, a psychologist may recommend a combination of the following treatments and management techniques:

Exposure therapy

In exposure therapy, therapists typically “expose” clients to the source of their fear or anxiety in a series of guided sessions. In the case of autophobia, a therapist may gradually introduce a person to situations in which they’re left alone or ask them to think about being alone. Therapists who use this type of therapy are trained to use the technique in specific and safe ways. As a result, individuals tend to slowly become more acclimated to the root of their phobia through small, incremental exposures. There is robust scientific support for the effectiveness of exposure therapy, which is widely considered the preferred treatment method for specific phobias. 

Cognitive behavioral therapy (CBT) for physical and mental health

CBT typically focuses on identifying, understanding, and ultimately changing a person’s thought and behavioral patterns to enhance their physical and mental health. Depending on the severity of a patient’s autophobia and treatment preferences, a therapist may apply the general framework of CBT to meet a broader set of treatment goals. 

Therapists may deliver CBT over a series of sessions, during which individuals often learn how to manage cognitive distortions, or unhelpful and inaccurate patterns of thought. By changing these thoughts, individuals can often overcome unwanted behaviors and develop a sense of control and confidence in their coping skills. 

Individual coping skills that can be helpful for the fear of being alone

Self-care can also play an important role in addressing autophobia. These may include relaxation techniques and other tools that you can practice over time.

Therapists also typically help clients develop personalized coping strategies to apply to their everyday lives outside of therapy sessions. The following are some of those techniques:

• Deep breathing: Deep breathing exercises are some of the most common strategies for patients with autophobia. By tuning into your breath and sitting or lying down in a calm, comfortable space, you may find that you can combat the physical symptoms of anxiety with slow, calming breaths. 
• Meditation: Meditation is another coping strategy for many people with autophobia or other types of anxiety disorders. With a focus on breathing and mindfulness, meditation can calm the mind and enhance a person’s awareness of their body, thoughts, and feelings. 
• Yoga: As both an exercise and mindfulness activity, yoga can be a useful tool for people with autophobia. By integrating breathing with intentional movements, yoga can reduce the physical and emotional effects of autophobia. 
• Visualization: Combining deep breathing with visualization, you may imagine feeling relaxed, comfortable, and self-sufficient. This relaxation technique may reduce the fight-or-flight response triggered by the fear response, redirecting your attention. 
• Background noise: Focusing on background noise, such as listening to music, a podcast, or an audiobook, may help alleviate anxiety when alone, although it may be helpful to use it mindfully, rather than as an avoidance behavior. 
• Cognitive restructuring exercises: While cognitive restructuring is typically associated with cognitive behavioral therapy, you may do exercises on your own to challenge negative thoughts when they arise. 

Exercise, a nutritious diet, and limiting caffeine can also play a role in reducing anxiety. 

When to seek professional help

While there may be many strategies you can try on your own, it can be challenging to address a phobia on your own. Seeing a therapist can guide and support you through gradual exposure to feared situations and provide you with effective coping mechanisms along the way. If you’re living with autophobia, you can foster hope and build confidence in your ability to develop a healthier relationship with your own company. While it may not happen overnight, having a safe, nonjudgmental, and empathetic space in which to explore and challenge negative patterns may significantly improve your quality of life and well-being.

If you have a fear of being alone, therapy can improve your mental health 

Exposure therapy and CBT are two common and empirically supported therapies for autophobia as well as other specific phobias. In addition to these specialized treatments, many patients benefit from traditional talk therapy, during which they can discuss the nuances of their condition with a licensed therapist. 

Consider using BetterHelp

While some people prefer traditional in-person therapy, a growing number of people use online therapy as an affordable and convenient alternative. For those who experience fear of being alone, connecting with a therapist online might be especially helpful, making it easy to speak with a therapist from anywhere with an internet connection. Digital platforms like BetterHelp can connect you with a licensed therapist within a few days of completing a short questionnaire. If you’re experiencing autophobia or another form of anxiety, you may appreciate the opportunity to engage in therapy from the comfort of your own space and at your own convenience. 

Effectiveness of online therapy for mental health

Numerous studies have demonstrated the effectiveness of online therapy. This includes a 2017 study of internet-based CBT (iCBT), which was found to be effective for phobias, anxiety, and depression, among other mental illnesses.