Enochlophobia refers to the fear of crowds and is closely related to other phobias like, ochlophobia (fear of mobs) and agoraphobia (fear of situations or places). People with such a phobia fear getting harmed or lost in a crowd.

Although exact medications to treat this phobia are unknown, people can undergo therapies and counselling sessions to cure from its symptoms. This article will detail all about enochlophobia, its causes and the possible treatment options.

Sometimes, one does not need to be physically present inside a crowd to feel triggered but simply thinking about being in a crowded place may also result in anxiety and stress. There are several other scenarios that people with enochlophobia fear, including the following:

• People suffering from enochlophobia experience intense anxiety and fear whenever they watch a film showing a crowd or a gathering of people.
• People with such a phobia may be hesitant to visit crowded events such as: sports, festivals, theme parks and exhibitions.
• Due to a fear of crowds, it is challenging for such people to live or work in an extremely populated area.
• People may avoid travelling in public transportation such as a bus, metro, subway, etc., as they want to avoid any interaction with the crowd.
• They may not want to visit places of entertainment like shopping plazas, city centres or movie theatres to avoid public gatherings.
• This phobia may be aggravated by another type of fear, namely nyctophobia (fear of darkness).
• People also may be hesitant to visit grocery stores or shopping malls where there are chances of being crowded.
• They will also avoid beaches and public swimming pools because they fear crowds.

Due to all these factors staying away from home, alone, becomes a challenge, and hence life becomes quite stressful.

Usually, the symptoms of enochlophobia depend upon the severity of the phobia and the related mental disorders that come alongside it. Therefore, these symptoms are divided into three categories – physical, cognitive and behavioural symptoms. Let us explain them in detail:

• Physical Symptoms:
  • Frequent black outs and dizziness (primary sign). 
  • Dilated pupils, blurred vision and experience frustration on having people around them.
  • Extreme headaches, recurrent hallucinations and disturbed sleep cycle.
  • Increased heart palpitation, shortness of breath, increased blood pressure, chest pain, sweating and stress due to overthinking.
  • Muscle tension, aches and tremors. 
  • Nausea, panic attack, stomach pain and suffocation. 
• Cognitive Symptoms:
  • Negative thoughts and feelings tend to fog one’s minds as they prefer to stay in secluded places and stop interacting socially.
  • Suppressed feelings of anger, anxiety and stress give rise to negative thoughts.
  • Since individuals prefer to keep themselves locked indoors, they become desperate and this may cause them to show violence. 
  • This fear induces depersonalisation, where they feel they are physically and mentally detached from themselves and have irrational thoughts.
• Behavioural Symptoms:
  • People with this phobia avoid any and every public place and avoid situations where there can be gatherings.
  • They always tend to find support and become dependent on their caregivers to a large extent.
  • They often resort to cribbing and crying in order to escape situations associated with public gatherings.
  • The aforementioned symptoms help one to identify that a person is suffering from enochlophobia.

This phobia of a duck watching you can lead to different types of symptoms affecting both physical and mental well-being. Apart from feeling anxious or experiencing panic attacks, there are other noteworthy symptoms which can interfere with daily life, like:

• Heart palpitation or tight chest.
• Experiencing shortness of breath or breathlessness.
• Feeling discomfort while exposed to ducks.
• Sweating.
• Dizziness or light-headedness.
• Feeling extremely anxious or chills.

People with a fear of birds in general, or ornithophobia, will face similar symptoms, and it will involve some other psychological symptoms like:

• Feeling threatened.
• Experiencing extreme urge to escape a situation.
• Feeling the fear of losing control.
• Inducing self-harming thoughts.
• Feeling unreal.

Although the exact reason for developing this phobia is unknown, it can develop due to a chemical imbalance of neurotransmitters (dopamine and serotonin) in an individual's brain. Here are the causes of enochlophobia:

• Genetics: If a family member has this phobia of fearing crowds, a child may pick up this habit which may eventually develop into a phobia.
• Negative Experiences: If a person has experienced a traumatic past event involving a crowd of people, they may develop this phobia. For example, if a person gets injured or lost in a crowd, this incident may start to haunt the subconscious mind repeatedly, preventing the person from being in crowded places.
• Learning About Related Experiences: Hearing someone’s experience about a scary incident related to a crowd of people can trigger fear of crowds. Fear occurs as people expect that “something” may cause suffering.
• Media Portrayal: If someone watches a television show containing violent incidents amidst a crowd of people, fear out of it can trigger this phobia. Watching a number of news and movies associated with horror, crime thrillers or shows with violence over an extended time can trigger enochlophobia.
• Watching Reactions: A child can develop signs and symptoms of this phobia if they watch their parents react to a particular stressful scenario involving unmanageable crowds, inducing fear.
• Fear of People: A general dislike of people or fear of people (anthropophobia) can also instigate enochlophobia. Due to this, one may hesitate to visit crowded places.

Although people with anthropophobia may feel comfortable that the symptoms are at bay for a considerable time period, it can be a disadvantage if left untreated. This is because the phobia causes a person to skip interacting with others socially and from enjoying their life.

Although several factors contribute to the fear of crowds, many risk factors are associated with it. These risks instigate fear in the minds of people. Some of the risk factors include:

• An anxious person or a person suffering from periodic anxiety may become susceptible to this phobia.
• Someone has underlying severe mental health issues, namely - panic disorder, anxiety disorder, etc., triggering the phobia.
• Cultural beliefs can play a major role in developing this phobia.
• Enochlophobia can be developed if an individual is suffering from Post-Traumatic Stress Disorder (PTSD).

Since it is impossible to avoid people and places, individuals who have a fear of crowds choose to stay at home and seldom interact with others. Unfortunately, this affects their daily life, mind and body, causing other illnesses (physical and mental) to develop. Therefore, it is mandatory to treat this phobia as it can severely hamper normal well-being.

A person develops complications due to a phobia when they get plagued by fear for a long period of time. It pushes one towards more fearful consequences as they are unable to share their experiences with others. Even staying indoors can be fearful for them as they try to imagine people around them.

Here are some of the other complications that might occur:

• Substance Abuse: As there are no specific medications to reduce such phobias, it triggers anxiety and depression. At this point, people cannot manage their emotions and fall prey to substance use disorder, ruining their life.
• Social Isolation: The fear of people and crowd haunts in such a way that people gradually isolate themselves from social interactions. They avoid school and work, which affects their performance levels too. This results in trouble with social skills as their approach differs from their peers and colleagues, causing them to isolate themselves.
• Mood Disorders: A specific phobia is enough to trigger related anxiety disorders, which lead to extreme emotional stress. The affected individuals gradually start developing negative attitudes due to these mood disorders and lose control over themselves.
• Suicidal Thoughts: It is impossible for someone to live alone for an extended time period. But people with fear of crowds would never opt to interact. This instigates suicidal thoughts, and it is then when they start to self-harm.

When a family member notices such symptoms in a person, they should immediately seek professional assistance to prevent the situation from aggravating.

The diagnosis of enochlophobia is listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This manual explains the criteria by which this phobia is diagnosed in individuals as follows:

1. A doctor will first query about the symptoms and try to identify the severity and triggers of the phobia.
2. The healthcare professional will then try to learn whether this phobia has been occurring for more than 6 months.
3. The next step involves understanding how and in what ways this phobia is affecting daily life chores and affecting the patient’s mind.
4. After considering all the above factors, the doctor will formulate a customised treatment plan and refer the patient to a therapist, psychiatrist or counsellor for further treatment.

There are several ways that help in the treatment of enochlophobia. It includes the following:

1. Exposure Therapy: Having a response rate of 90%, exposure therapy is an effective technique where people are exposed to crowded places. A gradual increase in the period of exposure reduces fear and anxious feelings over time.
2. Cognitive Behavioural Therapy (CBT): Cognitive behavioural therapy assists people by identifying and altering their negative behaviours related to the phobia. As people are able to recognize their negative approaches, they know how to replace irrational thoughts with rational ones.
3. Virtual Reality Therapy: Therapists desensitise the fear of crowds without the person requiring physical presence of it. They interact with a stimulus on a computer screen and develop response tactics and strategies accordingly.
4. Visualisation: This therapy is performed under the guidance of a trained clinician. A person requires visualising a crowd at a distance, and as the crowd moves towards them, they have to sit without feeling anxious or uncomfortable.
5. Medication: Doctors will prescribe anti-anxiety medications to reduce anxiety and stress caused due to the phobia. However, there is a certain dosage of the medicines one needs to take, and a family member must monitor it to reduce the risk of overdose. Some medicines include antidepressants, sedatives and beta blockers.
6. Eye Movement Desensitisation and Reprocessing (EMDR): This is an effective treatment where therapists work on memories so that people try to overcome their fear if caused due to any past traumatic experience.
7. Other Desensitisation Techniques: Apart from following the above techniques, therapists expose individuals to a list of triggers so that they learn several ways to deal with anxiety. This includes learning to control their breath and relaxing their minds.

In 30% of cases, phobias last for several years or even decades. In addition, they tend to instigate other phobias and disorders, including shifts in mood, anxiety attacks, hallucinations and substance use disorders. However, it depends on the severity of the phobia and the treatment a person receives.

If a person receives no treatment at all, this phobia may last for an extended time period. Additionally, children who have witnessed traumatic experiences in their childhood can have enochlophobia till a certain age. It will, however, fade away with time if treated well.

It is crucial to seek advice from a registered healthcare specialist if a person continuously suffers from anxiety and panic attacks related to enochlophobia. Additionally, they must immediately consult a therapist if they witness signs of other phobias affecting the mind.

Besides, if there are severe symptoms such as insomnia, disturbed sleep, depression, or excessive mishaps due to fear, medical assistance is a must. People around the world suffer from many phobias and enochlophobia is one of them.