Ergophobia

What is ergophobia?

Ergophobia, also occasionally referred to as ergasiophobia, work aversion, or workplace phobia, is the irrational and excessive fear of work. It can cause severe distress as well as impairments in social and professional functioning, and may result in the long-term avoidance of work ^[1].

People with ergophobia instantly feel immense fear and anxiety when anticipating going to work or when at work. This fear can cause physical and mental distress and result in an inability to carry out professional tasks and activities.

Although ergophobia is not specifically mentioned in the Diagnostic and Statistical Manual of Mental Disorders, 5^th edition (DSM-5) ^[2], it is considered a specific phobia, further categorized as a situational type ^[3].

Research about specific phobias is limited. The limited research is partially because many people with phobias do not seek professional help. Without professional help, individuals aren’t diagnosed, thus limiting available information ^[4]. Often, phobias will overlap with other mental health disorders, such as generalized anxiety disorder, OCD, or depression, therefore, making it even more challenging to diagnose.

In order for someone to be diagnosed with a specific phobia, the fear must be disproportionate to any actual threat ^[2]. For example, a surgeon may experience some level of anxiety about the minimal risk of a patient dying on the operating table. However, a surgeon with ergophobia might experience a debilitating fear of this occurring, causing them to avoid operating on patients altogether.

Another of the criteria outlined in the DSM-5 under specific phobia is that the fear and anxiety is not better explained by the presence of another mental disorder, such as obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), or social anxiety disorder ^[2].

As such, ergophobia is not caused by the presence of these conditions or by their symptoms, although there may be similarities in their presentations. For example, someone with OCD may experience a preoccupation with producing perfect work, which might also cause high levels of stress and anxiety and result in avoidance but would not be classified as ergophobia.

Symptoms of ergophobia

Symptoms of ergophobia may vary depending on the person and their choice of career, but will typically include ^[2][3][5]:

• Going to work, or anticipating going to work, causes immense fear and anxiety.
• Physical symptoms of anxiety are likely to be present, such as shaking, sweating, fast heartbeat, dry mouth, difficulty concentrating, and breathing difficulties.
• Fear may result in avoiding work entirely, taking long periods of sick leave, or avoiding applying for roles or attending job interviews.
• Ongoing and worsening distress and anxiety.
• Impairments in one or more areas of life, including social and professional functioning.
• Symptoms that persist for at least 6 months.
• There may be a presence of other specific phobias, such as a fear of injections or spiders.
• There may be a presence of other mental health conditions, such as other anxiety disorders, mood disorders, or substance use disorders.

Causes of ergophobia

The exact cause of ergophobia is not known, but research suggests several potentially contributing causes and risk factors that can increase the chance of a specific phobia developing.

Performance anxiety

Someone with ergophobia might experience severe anxiety about the possibility of making a mistake at work, which could result in punishment, embarrassment, an increase in low self-esteem, or other negative consequences ^[3].

Conditioned response

Ergophobia may be caused by exposure to a traumatic experience at work or a serious consequence to an occurrence that caused an intense emotional response, resulting in a debilitating fear that becomes associated with going to work ^[5].

For example, an employee may regularly be shouted at by their boss, resulting in feelings of shame and guilt, thereby creating a conditioned emotional response to the workplace.

Modeling

Similar to the above, a person may develop ergophobia if they are exposed to a colleague experiencing a traumatic event or negative consequence to their actions, who then has an intense emotional response.

The same emotional response may be experienced by the individual, despite the situation not being directly related to them, as it has been modeled by their colleague and internalized, so they now associate this emotion with work ^[5][6].

Genetics

Studies indicate that there is a strong familial link associated with the development of specific phobias. A large proportion of people with a specific phobia have been found to have a relative with an anxiety disorder, phobia, or both, showing that a genetic predisposition is likely ^[7].

Brain functioning

Studies of the neurobiology of fear and specific phobias have found that there may be a difference in the activation and function of the fear response in the amygdala of people with a phobia, suggesting that they may have an increased sensitivity to fear that has caused the development of a phobia ^[6].

Treatment for ergophobia

Many people with a specific phobia don’t seek treatment, as they may just continue to live with the phobia, avoid the triggering stimulus, or feel anxious about asking for help. However, without treatment, most phobias will persist and may worsen, so it is important to seek professional advice ^[5].

Currently, it is not clear if each phobia responds to treatment in the same way, as there is limited research on the different types of specific phobia. Treatment for phobias will typically involve exposure, response prevention, and desensitization, with the aim to gradually decrease fear associated with a stimulus ^[4].

Therapy

• Behavioral therapy: Therapy such as cognitive behavioral therapy (CBT) aims to recondition emotional responses and behavior that have developed as a response to fear, by teaching techniques to tolerate distress, managing extreme emotional responses to fear, and providing positive coping strategies ^[5][8].
• EMDR: Eye movement desensitization and reprocessing (EMDR) is a specialized trauma therapy, in which the individual is gradually exposed to their fear or traumatic memories, with the view to desensitize, increase tolerance, and alleviate ongoing distress ^[9].
• Virtual reality therapy: Virtual reality therapy is a recent treatment that provides exposure to an anxiety-provoking stimulus through virtual reality, to gradually desensitize the individual in a safe environment. ^[5][10].
• Exposure and response prevention: ERP has been found to be a helpful treatment for various anxiety disorders and OCD. It provides the individual with exposure to the feared stimulus, while teaching new responses and ways to prevent unhelpful responses, thus increasing tolerance ^[11].
• Other therapies: Interpersonal therapy, family therapy, and other forms of therapeutic intervention can also be helpful for the individual to receive support and validation, and to provide skills to reduce negative emotions associated with their phobia ^[8].

Medications

Although there are no approved medications for the treatment of a specific phobia, a medication may be prescribed to help manage the symptoms, including ^[5][6][8]:

• Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) such as citalopram and sertraline, serotonin and norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine, and tricyclic antidepressants (TCA) such as clomipramine, are regularly used in the treatment of anxiety disorders.
• Antihistamines: Hydroxyzine is an antihistamine that is approved by the FDA for the treatment of anxiety disorders.
• Anxiolytics: Benzodiazepines can be prescribed as a short-term treatment of anxiety disorders and phobias but are not typically used as a long-term treatment because they can be addictive.
• Beta-blockers: Beta-blockers such as propranolol are often used to treat the physical symptoms of acute anxiety and can help to manage the symptoms of a specific phobia.

You should take your medication exactly as prescribed by your doctor, without taking too much, skipping doses, or suddenly stopping your medication, as this can cause adverse effects and potentially worsen your mental and physical health.

Self-help

If you have ergophobia, you may be able to manage some of your symptoms by utilizing some self-help techniques, including ^[8][12]:

• Speaking with others: Sharing your symptoms and experiences with friends and family or with a professional may reduce negative emotions and provide a space to rationalize your fears.
• Relaxation exercises: Calming activities, such as breathing exercises, meditation, or yoga, have been found to alleviate symptoms of anxiety and can be useful in triggering situations to reduce acute symptoms of a panic attack or severe emotional responses.
• Support groups: Attending a support group in person or online can increase understanding and acceptance of your phobia, while speaking with people who have had similar experiences may reduce distressing emotions.
• General wellbeing: Taking care of your general wellbeing, by eating healthily, ensuring you get enough sleep, and engaging in regular exercise, can make it easier to manage symptoms of anxiety caused by ergophobia.

Frequently asked questions about ergophobia

How common is ergophobia?

The prevalence of ergophobia is not known, due to a lack of research and reporting of the condition. However, studies show that between 1-10% of the population experiences a debilitating phobia, while females are more likely than males to be diagnosed with a specific phobia ^[13].

Ergophobia vs normal work anxiety – what’s the difference?

It is normal to experience anxiety about work, due to a pressure to perform, worrying about upcoming meetings or presentations, difficult dynamics amongst colleagues or with your boss, or because of burnout and excessive fatigue caused by being overworked ^[14].

These stressors may cause an impact to physical and emotional wellbeing and result in taking time off work or slight impairments in performance, along with increasing anxieties and stress related to work.

However, this would be a proportionate and rational response to such challenges, thus would not be classified as ergophobia, which is defined as an irrational and disproportionate level of anxiety ^[2]. If this persists and worsens to become debilitating or leads to excessive distress or avoidance, it may develop into ergophobia.

Similarly, anxiety about work may be due to social anxiety, causing a fear of speaking in meetings or socializing with colleagues, which may have similar outcomes to ergophobia, such as excessive distress or avoidance and may also be considered disproportionate ^[3].

However, the diagnostic criteria states that the symptoms of ergophobia are not due to another mental condition, such as social anxiety, so although the two may be similar in many ways, in this instance it would not be classified as ergophobia ^[2].