Decidophobia: Causes, Symptoms, Diagnosis, and Treatment

What Is Decidophobia?

Do you find it difficult to make even minor decisions, such as what to wear to work or what to make for breakfast? Do big decisions feel impossible and give you paralyzing anxiety? Do you dread making decisions and put them off for as long as possible? Are you terrified of making the wrong decision?

“Decidophobia is the paralyzing fear of making a wrong decision. Most of us have a little anxiety about some decisions, but someone with decidophobia will feel intense, paralyzing fear about even everyday decisions,” says Aimee Daramus, PsyD, a licensed clinical psychologist and author of “Understanding Bipolar Disorder.”

The term “decidophobia” was coined by Walter Kauffman, a philosopher at Princeton and Harvard universities. He introduced the term in his book “Without Guilt and Justice: From Decidophobia to Autonomy,” published in 1973. The book focused on the philosophical implications of decidophobia, which can lead to religious and political conformity, according to Kauffman.

However, from a mental health perspective, decidophobia is classified as a specific phobia, under the umbrella of anxiety disorders. A specific phobia is defined as an extreme, irrational fear of a specific object or situation that doesn’t actually pose any danger.

This article explores the symptoms, causes, and diagnosis of decidophobia, as well as some treatment and coping strategies that may be helpful.

Symptoms of Decidophobia

These are some of the symptoms of decidophobia, according to Dr. Daramus:

•Panic and anxiety: You experience extreme anxiety or have a panic attack when you need to make decisions. You may also experience other symptoms such as rapid heartbeat, difficulty breathing, nausea, sweating, tremors, and chest or stomach pain.

•Procrastination: Your fear of making the wrong choice causes you to put off making decisions for as long as possible. You find it easier to avoid making a decision and live with uncertainty, than to decide and regret your choice. As a result of your procrastination, you may miss out on a lot of opportunities.

•Undervalued instincts: Instead of paying attention to your needs and instincts, you focus on gathering a lot of information or soliciting others’ opinions to help you make your decision. However, rather than being helpful, this can cause you to reach a point where you’re completely overwhelmed instead.

•Strained relationships: You put a strain on your relationships with loved ones because you leave them to make big choices alone, which puts pressure on them to try and please you without actually knowing what you want.

•External dependence: You create situations where you let others decide for you, instead of making decisions for yourself. You may attract a lot of manipulative or authoritarian personalities into your life because their willingness to take charge feels good to you at first.

•Exaggerated consequences: You exaggerate the consequences of small decisions. This can cause you to put a lot of pressure on yourself to make the right choice.

Causes of Decidophobia

These are some of the potential causes of decidophobia, according to Dr. Daramus:

•Learned behavior: Phobias are often learned. There may have been a time in your life when it was useful or necessary to let others take charge of making decisions for you. As a result, you may have learned to avoid making decisions. Alternatively, you may have learned your anxiety as a child, from family members who displayed anxious or stressed behavior.

•Past experience: Another possibility is that you made some decisions in the past that turned out badly, and you generalized it from "I messed that one up" to "I'm always making wrong decisions." Phobias often happen when one bad event gets generalized into fearing all similar events.

•Genetic factors: Genetic factors can also play a role in the development of phobias. Anxiety disorders may run in some families and get passed on genetically.

Diagnosing Decidophobia

Decidophobia can be diagnosed by a qualified mental healthcare provider such as a therapist or psychiatrist. They may conduct an interview with you where they ask you questions about your:

•Symptoms

•Family history

•Personal medical history

•Thoughts, feelings, and behaviors

Based on this interview, your healthcare provider will determine whether your symptoms meet the criteria listed for specific phobias in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This document helps healthcare providers identify and treat mental health conditions.

These are the diagnostic criteria listed for specific phobias in the DSM-5:

•Excessive, unreasonable fear at the prospect of the triggering object or situation

•Immediate anxiety response when faced with the feared object or situation, which could take the form of physical or emotional symptoms (i.e., a panic attack)

•Avoidance of the feared object or situation

•Significant disruptions to daily life and routine as a result of the fear

•Persistent fear that lasts over six months

For instance, someone with decidophobia will not even be able to think about making a decision without triggering their fear response. They avoid thinking about making decisions or making decisions at all costs. They find their relationships, career, and daily life are impaired due to their fear.

Treating Decidophobia

Decidophobia can be treated with therapy. Below, Dr. Daramus outlines some forms of therapy that can help treat this condition.

Cognitive Behavioral Therapy

Cognitive behavioral therapy can help you examine the irrational thoughts and harmful behaviors you’re engaging in as a result of the phobia. It can help you develop healthier habits and thought patterns, to counter the phobia.

Exposure Therapy

Exposure therapy is the most common form of treatment for phobias. It is a type of cognitive behavior therapy that has been developed specifically to treat phobias.

In exposure therapy, you're given a series of challenges related to your phobia, starting with very easy challenges and working up to much more difficult challenges. You give each challenge a number from 1 to 10, based on how much you fear it, and slowly work your way from levels 1 to 2 up the scale to level 9 or 10 challenges.

Your therapist may teach you calming techniques to help you manage the anxiety as you confront these challenges. They may also put in rewards, called reinforcers, at certain levels to motivate you.

Coping With Decidophobia

Believe You Can Make Good Decisions

It can be helpful to look for evidence that you can make good decisions. You can make a list of decisions you've made that have turned out well. Ask friends or family to help with the list.

Examine Past Decisions

Review your bad decisions from the past and see if they were really as bad as you think they are.

For instance, you may have accepted a job that turned out to be really awful; however, that doesn’t mean it was your mistake. The job may have genuinely looked good, and anyone would have accepted it.

The Bottom Line

We typically need to make multiple decisions per day, at home, school, or work. While most people occasionally struggle with some decisions, having decidophobia means you experience considerable anxiety when faced with even the smallest decisions.

If your condition is making it difficult for you to go about your day, it’s important to seek help for it. Like other phobias, decidophobia can be treated with therapy.

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