Dec. 19, 2025

Anxiety Disorders and the Fear of Insanity (Episode 137)

Anxiety Disorders and the Fear of Insanity (Episode 137)

One of the most terrifying fears in anxiety disorders is the fear of losing your mind. In this episode, Drew and Josh explore dementophobia - the fear of insanity - and why it's so common among people experiencing panic disorder, OCD, agoraphobia, and health anxiety.

 

The guys discuss how the brain's threat response can turn inward when it can't find an external danger, creating the believable (but inaccurate) story that you must be going crazy. They explore why symptoms like depersonalization and derealization can fuel this fear, and how the disorder creates a "checking state" where you're constantly scanning for signs of mental deterioration.

 

In this episode:

  • Why feeling like you're losing your sanity is such a common fear
  • How panic and anxiety symptoms can feel like evidence of insanity
  • The difference between being afraid and being in actual danger
  • Common compulsions that keep the fear alive (checking, avoiding, reassurance seeking)
  • Why combat veteran comparisons miss the mark
  • How experience, not reassurance, changes the brain's predictions
  • "Did It Anyway" stories of facing fears
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Key principle: Your brain only needs to find a believable story - it doesn't have to be accurate. The intensity of your fear only confirms that you're afraid, not that the danger is real.

 

Remember that while this fear is genuinely terrifying, there is no path from anxious to insane. Recovery involves learning to move through these frightening moments rather than compulsing against them.

 

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The Disordered Guide to Health Anxiety is now available. If you're struggling with health anxiety, this book is for you.

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Struggling with worry and rumination that you feel you can't stop or control? Check out ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Worry and Rumination Explained⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, a two hour pre-recorded workshop produced by Josh and Drew. The workshop takes a deep dive into the mechanics of worrying and ruminating, offering some helpful ways to approach the seemingly unsolvable problem of trying to solve seemingly unsolvable problems.

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