People think about death differently. Some are so terrified of it they develop thanatophobia (death anxiety). Others experience debilitating grief over a loved one’s passing and become clinically depressed. Still, others find peace and happiness as death approaches. Recent research suggests people’s attitudes toward death have a lot to do with their proximity to it.
Death Anxiety: Preoccupation With Death
Some anxiety around death is natural and even healthy. After all, fear of death is a strong motivator behind survival instincts. People with death anxiety, also known as thanatophobia, become so consumed with thoughts about death that they interfere with their ability to function in everyday life. Many of these people are relatively young, in good health and have no reason to believe their chances for living many more years are worse than others. Death anxiety was first written about by Sigmund Freud and has since been the subject of many research studies. Some psychologists propose most people possess a self-protective instinct that shields them from spiraling into paralyzing worry about death. Termed Terror Management Theory (TMT) by anthropologist Ernest Becker, this concept proposes that most human behaviors, beliefs and endeavors are aimed at avoiding or unconsciously fighting against the inevitability of death. This includes pursuits and principles like religion, work, laws, culture, talents and search for life’s meaning. Lacking in some of the self-protective qualities of TMT, people with death anxiety:
- Feel intense dread and fear around death
- Fantasize about how, when and where they will meet their demise
- Experience abnormal levels of anxiety about death that interferes with personal and professional endeavors
- Become preoccupied with the unknowns of what happens to them when they cease to exist
- Experience persistent sadness, guilt and agitation around thoughts of death
- May have panic attacks or heart palpitations when thinking about death
- Feel anxiety even discussing peripheral situations around death such as organ donation
Research finds people with death anxiety often also struggle from mental health disorders such as obsessive-compulsive disorder, PTSD and depression. Death anxiety is not yet an official clinical diagnosis. People with these experiences and attitudes toward death will likely be diagnosed with generalized anxiety disorder.
Grief and Depression
Just as having some fear around death is normal, grief after the loss of a loved one is natural. Similar to how anxiety about one’s mortality can become overwhelming, grief also has the power to take an unrelenting hold on people and begin interfering with everyday life. Some people even require specialized grief treatment to get through the experience. While there is no “normal” way to grieve or a set time period to heal from the loss of a loved one, waves of sadness and loss usually get less intense after several months. Additionally, sadness from grief shouldn’t be accompanied with feelings of worthlessness as in a depression diagnosis. Grief as a mental disorder is a topic of controversy among behavioral health professionals. The Diagnostic and Statistical Manual of Mental Disorders (DSM) has gone back and forth between inclusions of a “bereavement exclusion” for major depressive disorder. This designation excludes people from a depression diagnosis following the loss of a loved one. The main reason for the bereavement exclusion is that many of the symptoms of normal grief align with some of those of mild depression. DSM writers omitted the bereavement exclusion in the latest version, DSM-5. Justification was that people can be diagnosed with depression following other life stressors like divorce, job loss or financial stressors; why should death be any different? The DSM-5 also added an appendix item for consideration in the next DSM: persistent complex bereavement disorder, also known as complicated grief disorder. This syndrome would offer more flexibility in diagnosing depression versus grief. It could help prevent possible over diagnosing of depression, a concern of bereavement exclusion opponents.
Positive Outlook on Death
A 2017 study published in Psychological Science found some people actually feel surprisingly positive as death nears. Researchers compared attitudes toward death of people either on death row or with a terminal illness to people asked to imagine they were dying. Here’s what they found:
- The first part of the study compared blogs of people pretending they had a few months to live with people who had cancer or amyotrophic lateral sclerosis (ALS).
- A computer program analyzed the number of negative or positive emotions in their writings based on descriptors associated with these feelings.
- Blogs of participants with terminal diseases contained significantly more positive emotions and positive words, which even increased as death drew nearer.
- The second part of the study used the same approach but examined letters instead of blogs and compared inmates on death row to people imagining they were on death row.
- Writings of death-row inmates were much less negative and significantly more joyful than people imagining their death.
The takeaway: Imagining one’s death might bring about excessive worry and negativity that doesn’t necessarily reflect what feelings might be as death becomes more of a reality.
Still Down About Death?
Other studies have also shown the grim reaper might not be so grim. A 2012 extensive review on studies about death published in the Society for Personality and Social Psychology found increasing one’s awareness of death by thinking about death or even participating in death-related activities like walking through a cemetery can:
- Increase tolerance and acceptance
- Reduce prejudices
- Increase compassion and empathy
- Encourage feelings of harmony and peace
- Promote more environmental sustainability practices
- Boost compassion toward different religions or views
- Increase self-care activities like smoking less, exercising more, wearing sunscreen and performing breast self-exams
While some data does support increased death anxiety as people such as the elderly draw closer to death, other data shows quite the opposite. A 2017 study published in Frontiers of Medicine found children of elderly parents experienced far greater anxiety about their parents’ impending death than the parents. People 95 and older interviewed for studies give a variety of reasons for their seemingly positive attitudes toward death. These include feeling it will bring them peace and rest. Many enjoy living more in the moment, taking life day by day. Others with health issues look forward to the absence of pain. Worries about death tend to revolve more around the feelings and well-being of people they’re leaving behind than their own passing.