|Year : 2017 | Volume
| Issue : 1 | Page : 48-49
Rain rain go away: A case report of lady with ombrophobia
Niska Sinha, Rajesh Kumar, Krishna Kumar Singh
Department of Psychiatry, Indira Gandhi Institute of Medical Sciences, Sheikhura, Patna, Bihar, India
|Date of Web Publication||14-Feb-2017|
Department of Psychiatry, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna
Source of Support: None, Conflict of Interest: None
Phobias occur in several forms. The two main types of phobias are social phobia and specific phobia. A marked specific fear of an object or situation is called a specific phobia. Ombrophobia or pluviophobia is a type of natural environmental subtype of specific phobia. We report a case of ombrophobia in a lady with an interesting psychopathology and treatment outcomes.
Keywords: Ombrophobia, Pluviophobia
|How to cite this article:|
Sinha N, Kumar R, Singh KK. Rain rain go away: A case report of lady with ombrophobia. J Indira Gandhi Inst Med Sci 2017;3:48-9
| Introduction|| |
The American Psychiatric Association (APA) defines phobia as a “marked fear or anxiety about a specific object or situation.” The APA further designates diagnostic criteria for five broad categories of specific phobia classifications, including the natural environment type, where fears are prompted by an object or phenomenon in the natural landscape (e.g. water). Natural environment phobias include weather-related conditions such as fear of thunderstorms and lightening (astrophobia), clouds (nephophobia), hurricanes (lilapsophobia), snow (chionophobia), cold (cryophobia), wind (ancraophobia), fear of fog (Homichlophobia), fear of flooding (Antlophobia), fear of drowning (Aquaphobia) and rain (ombrophobia), among others and interestingly can co occur in same individual at times. Incidence and prevalence data for common fears and phobia based on a probability sample of the general population show the frequency of mild phobia to be 76/1000 and of severe phobia to be 2.2/1000.
Natural environment phobias have the second highest prevalence rate (about 9% to 12%) among phobia subtypes with storm phobia alone occurring in 2 to 3% of general population and about similar prevalence is estimated for rain phobia though exact prevalence remains unknown.
| Case Summary|| |
Index patient Mrs. L, a 43 yr old married female hailing from middle socio economic strata of rural Bihar presented as outpatient in Department of Psychiatry, IGIMS, Patna in month of August, 2016 with chief complaint of fear of rain. She has history of sleeplessness, restlessness, trembling on cloudy days and diagnosis of rain phobia was made, which responded to paroexetine (an antidepressant). On detail assessment and investigations it was found that such fears in past arose after witnessing news on television about earthquake calamity in Nepal in April 2015. Interestingly she gave account of enjoying rain a lot in her childhood days. The acute onset, age of presentation, severity of fear and similar past history with quick dramatic response on paroexetine was interesting presentation. She was so perturbed that she would be awake whole night on cloudy days and during the daytime would remain anxious looking for weather changes. Even with slightest of thunder sound she experienced palpitations, restlessness and thoughts of being drowned in rain water. There would be no such thoughts seeing pond or water around on normal days. If it rained she would awaken everyone around out of fear and insist to be with her locked in room till it stopped raining. She would admit these to be completely irrational. All routine investigation were found normal. She was diagnosed as a case of ombrophobia and seeing past response was put on paroexetine 25 mg and clonazepam 0.5 mg. She received psychotherapy and relaxation techniques were also taught. She showed good response to therapy.
| Discussion|| |
Ombrophobia or Pluviophobia is fear of rain - an anxiety disorder seen more commonly in children, and teenagers. The term Ombrophobia originates from Greek ‘Ombros’ meaning “storm of rain” and phobos meaning “fear or aversion”. Symptoms include: an irrational, persistent extreme fear of rain, trembling, palpitation, sweating, chest pain, nausea, dizziness, fainting, feeling numb, heightened anxiety, panic attacks, monitoring of weather forecasts, avoidance of outdoors during rainy days.
Ombrophobia causation theories are
1. Evolutionary Survival Mechanism : The fear can be actually be rooted in the genetic composition of a person. Rain can be responsible for calamities like floodsand landslides to occur. Thus, every human being has a self-defense within to respond to these strong and heavy rains. When this survival instinct goes to the extreme, it may result in ombrophobia.
2. Traumatic Incident: Every phobia can be associated with related trauma at some point in a person’s life. Anytraumatic experiences such as getting injured due to flood or landslide, or loss of property during the same or witnessing someone else go through similar ordeals can strongly cause the person to fear rain. Ombrophobiacan present after a traumatic event experienced during lifetime. In this case, the sight or idea of rain triggers the repressed traumatic event and cause the person to relive the moment. Phobias not only causedistress but disability also in the person and is likely to worsen over time if not properly treated by eitherprofessional or self- help methods and later during the course depression, may begin to appear.
Treatment modalities include: A. Cognitive Behavioral Therapy (CBT) which helps in recognizing the root causes and thoughts responsible, helps to build a positive outlook towards rain, and resist fear.CBT also helps releasing thoughts underlying in sub-conscious; B. Exposure Therapy with relaxation: The key to any phobia is facing the fear. Exposure therapist makes the person face settings with imitation of train, or videos of heavy rain,. Various relaxing methods such as controlled breathing, mental visualizations and muscle relaxation are taught. Eventually, the person learns to relax oneself even when the fear is triggered and control it; C. Medicines: In severe anxiety and panic cases, medicines are used for eliminating the fearful feelings. Anti-anxiety and anti-depressant medicines are effective.
Thus it may be concluded that a lot of people are fascinated by rain but then there are few other group of people who prefer staying indoors, and not getting wet at all. Moresoever, there are few people who are extremely scared of rain. Such kind of intense and irrelevant fear of rain is known as ombrophobia and it is interesting phenomenon that survival fear instinct, traumatic experiences in life can cause such fears in lifetime. Thus a detail investigation and history is of utmost importance in psychiatry specially as psychopathology of every case is unique and aids a lot in treatment outcomes.
Competing Interests: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this paper.
| References|| |
American Psychiatric Association, 2013: Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Publishing, 947 pp.
Coleman JS, Newby KD, Multon KD, Taylor CL. Weathering the storm: revisiting severe-weather phobia. Bulletin of the American Meteorological Society. 2014 Aug; 95(8):1179-83.
Watt MC, DiFrancescantonio SL. Who’s afraid of the big bad wind? Origins of severe weather phobia. Journal of Psychopathology and Behavioral Assessment. 2012 Dec l;34(4):440-50.
Westefeld JS. Severe weather phobia: an exploratory study. Journal of clinical psychology. 1996 Sep 1;52(5):509
McLeod BD. Pathological Anxiety: Emotional Processing in Etiology and Treatment. Edited by BO Rothbaum (Pp. 272; ISBN 1593852231). The Guilford Press: New York.
American Psychological Association. Task Force on Psychological Intervention Guidelines.(1995). Template for developing guidelines: Interventions for mental disorders and psychosocial aspects of physical disorders. 1995 Feb.
Kleinknecht RA. Simple and Social Phobia. In Mastering Anxiety 1991 (pp. 87-112). Springer US.
Kaloiya GS, Niji VN, Grover N. Cognitive-behavioural Treatment of Water Phobia: ACase Report. Indian Journal of Clinical Psychology. 2009; 36(2):75-8.