Anxiety Disorders and the Fear of Insanity (Episode 137)
Disordered: Anxiety Help
Josh Fletcher and Drew Linsalata
4.9 • 665 Ratings
🗓️ 19 December 2025
⏱️ 45 minutes
🧾️ Download transcript
Summary
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
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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Transcript
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| 0:00.0 | We hit the sensitized state. When there's no actual threat, we can land on the fear of insanity. |
| 0:05.6 | And it's something that I absolutely wrestled with a lot, not helped with the symptoms of anxiety that kind of play into that kind of narrative. |
| 0:15.3 | De-realization and depersonalization. My personality is disintegrating. I'm losing my sanity somehow. |
| 0:24.6 | You combine that with a threat response, a load of adrenaline, a load of cortisol. Makes sense why people would jump to that conclusion. |
| 0:27.6 | All your brain needs to do is find a believable story. |
| 0:30.6 | It doesn't have to be accurate. It just has to be believable and insanity feels believable if you're experiencing those things. |
| 0:36.6 | Only experience will change the prediction. |
| 0:40.1 | You can't just decide to believe, oh, Josh and Drew said, I'm not going insane. |
| 0:44.2 | I'm cured. |
| 0:45.0 | Yay. |
| 0:45.7 | Let go. |
| 0:46.7 | And just let that feeling be there. |
| 0:52.8 | Welcome to Disordered. |
| 1:11.3 | This is episode 137 of the podcast. We are talking about anxiety and the fear of insanity, otherwise known as Dementophobia, very common fear among people that suffer with anxiety disorders. I am Drew Linzalata. I am a therapist that specializes in the treatment of anxiety and anxiety disorders in New York, |
| 1:14.2 | former suffer of the stuff we talk about here on Disordered. |
| 1:16.7 | Now a four-time author on this topic. |
| 1:18.2 | We just got a new book out. |
| 1:19.0 | We'll talk about that. |
| 1:23.1 | And yeah, like guy with expensive microphones that likes to talk about anxiety. |
| 1:25.2 | And I am joined by the other half of disordered. |
| 1:26.6 | That would be... I'm Joshua Fletcher, also known as anxiety, Josh, therapist, author, podcaster. |
| 1:32.9 | I can really relate to today's subject. |
... |
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