This article discusses the fear of dying and intrusive thoughts about death. However, if you are having thoughts of suicide or self-harm, please call 911 or go to the nearest emergency room immediately. In the United States, you can also reach out to the National Suicide Prevention Lifeline at 1-800-273-8255 or text the Crisis Text Line, available 24/7.
Death is a natural part of life, and everyone has their own relationship with it. Some people feel comfortable thinking about it, while others find it unsettling or even scary. Both reactions are completely okay—there’s no “right” or “wrong” way to feel about death. But if thoughts of dying start taking over your days, if you’re constantly worrying about something happening to you or your loved ones, it might be time to look a bit deeper.
For instance, maybe a newfound fear of dying keeps you from doing things you once enjoyed, like driving, traveling, or even spending time away from home. Or perhaps you lie awake at night, unable to shake the thought of losing someone close to you.
If you’re finding it hard to escape these fears, know that you’re not alone—by understanding what’s behind these thoughts, you can take the first step toward a healthier, more peaceful relationship with them.
What causes persistent thoughts of death?
Constant thoughts about death can feel unsettling and even isolating. For some, these thoughts seem to come out of nowhere. For others, these thoughts are linked to specific events or emotions—like the loss of a loved one, a traumatic experience, or a mental health condition that amplifies fears about death.
We spoke to Melanie Dideriksen, LPC, CAADC about some of the common reasons people may experience persistent thoughts about death. Understanding these causes can help you make sense of why these thoughts are arising and offer some reassurance that you’re not alone in facing them.
Losing a loved one, or coming to terms with mortality for the first time
For many people, the first encounter with death—whether through the loss of a loved one or an early confrontation with the idea of mortality—can lead to a heightened awareness of dying. As Dideriksen explains, “I lost my grandmother at the age of five. She drowned after a boating accident. This traumatic event triggered a fear of death that would haunt me for years.” As a child, she recalls, “I spent hours ruminating about dying and grappling with the uncertainty of it. For a long time, I avoided all movies and books related to death and the afterlife—like ghost stories, scary movies, or murder mysteries.”
In some cases, this kind of experience can bring about certain rituals or coping mechanisms aimed at sidestepping death. Diderkisen went through this herself. “Before I was ten years old, I was checking my pulse and monitoring my breathing daily, avoiding hard foods because I thought they would cause me to choke, and treating everyday life like a medical emergency was around the corner. I sought reassurance constantly from family and friends and prayed repeatedly for God to ‘give me a long, long life,’” she explains.
Prolonged grief disorder (PGD)
For some, grief extends beyond the first year after a loss, becoming what’s known as prolonged grief disorder (PGD). Previously known as “complicated grief disorder” and “persistent complex bereavement disorder,” PGD is defined by intense pain lasting a year after a loss, with an inability to resume past activities.
PGD often leaves people feeling unable to accept their loss. “People with prolonged grief disorder often ruminate on other scenarios that could have unfolded in which their loved one’s death could have been averted. For example, ‘If only my sister could have gotten into a clinical trial,’” says Dideriksen.
PGD can also involve excessive avoidance of places or situations that remind people of the person they lost. This ends up doing the opposite and keeping thoughts of death front and center. Even though you’re avoiding thinking of something, that constant reminder to avoid those thoughts just makes you think about them more.
Depression and loss of hope
Persistent thoughts about dying can often be linked to depression. In moments of intense hopelessness, these thoughts may become overwhelming, especially when a person feels there’s no way forward. Dideriksen reminds us, “Suicidal ideation or intent is not something that should ever be taken lightly.” She adds, “If you find yourself feeling like there’s no hope, reaching out for help can make a difference—you’re not alone in this.”
If you or someone you know is experiencing thoughts of self-harm, support is available:
- Call 911
- Go to your local emergency room
- Call 988 (Mental Health Crisis Line)
- Text HOME to 741741 (Crisis Text Line)
- Dial 1-800-273-TALK (8255) National Suicide Prevention Line
Intrusive thoughts
Some people experience intrusive thoughts about death, which may include fears of dying or worries about losing loved ones.
Intrusive thoughts are mental experiences that are unpleasant, distressing, and happen against your will. These thoughts can vary widely in content, and while everyone has them from time to time, persistent and distressing thoughts about death may sometimes indicate conditions like OCD or PTSD.
“There’s a major difference between an intrusive thought about death and intent to harm oneself,” Dideriksen explains. An intrusive thought about death often triggers fear or anxiety without any actual desire to die. While these thoughts aren’t a sign of suicidal intent, they can still be deeply distressing, especially when they start to feel persistent or overwhelming.
Can constant thoughts of death indicate other mental health conditions?
Sometimes, persistent thoughts about death are linked to specific mental health conditions. Dr. McGrath, Chief Clinical Officer at NOCD shares that sometimes mental health conditions like OCD, PTSD, and anxiety can make thoughts of death feel constant and overwhelming. Each of these conditions can create patterns of worry or fear that intensify your negative thoughts.
Obsessive-compulsive disorder (OCD)
OCD is a mental health condition marked by intrusive, unwanted thoughts, images, or urges that appear in the mind and cause significant distress. People with OCD often react to these obsessions by performing rituals known as compulsions, which may be physical actions or mental exercises meant to temporarily relieve anxiety. However, this relief doesn’t last, and it often leads to a continuous cycle of OCD that can feel hard to escape.
As we’ve mentioned, people with OCD may sometimes have intrusive thoughts related to death that feel persistent and overwhelming. But what does this actually look like in everyday life?
Some examples of common obsessions that may be present in a person with OCD and a fear of death include:
- Worry that one has some fatal condition, like cancer
- Fear about the dying process
- Fear of dying alone
- Worry about a loved one dying
- Fears about being ready for death when it comes
- Fears about the afterlife
- Fears about religious repercussions due to their doubts about the afterlife
People with OCD engage in compulsions, which are repetitive physical or mental acts done in an attempt to alleviate the distress brought on by obsessions, or to avoid an unwanted outcome. Some compulsions that may result from obsessive thoughts about death include:
- Researching illnesses that lead to death
- Seeking reassurance from loved ones, priests, or others
- Avoiding any situations that could lead to death, such as driving
- Rigidly adhering to health practices to reduce anxiety about death
- Studying and exploring beliefs about the afterlife in response to anxiety
- Searching the internet for the stories of people who have had near-death experiences
- Excessively checking in with loved ones to make sure they’re safe
- Excessive prayer
Unfortunately, engaging in compulsive behaviors only brings short-term relief. “Over time, more and more compulsions are necessary to reduce anxiety; it’s an endless cycle,” explains Dideriksen. “The brain starts to learn a false message: ‘I must engage in compulsions to feel better.’” But this response doesn’t actually stop obsessions from coming back—it only reinforces the cycle, making it feel harder and harder to break free.
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PTSD
PTSD, or post-traumatic stress disorder, is a mental health condition that can develop after someone has experienced or witnessed a traumatic event. It’s marked by distressing memories, flashbacks, or nightmares about the trauma, along with strong emotional or physical reactions when reminded of it. For people with PTSD, these responses can make it challenging to feel safe or fully grounded in the present.
“Trauma sometimes feels overwhelming, or comes up way after the event occurred, because the memory can trigger the fight-flight-or-freeze response,” shares Dr. McGrath. Intrusive memories can pop up in different ways, but in doing so, they bring up those same feelings and fears the person felt in the moment of their traumatic experience. For instance, if someone has witnessed the death of a loved one or experienced a traumatic loss, they might find themselves constantly thinking about death.
Dr. McGrath shared that a common theme related to PTSD and death is regret. People tend to regret moments they could’ve had with loved ones, or criticize how they acted in certain moments. “We’re really good at reminding ourselves about how much we think we suck, and sometimes it takes a little bit of time to get past that,” he says. PTSD can make it difficult to separate the past from the present, and the reminders of your own shortcomings can feel all-encompassing, further reminding you of the person you lost and what you could have done differently.
To manage these feelings, people with PTSD may engage in avoidance behaviors, steering clear of places or situations that remind them of the trauma, or attempting to control certain aspects of life to feel safer. While these strategies may bring short-term relief, they often reinforce distress and make it more challenging to process and heal from the trauma over time.
Anxiety
Anxiety is a mental health condition marked by excessive worry, fear, or nervousness that can feel difficult to control. For people with anxiety, everyday situations can trigger a heightened sense of danger or risk, even if the threat isn’t real. This constant sense of worry can make it hard to relax or feel safe, as anxiety often leads to imagining the worst-case scenario in various situations.
For some, anxiety can center on fears related to death, creating persistent worries about their own mortality or the safety of loved ones. This might look like a constant fear that “If I do this, I could die,” or feeling that death is always lurking around the corner. If someone has recently lost a loved one or witnessed a traumatic event, these fears can intensify, making it challenging to stop thinking about dying or worrying that tragedy will strike those they care about.
“It takes one time to be afraid of something and it takes multiple times to be safe,” says Dr. McGrath. “So if something has happened, and we’ve encoded a fear of that thing, we want to stay away from that thing because we think, ‘Well, that thing almost killed me and I don’t know if I can handle it again, so it’d be better to never have to deal with it.’”
In response to these fears, people with anxiety often develop coping mechanisms that offer a sense of control, like avoiding activities they perceive as risky or frequently checking in with loved ones for reassurance. While these behaviors can provide temporary relief, they tend to reinforce the cycle of anxiety, making it harder to escape from constant worry about death.
How to stop thinking about death
Constant thoughts of death can feel overwhelming and exhausting, especially when they interfere with daily life. If you’re struggling with these thoughts, know that there are effective treatments available to help you find relief and regain a sense of control. Many approaches target the root causes of these intrusive thoughts, addressing any underlying mental health conditions and helping you to manage distress in healthier ways.
Treatment options
Exposure and response prevention (ERP)
ERP is a highly effective treatment specifically designed to help individuals confront distressing thoughts or fears without performing the usual behaviors that bring temporary relief. While ERP is best known for treating OCD, it’s also used to help people with PTSD and anxiety manage persistent fears, including thoughts of death.
In ERP, you work with a therapist to gradually face the thoughts or situations that cause you distress. For example, if you have OCD and constantly worry about your own death or the death of a loved one, ERP would involve slowly exposing you to these thoughts in a controlled way. You might try writing down or verbalizing your fears, while resisting the urge to perform any compulsive behaviors that usually ease your anxiety. Over time, this helps retrain your brain to tolerate uncertainty and reduces the need for compulsions, making these thoughts less overwhelming.
Dr. McGrath gives us an example of what ERP can look like with a patient who has an intense fear of driving. Dr. McGrath says he would slowly expose the individual to their fear of getting in an accident and dying. He would start by having the person drive in a parking lot, then move on to side streets, and then busy main stress. If this person has previously been in an accident, he would gradually encourage them to drive past the location where it occurred, helping them see that they can manage the experience safely. “I don’t try to teach them they’ll never be in an accident. I just try to show them that one experience does not define things and you can still live your life,” explains Dr. McGrath.
Mindfulness and Acceptance-Based Therapies
Mindfulness practices, such as those used in acceptance and commitment therapy (ACT), encourage you to observe your thoughts without judgment. Instead of focusing on eliminating thoughts of death, ACT emphasizes accepting these thoughts as part of the human experience and teaches you to commit to actions aligned with your values. By learning to “make room” for distressing thoughts, ACT can help you develop a new relationship with them—one that allows these thoughts to come and go without letting them control you. This approach reduces the fear and urgency often created by intrusive thoughts, providing a sense of peace over time.
Medication
In some cases, medication may be recommended to help reduce the intensity of intrusive thoughts about death. Antidepressants, such as SSRIs, are commonly used to manage symptoms of OCD, PTSD, and anxiety. These medications can help reduce overall anxiety and obsessive thinking, making it easier to engage with therapeutic practices. A psychiatrist or primary care provider can help determine if medication is right for you.
Support groups and peer support
Talking with others who share similar experiences can be incredibly comforting and help reduce feelings of isolation. Support groups—whether in person or online—provide a space to openly discuss fears around death, learn from others, and find reassurance that you’re not alone in facing these thoughts.
Connecting with others who “get it” can make a world of difference. Some people find comfort in joining groups specifically for OCD, PTSD, or anxiety, where they can hear from others who also deal with distressing thoughts about death. Others find strength in one-on-one peer support, where they can share personal experiences and receive encouragement from someone who truly understands what they’re going through.
Bottom line
Constantly thinking about death can be overwhelming and unsettling, especially when these thoughts intrude on daily life. By identifying what might be driving these thoughts—whether it’s anxiety, OCD, PTSD, or something else—you can begin finding the right support and treatment that truly targets the source of your distress.
Evidence-based treatments, like exposure and response prevention (ERP), can help you face and gradually overcome these fears, breaking the cycle that keeps them coming back. With the right support, you can regain a sense of peace and control over your life. Whether it’s through therapy, peer support, or working with a mental health professional, remember that help is available—and healing is possible.
Key takeaways
- Persistent thoughts about death are often linked to underlying mental health conditions like OCD, PTSD, anxiety, or prolonged grief. Understanding these causes is the first step toward managing them effectively.
- Evidence-based treatments, such as exposure and response prevention (ERP) and mindfulness-based therapies, can help you confront and reframe fears about death.
- Support from mental health professionals, peer groups, and, in some cases, medication, can provide a path toward healing and a more peaceful relationship with thoughts about mortality.