There aren’t many things in life that scare me. Bugs, heights, and murky ocean water, the usual stuff. Oh, and vomit. Vomit is my gravest fear. Throwing up is a hellish nightmare I wouldn’t wish on my worst enemy.

I know what you’re thinking. Big whoop—no one likes to vomit. (Unless you’re Jeff “The Vomit Guy” from Howard Stern, whom of all people, I’ve had the misfortune of meeting while volunteering at a cat shelter.) But for me, it’s more than an unpleasant bodily occurrence, it’s a full-fledged phobia that’s taken a serious toll on my mental health and well-being. Terrified of the smell, taste, and loss of control, I’ve managed to keep the act of vomiting at bay for upwards of 10 years at a time, fully equipped with a bevy of antacids and bismuth tablets for any unexpected encounters. If there were a kryptonite to fend off vomit, I’d be sure to have it in my possession.

Memories of the fear go back to when I was five years old, wide awake in the yellow-swathed bedroom of my childhood home, miserably sick to my stomach. I reasoned with a God that I wasn’t even sure existed. “Please!” I begged. “I’d rather have strep throat or break my arm than have to throw up, ever again.”

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As the years passed, episodes of the stomach flu and carsickness further cemented my fear. This was around the same time I began keeping a mental catalog of all the times I’d been sick. My rationale was this: If I was able to secretly recall each episode in painstaking detail, I could somehow prevent it from happening again in the future. Each occurrence was tied to a time and place, article of clothing, and of course, the meal prior.

The one I replayed the most happened on the drive back from dinner at East Side Mario’s in Portland, Maine. Back at home, my mom mopped up the backseat with a wool blanket while my father helped me out of my bright-green shorts and into the bath. From that day on, I refused to eat linguini or wear my bright-green shorts ever again. No matter how many times it was washed, or how cold I got, I shunned the warmth of the wool blanket. And every time we drove past East Side Mario’s, I looked the other way and held my breath until it was out of sight, not wanting to jinx myself by looking directly at it.

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When I hit puberty, things took a turn for the worse. I became so obsessive compulsive that I couldn’t even write, type, or say the word “vomit” aloud. I was completely unaware that my fear had escalated into a panic disorder. I just knew that whenever I got worked up, my heart would race uncontrollably and my stomach would start to flip-flop in the same way it did when I was sick. But despite my suffering, I still refused to share my secret obsession. If I told people, I was sure I’d jinx my recent milestone of having been vomit-free for 10 whole years.

But then something peculiar happened. One night while watching MTV, I stumbled across a re-run of True Life featuring a young woman dealing with OCD, along with a mild fear of vomit. I wasn’t alone in my battle! I was completely moved by her. Suddenly I had the confidence to start researching online. With the click of a button, I found a name for what had been tormenting me my whole life: emetophobia—the irrational fear of vomit. I slowly worked up the courage to tell my parents. They were wary at first, but finally decided to enroll me in cognitive behavioral therapy. I felt a lot better. Each week, I had a safe space to talk about my fear, understand my newfound mental illness, and develop healthy coping skills. My therapist also suggested I seek help from a psychiatrist, who prescribed me antidepressants.

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Her explanation of anxiety and panic made it all seem so simple. In healthy amounts, anxiety serves an important role. For most people, it triggers a heightened sense of awareness to fight off potential threats. But for some, a traumatic experience, or panic disorder, blocks the ability to turn off the fight-or-flight response, and instead triggers the physical and emotional effects of anxiety on a day-to-day basis. For me, these physical effects included my arch nemesis: nausea. To help moderate my imbalance, she prescribed Paxil, a selective serotonin re-uptake inhibitor.

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Paxil worked like magic. Within a few weeks, I felt a tremendous weight lifted from my shoulders. I was still afraid of vomit, but no longer let it control my life. My obsessive-compulsive disorder also slowly diminished. It was so much easier to concentrate in school, interact with friends, and enjoy being a teenager. I didn’t have to hide my phobia any more; it simply didn’t make itself present.

The only downside was the medication’s side effects, including night sweats and loss of libido. My doctor shuffled me through three different medications over the course of six years before finally settling on Effexor. I still had to deal with the night sweats, but otherwise, felt almost entirely detached from my anxiety. I even threw up on three separate occasions! What a triumph it was to celebrate vomit, instead of obsess over it.

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After three breezy years on this wonder drug, I began to downplay the mental illness it was masking. If I were to slowly titrate my dose, would my phobia still hold true? As a full-grown woman, perhaps I had a better handle on anxiety. I found a new psychiatrist that offered to help me withdraw. He was supportive, but warned me that my panic disorder was likely to resurface. Even so, I insisted, and six months later, was 100 percent Effexor-free. I had some mild anxiety, but found relief by exercising my old coping mechanisms. I even reenrolled in talk therapy.

But then, out of the blue, the panic attacks crept back in. I’d wake up in the middle of the night, heart racing, terrified to move. The feeling was all too familiar. Just as before, I was seized with what felt like never-ending bouts of anxiety-fueled nausea.

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I realized that I couldn’t close my eyes and pretend the fear was gone. No, in order to deal with it, I was going to have to face it and embrace it. I’ve been back on medication for almost five months now, but I’m still working to piece my mental health back together. Part of my treatment includes dialectical behavioral therapy, which encourages one to identify an overwhelming emotion, and apply the opposite action in an attempt to diminish the former’s power. For over 20 years, I’ve felt nothing but shameful of my phobia. The opposite action of shame is to share. So here it is, in writing, for the entire world to see: My name is Holly. I’m a 26-year-old woman, and I have emetophobia.