Do you start sweating and shaking when it is your round?

Chrometophobia – the fear of cash or spending – is a real issue, reports Mattie Brignal

Offering to pick up the tab after a meal out can be a nerve-wracking experience as your bank balance ticks down to previously unknown depths.

But for a small number of people, paying a large bill would be their worst nightmare. Chrometophobia is a rare and debilitating condition causing extreme stress and anxiety at the mere thought of spending money, akin to an arachnophobic discovering a tarantula in the bedsheets.

The condition can be so debilitating that sufferers cannot socialise, manage their finances or even feel able to pay for essential medical care.

Here, Telegraph Money explains how to spot the symptoms, and what lies behind the phobia. bia, they’ll likely experience the following:

Feelings of intense fear, panic or anxiety that are difficult to manage

Fear or anxiety that is out of proportion to the situation

A fear of spending money that lasts for a minimum of six months Engaging in avoidance behaviours to prevent encounters with money or situations where you will need to spend money A fear of spending money that interferes with your day- to- day life, overall wellbeing or sense of safety debilitating and hold people back.”

The comparative rarity of the condition is “absolutely” down to under-diagnosis, she adds.

“I’ve had people coming to me with fear of money, but they don’t know the term chrometophobia. They would come with anxiety and other symptoms and then when we peel it back we would discover their irrational fear.”

Joyce Marter, a psychotherapist and mental health expert, says a harsh economic climate tends to increase the prevalence of chrometophobia.

She says: “In 25 years of clinical practice, I have seen dozens of cases – especially during times of economic distress and/or when there is another underlying mental health condition, such as generalised anxiety or post-traumatic stress disorder. During the current period of global economic uncertainty, money anxiety [ is] much more common, which has increased occurrences of the condition.” thinking about or remembering spending money.

The condition is related to obsessive compulsive disorder, where a pattern of unwanted thoughts and fears leads to repetitive behaviours.

Quinn says: “There is a compulsive element to it – the compulsion to spend, to save or to avoid money.”

The pandemic has turbocharged these anxieties, she adds.

“Covid has made lots of different anxiety disorders worse. In this case, fewer people are handling money, so for people with a fear of handling cash because of the bacteria, their anxiety can shoot up and they can have a panic attack.”

Common physical symptoms of chrometophobia are similar to other phobias, and include:

Increase in heart rate and blood pressure

Excessive sweating or feeling clammy

Shortness of breath, hyperventilating

Trembling or shaking

A prickly sensation or feeling like you have pins and needles Feeling dizzy or lightheaded Feeling hot or cold or being extra sensitive to temperature Feeling confused or disorientated Difficulties swallowing or feeling like something is stuck in your throat

Muscle tension or feeling like your muscles are stiff Experiencing a panic attack Nausea, vomiting, stomach pain A lack of appetite

Unusual fatigue or tiredness Insomnia Chrometophobia can also trigger or exacerbate mental health conditions such as anxiety and depression, and can contribute to physical health conditions such as gastrointestinal problems, hypertension and heart disease, and diabetes.

The impact on someone’s life can be profound, according to Quinn.

“A fear around spending money can stop sufferers from going out, stop them having fun, stop them buying things and severely affect relationships,” she says.

The following behaviours are typical of chrometophobia sufferers:

A refusal to spend money, even on essential items or to pay your bills Excessively checking your bank account or counting your money Refusing to deal with, talk about, or think about money Refusing to touch money Becoming socially withdrawn Refusing medical care that costs money, such as dental care, eye care or paying for prescriptions

Because money influences everything from basic needs to social status, professional success, and psychological wellbeing, the fact it can be a source of fear and stress is perhaps unsurprising.

Yet the key to explaining why a phobia develops often lies in a patient’s past. Chrometophobia can be caused by childhood trauma and deeper emotional issues, Quinn says.

“The family attitude towards money growing up can affect it, and fear can be passed down through parents if there were financial difficulties. If you’ve felt this fear and anxiety as a young child it can grow.”

Negative or traumatic experiences could include seeing parents fight or break up over money, experiencing them getting into debt, seeing them get scammed after making a purchase, or believing you caught a virus or illness from touching notes or coins.

The event that caused the traumatic conditioning may not have involved real danger or risk. However, as long as someone experienced significant fear or distress this can lead to developing the phobia.

Marter says: “The longer the duration of the financial traumas, the higher the severity of those experiences, and the more frequent they have been, can all increase the likelihood of chrometophobia. People with less support and underlying mental health conditions are also at higher risk.”

Current financial circumstances can also play a role, as well as the time of the year, according to Quinn.

“Losing a job or worries about your career can definitely have an effect. The Christmas period can also prompt the condition, with its focus on spending money, and can increase anxiety.

“Even at the end of summer, negative thoughts can start to emerge about Christmas and how they are going to cope. People can feel overwhelmed with the pressure to spend and buy presents.”

Quinn treats the disorder with a mixture of psychological techniques, including mental exercises in which patients imagine themselves entering a room with money in it, known as exposure therapy.

She says: “If a client’s fear was around the bacteria from holding or touching money, for example, and if they glimpsed a coin from the corner of their eye, this would bring up huge anxiety and fear.

“Through mental visualisation we would bring them in and out of a situation where they would get closer to this coin, after first establishing a safe place where they were feeling calm and relaxed.

“When the client has tools for emotional regulation, then I might bring a real coin into the room. But in psychology the mind and imagination are most important, because thoughts create feelings and feelings affect our behaviour.

“So if we change our thoughts through mental imagery then the feelings can change without having the money in the room. And if someone is scared of spending or losing money, I play through different scenarios where they are exposed to their worst fear, but also in control and can cope well. It can take a different amount of time for different individuals.”

Quinn uses a two-pronged approach for the most severe cases of chrometophobia. “The first deals with immediate issues – learning how to cope. This includes breathing techniques, hypnosis and exposure therapy, to create emotional calm and coping mechanisms. “Then if there are deeper emotional issues, we explore what the root causes of the anxiety are, going back into childhood.”

One of the biggest obstacles to recovery is not seeking treatment in the first place, she adds, which is why talking about the condition is important. “It really helps for people to know they’re not alone and that they can go and get help.”

Do you think you have chrometophobia? Email money@telegraph.co.uk