But the one powerful phobia that fills Mellen with the most dread is vomiting.
The fear of throwing up is called emetophobia, and millions of people in America have it. Mellen’s entire life is choreographed around keeping herself protected against it. She takes every precaution against catching the flu from co-workers and carries antacids, tummy drops, cough drops and hand sanitizer in her purse.
“The fear just engulfs, and it swallows everything around you,” Mellen said.
Her phobia even once threatened the dream she shared with her now-husband of having children. Mellen was so terrified of getting morning sickness that she refused to try and get pregnant.
She and Marvin Graaf met while working at the Philadelphia restaurant Falls Taproom, which they now own together. After they started dating, Mellen told Graaf about her anxiety disorder. At first, he had no issue with it. But when they started planning a wedding and a family, Mellen’s phobia morphed into anxiety about having children. It became a problem for the couple.
“I don't want to miss out on something that could be really special between the two of us because of my phobia. It's not fair to him either,” Mellen said.
Mellen’s phobia was so extreme that she researched hiring a surrogate to have their baby, which she said could cost $40,000 to $90,000.
“I would rather pay the money than throw up. I would rather do anything than throw up,” said Mellen.
But Mellen decided to fight her fear. Before her wedding, she underwent exposure therapy with Dr. Steven Tsao at the University of Pennsylvania’s Center for the Treatment and Study of Anxiety.
For five months, she endured an emotional roller coaster as he worked to desensitize her to her fears through direct confrontation of aspects of the phobia. As part of her exposure therapy, she was shown photos of people who were throwing up. It was an emotional moment, when she remembered what may have caused her phobia.
“The last time I got sick when I was younger, I threw up so bad I couldn’t breathe, and it was really scary,” she said.
In their therapy sessions, Dr. Tsao also had her eat food from an unregulated street vendor and confronted her with fake vomit made from oatmeal and soup. In an effort to confront her primal fear, Mellen forced herself to touch the fake vomit. Towards the end of her therapy, Tsao even had Mellen attempt to make herself throw up.
As the weeks passed by, Mellen realized that her fears were rooted in anxiety and not in reality.
“I just have to keep trying my best,” Mellen said.
Five months of therapy may not have cured her of her fear. But she now knows how to manage it.
“I mean it’s for me, and it’s for him and it’s for us,” Mellen said. “But at the end of the day, it’s for me.”
On a bright, fall day earlier this year, despite a brief panic attack, Mellen married Graaf.