phobias

Phobias: description

In principle, anxiety is a natural reaction to danger. To a healthy extent, fear assures our survival by shying away from threat. In contrast to the healthy fear, the fear is morbidly exacerbated in a phobia and affects the lives of those affected.

What is a phobia?

People with phobias are afraid of situations or objects that objectively do not pose a threat, or the fear of those affected is unreasonably high. Exposing oneself to the dreaded situations is almost unbearable for anxious patients. If possible, try to avoid them altogether.

As a result, some sufferers withdraw more and more and are thus severely restricted in their freedom of action. Although they know that the extent of their fear is irrational, they can not control it.

Phobias create a high level of suffering. The fear is not only associated with threatening thoughts, but also with physical symptoms such as shaking, sweating or palpitations. If the phobia is severe, some people even fear dying from the physical effects.

Many anxiety patients initially suspect an organic cause of their discomfort and run from one doctor to another. Some take years to get the right diagnosis and help them.

There are several types of phobias that can occur alone as well as in combination. Experts distinguish between the following three forms of phobic disorders, social phobia, agoraphobia and specific phobias:

Social phobia

People with social phobia are very afraid of embarrassing or being rejected by others. They therefore avoid social contacts and situations and withdraw. Read more in the article social phobia.

agoraphobia

People with agoraphobia are very afraid of situations where they can not escape in an emergency or are difficult to help with a panic attack. They therefore avoid public places, crowds or admissions. Read more in the article Agoraphobia.

Specific phobia

Unlike people who suffer from social phobia or agoraphobia, people with specific phobias fear a particular situation or object.

The list of phobias is long. In principle, people can develop a phobia with regard to every situation and every object. Experts distinguish four types of specific phobias:

• Animal type (e.g., fear of snakes,)
• Environmental type (e.g.
• Blood-splatter-injury type (e.g., fainting from the sight of blood)
• Situational type (e.g., fear of flying)
• Other type (e.g., fear of vomiting)

A common fear from the phobia list is the fear of animals (zoophobia), such as the fear of dogs (cynophobia), cats (ailurophobia), spiders (arachnophobia) or the fear of snakes (ophidiophobia). Also widespread is the fear of tight spaces (claustrophobia or claustrophobia). People with claustrophobia fear being trapped in rooms. But there are also more unusual phobias, such as the fear of vomiting (emetophobia) or the fear of bacteria (Mysophobia).

Some objects and situations can well avoid those affected. Those who do not have to fly professionally simply switch to other modes of transport. But not everything can be avoided at any time. Even a visit to the dentist is sometimes necessary. Avoidance can be very stressful, and in many cases, anxiety causes serious problems in everyday life. Serious consequences arise when people, for example, for fear of needles (Trypahophobie) or sharp objects (Aichmophobie) no longer dare to go to the doctor. At the latest then it is high time to seek help.

While the fear of animals for the people is usually traceable, have it difficult for people with unusual phobias, because the social environment often reacts with incomprehension. It is important for both sufferers and relatives to recognize anxiety as a condition that needs to be treated.

Phobias seldom occur alone

In many cases, sufferers in addition to the phobic disorder of other mental health problems. About 60 percent of anxious patients also have depression. The risk of becoming dependent on medication, drugs or alcohol is also significantly higher.

How many people suffer from phobias?

Anxiety disorders, which include phobias, are the most common mental disorders. The probability of getting an anxiety disorder is between 14 and 29 percent. Among the anxiety disorders, the specific phobia is the most common disorder. About ten percent of the population suffer from the specific phobia. Women are about twice as likely to be affected as men.

dental fear

Toothache is one of the specific phobias. Those affected have such a strong fear of going to the dentist that they can not be treated even if they have dental problems. Read more in the article Dental Fever.

Phobias: symptoms

The main symptom of a phobia is always a strong and excessive fear of certain situations or objects. These are increasingly being avoided by those affected. Such avoidance behavior, in turn, increases anxiety. In addition, there are other psychological symptoms, but especially severe physical symptoms such as palpitations or difficulty breathing, which can put the person in mortal fear.

For the diagnosis of a specific phobia, for example, according to the ICD-10 classification of mental disorders, the following symptoms must apply:

Those affected either have a clear fear of a particular object or situation or avoid such objects and situations. However, it is not an agoraphobia or a social phobia.

Since the onset of the disorder, at least two physical symptoms have appeared in the dreaded situations. There must be at least one of the symptoms of autonomic symptoms such as palpitations, sweats, tremors or dry mouth.

Other possible symptoms of the abdominal and chest area are:

• difficulty breathing
• tightness
• Chest pain or abnormal sensations
• Nausea and discomfort in the abdominal region

Typical mental symptoms are:

• Feelings of dizziness, insecurity, weakness or drowsiness
• the feeling that the objects are unreal or you are far away and not really there (derealization and depersonalization)
• the fear of loss of control, fear of going crazy or freaking out
• the fear of dying

In addition to the above symptoms, sufferers often suffer from hot flashes or cold showers as well as numbness or tingling sensations. Those affected are emotionally burdened by the symptoms and the consequences. However, you know that the fear is exaggerated.

Phobias: causes and risk factors

For our ancestors, fear played an important role in survival. Dangerous animals and darkness were a real threat. These fears have been passed down through generations. Road traffic is a much bigger danger for us today, but animal phobias are much more common. The emergence of a phobia lead experts back to a combination of learning experiences, biological and psychosocial factors.

Phobias: Learned fear

At the beginning of a phobia is a learning process. A neutral object or a neutral situation is given a negative rating due to a bad experience. Experts call this process conditioning.

For example, a dental fear can arise if the patient had a very unpleasant experience with the dentist. The affected person associates the pain during the treatment with the odors and noises of the dentist. Fear of the dentist and the treatment are the result. Because the negative feelings that have occurred during the treatment, appear on the next visit to the dentist or alone the thought of it again. Physical symptoms such as severe palpitations or sweating are then interpreted by those affected as confirmation that they are in danger.

Phobias: avoidance

Many situations cause discomfort in almost all people without developing a phobia. For example, most people feel uncomfortable with a dental treatment or are even afraid of it. A pathological fear is only when the person concerned avoids the dentist’s visit in the future because he is afraid.

By avoiding it, fear continues to intensify – a vicious circle. People with a so-called dental phobia are so afraid that they can not even go near a dental practice. Such avoidance behavior is a strategy that all people with phobias use.

Phobias: learning by the model

Many phobias, especially animal phobias, develop during childhood. For the development of animal phobia, the child does not even have to have bad experiences with an animal. They learn fearful behaviors already by the example of the adults. The technical term for this is “learning by the model”.

For the assessment of danger, children trust in their parents. If a child observes that the mother becomes anxious at the sight of a dog, it may take on that fear without knowing the reason. Even in adulthood, a specific phobia can arise indirectly, for example through media reports. But why does not everyone who has bad experiences develop a phobia?

Phobias: biological roots of fear

Some people are more prone to phobias than others. Thus, biological factors probably have an influence on this susceptibility (vulnerability). Family and twin research suggests that anxiety is partly genetic.

Also, an imbalance of the messengers serotonin, norepinephrine, dopamine and gamma-aminobutyric acid (GABA) affects the timidity. Similarly, physiological features may promote phobias. People who suffer from low blood pressure, for example, quickly become dizzy in stress situations, which can cause anxiety to those affected.

These biological factors promote an anxiety disorder, but education and environmental influences are the key drivers.

Phobias: Psychosocial factors

Experts believe that parenting has an impact on phobias. There seems to be an association between anxiety disorders in children and controlling, as well as little sensitive behavior of the parents. Children who are not sure about their parents are at risk of having an anxiety disorder later on.

The temperament also plays a significant role. Fearful people are more prone to phobias than others. They are quick to fear because they classify harmless situations as dangerous and their thoughts and attention are focused on possible negative consequences.

Already in childhood, one can recognize a tendency to anxiety, when children are very frightening, difficult to calm down and generally retire earlier. Experts summarize these properties under the term “behavioral inhibition”.

Phobias: examinations and diagnosis

If you suspect an anxiety disorder, you should first visit your GP, who may refer you to a psychotherapist. The doctor will ask you about your physical ailments and your anxiety symptoms.

In addition, to exclude other diseases, he will perform a physical examination. As a rule, this consists of a blood sample, an examination of the heart by means of an electrocardiogram (ECG) and the thyroid by ultrasound and blood values. With magnetic resonance imaging (MRI), pathological changes in the brain as the cause of anxiety can be ruled out.

The therapist is responsible for an accurate diagnosis of the mental disorder and the appropriate treatment. It is important to check if there are other mental disorders, such as depression. These must also be treated to restore mental health.

For the diagnosis of phobias, the therapist orients himself to clinical questionnaires, which query the important aspects of the symptoms. The following questions could ask the doctor to diagnose the specific phobia:

• Are there certain objects or situations that you are very afraid of (eg height, spiders, blood or other)?
• What physical signs do you feel when you think about or come into contact with these objects or situations (for example, palpitations, sweating, or dry mouth)?
• Do you have the impression that your fear is exaggerated?
• Does your fear limit itself to an object or a situation?

If parents suspect a phobia in their child, the therapist will investigate whether the fears are age appropriate or treatment is needed. Some fears children show are part of the normal course of development.

Phobias: treatment

Anxiety disorders are usually treated with the help of psychotherapy and medication. For the treatment of specific phobia, experts recommend psychotherapy only because there is no evidence of drug efficacy. The method of choice is exposure therapy, which is carried out as part of a cognitive behavioral therapy.

Outpatient treatment is often sufficient to treat specific phobias. If there are no other mental disorders, few therapy sessions can be enough to overcome the phobias.

Phobias: confrontation with fear

The idea of ​​Exposure Therapy is that the patient, by confronting his fears, can discard unreal fears. Together with the therapist, the affected person should seek out exactly the situations in the therapy that he has avoided due to the phobia.

Initially, the patient will experience great anxiety and strong physical symptoms – but these negative sensations will eventually lessen if he endures them. The patient makes a new experience. He learns that the fear disappears, that he can bear it and control it. The old fear pattern is overwritten and the anxiety reduced to at least a bearable level.

It is important that the patient dares to meet the object of his fear at some point alone. Only in this way can he learn that he can manage the fears without help and regains confidence in himself.

For some, the confrontation means walking in a park with dogs, while others have to overcome the need to re-enter a lift. For situations that are not so easily accessible in everyday life, there is now often the virtual reality exposure therapy. Patients use VR (Virtual Reality) glasses to see a seemingly real world in which they can move.

This method is often used for flight and height anxiety. The patients experience a flight including take-off and landing or virtually climb a very tall building. Many sufferers reduce their anxiety after only a few sessions. Because a change in behavior also causes a change in thinking.

Phobias: restructuring of thoughts

Cognitive behavioral therapy also involves questioning previous cognitive evaluations. People with phobias overestimate the danger. Harmless situations become a major threat in your mind. The therapist helps the affected person through targeted questions to replace the negative thoughts with realistic interpretations.

Phobias: relapse prevention

The person affected should also visit the dreaded situations regularly after the end of the therapy. Even if strong fears suddenly reappear, this is no reason to despair. Relapses can occur again and again. It is important, therefore, not to panic, but to remember the learned strategies. As the anxiety becomes more severe, sufferers should consult a therapist again. Seeking help is a sign of strength. Those who face their fears retain control over the fear.

Special Treatment of Blood Splash Injury Phobia

For patients with blood phobia, there is a special technique developed by the Swedish psychologist Lars-Göran Öst. It’s called applied relaxation. Because sufferers with a blood-splatter-injury phobia differ from the other anxiety patients in that in connection with appropriate medical examinations often gets sick or they even faint.

The special method of Öst is that the patients tense their muscles in the arms, legs and chest for 15 to 20 seconds. After a short relaxation break this tension is repeated. Many patients can use the tension technique to reduce symptoms such as sweating and discomfort in the case of exposure to blood or injections, and to prevent fainting.

Phobias: Disease course and prognosis

Phobias can develop at any time in life after scary situations. For example, fear of flying when a person is afraid to crash during a turbulent flight. However, phobias usually appear in childhood and adolescence.

Specific phobias often develop around the age of seven. At an early onset, specific anxiety may fade over time. Phobias, which are still present in adulthood or first appear, are usually chronic.

Among the phobias, the specific phobia has the best prognosis. The treatment of specific phobias by exposure therapy has a good chance of success even after a few therapy sessions. Nevertheless, many sufferers do not get help. If there are other anxiety disorders as well as depression or an addiction problem, a longer therapy is often necessary.