What are fears and phobias?
Being afraid is a natural human reaction that is intended to protect against threats and dangers. The body enters into an alarm state so that it can react quickly – with flight, waiting or attack. This process is accompanied by physical symptoms such as palpitations, sweating or tension. When the fear-triggering situation is over, the feeling and the accompanying symptoms disappear.
In the case of anxiety disorders, these anxiety reactions also occur again and again in situations that do not present a real danger. Those affected experience an intense feeling of anxiety that they can hardly control or stop. On the one hand, the fears can occur without concrete cause, on the other hand in connection with a certain situation, an object or a living being. In this case, they are called phobias.
What types of anxiety disorders exist?
Anxiety disorders can occur in many different forms. The most common are:
Agoraphobia
Anxiety about crowds and public places. They are afraid of not being able to escape from such a place in time.
Generalised anxiety disorder
Sufferers are constantly haunted by subliminal fears. Their exaggerated concerns are focused on things that could happen. For example, that they themselves or relatives are seriously ill or have an accident. Due to constant fear, they suffer from high internal stress.
Panic disorder
For no apparent reason, people repeatedly experience strong and sudden anxiety attacks, also known as panic attacks. These usually last only a few minutes and cause severe physical reactions such as rapid heart rate, shortness of breath and dizziness.
Social phobia
Feelings of anxiety are triggered by situations in which the focus is on the affected person - for example, during a presentation or a speech. They fear the judgement of others and have exaggerated fear of being embarrassed or making mistakes.
Specific phobia
This form includes fears about certain situations or objects: For example, spiders, heights or closed rooms.
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Those affected experience usually overpowering anxiety. Although they are aware that their fears are irrational, they can barely control or stop them. Anxiety response is accompanied by various physical symptoms, which may occur at different levels. These include palpitations to rapid heart rate, rapid breathing, shortness of breath, dizziness, restlessness, tension, sweating, trembling, tightness and pressure on the chest.
At the psychological level, fear, especially in the case of panic disorder, can also express itself in the feeling of having to die, go mad or losing control. When anxiety is associated with a situation or an object, people tend to avoid it. Withdrawal, social isolation and restrictions in everyday life are possible consequences.
The emotional life of those affected is also affected by the "fear of fear". Their constant expectation of the next fear reaction is strenuous and stressful.
How do I know if I am suffering from anxieties or phobias?
- I am afraid of a particular thing, a living being or a situation and I avoid it, although objectively speaking there is no danger.
- I am often, or always, fearful for no reason, although there is no reason.
- I experience physical symptoms such as rapid heart rate, tremors, chest or throat tightness, shortness of breath, excessive urination or diarrhoea.
- I feel like I'm fainting, going crazy, or suffer from a fear of dying.
- My fears and worries plague me so much that I have difficulty coping with my everyday life, for example working, learning, meeting friends or family.
How does a health care professional know if I am suffering from anxiety or phobias?
Doctors first investigate your disease history. This helps them to gain clarity about the onset of the disease, its nature and its extent. Since many symptoms of anxiety and phobias may also stem from other diseases – for example, the lungs or the cardiovascular system – physical causes must be ruled out. For this reason, physical examinations can be used in the context of diagnostics, such as an electrocardiogram (ECG), blood tests, computerized tomography (CT) or magnetic resonance imaging (MRI).
If physical causes are excluded, diagnosis continues with discussions. By means of a systematic questionnaire, doctors can obtain a precise picture of the anxiety disorder and find out how it affects the daily life of the affected people. Information requested includes, but is not limited to, previous or accompanying illness, illness or death in the family, circumstances and lifestyle.
It is important for those affected to become aware of the disease, to accept it and to face it. The tendency to avoid fear-causing things or situations can add to anxiety or phobias. Facing these fears can be understood as training that helps to reduce the anxiety itself. For many of those affected, however, this is a particularly daunting challenge.
Anyone seeking medical attention for fears or phobias is not revealing personal weakness, but rather a desirable way of dealing with the disease. This also includes involving one's own environment, such as family or friends. Valuable support can come from those close to them.. In addition, the visit of self-help groups for exchanges with other sufferers shows good results for some sufferers.
Relaxation techniques such as yoga, autogenous training or progressive muscle relaxation can also be helpful for therapy. Exercise is generally recommended, especially endurance sports such as running or cycling.
Relatives and friends must first acknowledge and accept that a loved one is suffering from anxiety disorder – and that this is a mental illness. It is important to learn about the disease. This can be done through professional medical advice as well as through discussion with other affected persons.
Friends and family members can help people affected by listening to them and showing that they understand the situation. In no case should suffering be a cause for criticism, reproach or ridicule. It is important that sufferers see that they are not alone and are supported. It is equally important to encourage those affected to seek professional help or, in the extreme case, to initiate their own medical examination.
Fears and phobias are serious mental illnesses that require professional help and treatment. The many different factors that can lead to a disease make it difficult for patients to identify the causes alone and to take effective countermeasures.
Among the different treatment methods, behavioural therapy has proved to be particularly promising. This can be supplemented by the administration of drugs, depending on the severity of the disease. A deep-psychological therapy, which is carried out by psychotherapists or psychiatrists, may also be appropriate in some patients.
In addition to professional treatment, regular exercise, exercise and a fundamentally healthy lifestyle have proved to be helpful. Relaxation techniques such as breathing exercises, yoga, autogenic training or progressive muscle relaxation are equally beneficial.
Although psychotherapy is considered to be the first choice in the treatment of anxiety disorders, in some cases medications can also be used. This is especially true if the affected persons are so severely impaired that psychotherapy in the first step is not possible or psychotherapy has not shown the desired success. In general, antidepressants are used to reduce anxiety and phobias, and to improve the mood of those affected relatively quickly. Benzodiazepines, also known as sedatives, offer another possibility. They can quickly resolve anxiety, but they are not a permanent solution and do not cure anxiety disorder. Medications are only given as part of a treatment and should never be taken without medical supervision.
Rapid heart rate, dizziness, shortness of breath – the symptoms of acute anxiety or panic attacks - are varied and usually last a few minutes to half an hour. Patients can either go to an emergency room with a psychiatric ambulance or try to help themselves with simple measures. These include breathing exercises, such as the 4-6-8 technique, in which they inhale for four seconds, hold the air for six seconds, and then exhale for eight seconds. Another self-help measure is not to suppress or control the feeling, but to accept the panic attack. It can also be helpful to look for a distraction, for example, to talk to people or to concentrate on a specific activity.
Fears and phobias can have very different causes, which in combination can trigger the disease. These include family predisposition, early childhood experiences, traumatic experiences, stressful situations or various personality disorders. Anxiety and phobias can also be caused by organic diseases, for example diseases of the cardiovascular system, the respiratory tract, thyroid disorders or pathological changes in the brain’s nerves.