Fear,
Anxiety, and Phobias
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Fear (or fright) is a normal emotional reaction to a threat
or a potential danger that may involve our mind or body. Sense of fear is
a built in mechanism to respond and react to a situation that might pose a
physical, psychological or emotional threat of injury. The response or reaction
may be an immediate one or it may prepare you to deal with it in a timely
and appropriate manner. It is normal to feel some degree of worry or uneasiness
about certain unforeseen situations, anything beyond this triggers a fight
or flight reaction preparing the body mentally and physically to fight off
the danger. This reaction is manifested in the form of increase in the heart
rate, increase in blood pressure, sweating, increase in respiration, tremor
of hands, shaking of legs and knees etc. Once the danger is eliminated, fear
goes away and the body functions gradually return to normal.
There are different types of fear:
- Fear may be a reaction (like a startle
reaction) to a brief moment when you are confronted with something
unknown or unfamiliar that you did not expect.
- Sense of fear can be a thrilling and exciting experience like a ride
on a roller-coaster or bungee jumping.
- There may be fear of embarassment, rejection or failing (social fears)
- There may be fear of heights, animals (like dogs, snakes), insects (personal
fears)
- Fear of public speaking (stage fright)
- Fear of war or violence (global fears).
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Anxiety is very similar to fear but with one very important
difference. The feeling of anxiety may result from the anticipation of future
danger although nothing bad could be happening there and then. Anxiety can
be mild or intense, depending on the person's perception, past experiences
and body's inbuilt responses to stressful and frightening situations. Some
degree of anxiety may actually be positive as it motivates us to keep on top
of things and perform to the best of our ability. Anxiety also helps the body
to prime for a more intense and taxing situation.
Everybody knows what it's like to feel anxious - the butterflies in your stomach
before a first date, the tension you feel when your boss is angry, the way your
heart pounds if you're in danger. Anxiety isn't always a bad thing. It can help
you cope with life's everyday stress. It makes you study harder for that exam,
keeps you on your toes when you're making a speech, and helps you stay focused
when looking for a job or asking for a raise.
But if you have an anxiety disorder, this normally helpful emotion can do just
the opposite. It can keep you from coping and can disrupt your daily life. Anxiety
disorders aren't just a case of "nerves." They are serious illnesses that can
grow worse when not treated. They are thought to be related to the biological
makeup and life experiences of a person, and often run in families. Every year,
more than 19 million American adults suffer from anxiety disorders. There are
treatments for these disorders that can help people lead full and healthy lives.
And, research is being done to find new ways to help people with anxiety disorders.
There are five types of anxiety disorders, each with different symptoms. They
include:
-
Generalized anxiety disorder (GAD) - constant and exaggerated
(more than normal) worry and tension about everyday life events and decisions
that lasts for at least six months. A person fears the worst, even though
there may be little reason to expect so. Physical symptoms can also happen,
such as fatigue, trembling, muscle tension, headache, or nausea.
-
Obsessive-compulsive disorder (OCD) - repeated, unwanted thoughts
(obsessions) or ritual behaviors (compulsions) that a
person feels they can't control or stop. A person can sometimes feel an
urgent need to perform a ritual behavior, such as always washing hands three
times because three is a "good luck" number and one isn't.
-
Panic disorder - feelings of extreme fear and dread that strike
with no warning and for no reason. These feelings can happen over and over
again. A person can have physical symptoms, such as chest pain, heart palpitations
(heart beating fast or skipping beats), shortness of breath, dizziness,
stomach problems, feeling disoriented or not "real," and have a fear of
dying.
-
Phobias - includes social phobia, an extreme fear of
being embarrassed, judged, or made fun of in social or work situations and
specific phobia, an extreme fear of an object or situation that
poses little or no danger. People with phobias often avoid certain situations
(like public speaking or parties) or objects (like elevators). Phobias can
affect a person's career, relationships, and daily life activities.
-
Post-traumatic stress disorder (PTSD) - involves how a person
reacts to a very frightening or stressful event, such as being tortured
or put in a prison camp during a war, seeing another person being hurt or
killed, or raped. With PTSD, a person can keep re-living the event with
nightmares and flashbacks. They can feel numb, depressed, angry, irritable,
and jumpy. Family members of victims can also develop PTSD.
Anxiety disorders are among the most common of all the mental disorders. Many
people misunderstand these disorders and think people should be able to overcome
the symptoms by sheer willpower. But, the symptoms can't be willed or wished
away. There are treatments, developed through research, that work well for these
disorders.
Anxiety disorders are treated in two ways - with medication and with certain
types of psychotherapy (sometimes called "talk therapy"). Sometimes only one
treatment is used or both treatments are combined. If you have an anxiety disorder,
talk with your doctor about what will work best for you. If you do choose psychotherapy,
make sure the therapist is able to provide you with medication, if needed.
A number of drugs used for treating depression, called antidepressants,
have been found to help with anxiety disorders as well. Monoamine oxidase
inhibitors (MAOIs) are used, along with the newer selective serotonin
reuptake inhibitors (SSRIs). Other medicines include anti-anxiety drugs
called benzodiazepines and beta-blockers.
Treatment with psychotherapy includes cognitive-behavioral therapy
(CBT) and behavioral therapy. In CBT, the goal is to change how a person
thinks about, and then reacts to, a situation that makes them anxious or fearful.
In behavioral therapy, the focus is on changing how a person reacts to a situation.
CBT or behavioral therapy most often lasts for 12 weeks. It can be group or
individual therapy. Some studies have shown that the benefits of CBT or behavioral
therapy last longer than do those of medications for people with panic disorder,
OCD, PTSD, and social phobia.
Keep in mind that it can be a challenge to find the right treatment for an
anxiety disorder. But, if one treatment doesn't work, the odds are good that
another one will. Your doctor and therapist will work together to help you find
the best approach. New treatments are being developed through ongoing research.
So, don't give up hope. If you have recovered from an anxiety disorder and it
comes back at a later date, don't think that you've failed. You can be treated
again. And, the skills you learned dealing with the disorder the first time
can help you in coping with it again.
If you think you may have symptoms of anxiety, a visit to your doctor is the
best place to start. Your doctor will perform a careful exam to figure out whether
your symptoms are really due to an anxiety disorder, which disorder you have,
and if there are any other problems present. Be aware that all anxiety disorders
are not treated the same.
The next step your doctor may suggest is a visit with a mental health professional.
This includes psychiatrists, psychologists, social workers, and counselors.
It is best to look for a professional who has special training in cognitive-behavioral
and/or behavioral therapy. Try to find someone who is open to the use of medications,
should they be needed. And if they are not a medical doctor, be sure they work
with one so medication can be prescribed. Keep in mind that when you start taking
medicine, it may not start working right away. You need to give your body a
few weeks to get used to the medicine. Then, you and your doctor can decide
if it's working.
You can get free information about anxiety disorders from the National Institute
of Mental Health. Call toll free 1-88-88-ANXIETY.
It's very important that you feel comfortable with your treatment. If this
is not the case, seek help elsewhere. If you've been taking medication, don't
stop it all of a sudden. These drugs need to be tapered off slowly, under the
care of your doctor. Talk with your doctor about how to stop the medication
you're taking.
Many people find it helps to join a support group because they can share their
problems and successes with others who are going through the same thing. While
it doesn't take the place of mental health care, talking with trusted friends
or a member of your faith community can also be very helpful. Family members
can play an important role in a person's treatment by offering support. Learning
how to manage stress will help you to stay calm and focused. Research suggests
that aerobic exercise (like jogging, bicycling and swimming) may be of value
as well. Other studies have found that caffeine, illegal drugs, and some over-the-counter
cold medicines can worsen the symptoms of these disorders. Check with your doctor
or pharmacist before taking any over-the-counter medicines.
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A
phobia is an unreasonable fear of a situation that is out of
proportion to the actual danger. Phobias lead the person to avoid situations
that they are afraid of. Phobia can be described as an extreme and intense cause
of distress and it affects a person's normal daily activities as they tend to
avoid that or object or situations that make them feel uncomfortable.
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National Institute of Mental
Health
Anxiety Disorders Association
of America
National Mental Health
Consumers' Self-Help Clearinghouse
National
Anxiety Foundation
National Mental Health Association
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