INTRO Everyone feels anxious or uneasy from time to time. On the way to the doctors, first day at a new job, walking past a dark alleyÃ¢ÂÂ¦ your palms sweat, you feel shaky, and your heart pounds. However, when your anxiety is so serious that to handle it you must rearrange your life then you may be suffering from an anxiety disorder. These disorders cause you to feel anxious most of the time, making some everyday situations so uncomfortable that you avoid them entirely. Or, you may experience instances of anxiety that are so terrifying and intense that you may be immobilized with fear. Phobic disorder is when severe anxiety is focused on a particular object, activity, or situation that seems out of proportion with the real dangers involved and lasts over a period of time. Phobic people make elaborate plans to avoid the situations they fear. Phobias can range from mild to extremely severe.
Most phobic people deal with their phobias by avoidance-which only reinforces their phobia by learning subconsciously that there is indeed a good reason to fear the situation as it must be dangerous because they are avoiding it. Phobias may be classified as agoraphobia, specific phobia, or social phobia.
PANIC ATTACKS Phobias can often be related to panic attacks because a person experiences the same symptoms when exposed to the thing he or she dreads. Some people who have panic attacks develop phobias. When they experience a panic attack they attempt to make a logical explanation for it. For example, if a person had a panic attack while driving on the highway, they might think that the highway was the cause of their attack and subsequently avoid highways from there on. Avoidance reinforces the fear and contributes to the development of the phobia. If the person continues to have panic attacks in other circumstances, then their list of situations to avoid grows until eventually they become completely housebound and are diagnosed as Agoraphobic.
AGORAPHOBIA Agoraphobia often, but not always, coincides with Panic Disorder. Agoraphobia is characterized by a fear of having a panic attack in a place from which escape is difficult. The ancient term agoraphobia is translated from Greek as fear of an open marketplace. It is an incapacitating fear of open spaces, crowds, and places that are difficult to escape from to a place of safety (which is commonly home). Agoraphobia therefore refers to a web of phobias embracing fears of leaving home: fear of entering shops, crowds, and public places, or of traveling alone on trains, buses, or planes. Many sufferers refuse to leave their homes, often for years at a time. Others create a fixed route, or territory, from which they cannot deviate. It becomes impossible for these people to travel beyond what they consider to be their safety zones without suffering severe anxiety. Agoraphobia occurs about 2 times more commonly among women than men. The phobia usually starts early in adult life. The presence of other symptoms such as depression, depersonalization, obsessional symptoms, and social phobias doesn't invalidate the diagnosis, as long as these symptoms don't dominate the picture.
SPECIFIC PHOBIA Specific phobia is an intense fear of a particular object or situation that is in actual fact relatively safe. Adults that have a specific phobia are aware that their fears are irrational, but the very thought of facing it brings on a panic attack or severe anxiety. Specific phobias afflict more than 1 in 10 people. They usually first appear in adolescence or adulthood. They start suddenly and tend to be more persistent than childhood phobias; only about 20% of adult phobias vanish on their own. When children have phobias, those fears usually disappear over time, though they may continue into adulthood. Specific phobias generally don't result from a single traumatic event. A lot of the time there is evidence of other family members being phobic and social or vicarious learning of phobias. Panic attacks also play a part in developing specific phobias.
Specific phobias are diagnosed when the person's fears interfere with their daily routine, job, social life, or if the fear is significantly distressful. Fears of certain types of animals are the most common types of specific phobia.
SOCIAL PHOBIAS Social phobia is a persistent irrational fear of situations in which a person may be closely watched and judged by others. It is a fear that the phobic person will embarrass themselves in a public place or social setting. It is typically a fear of being observed; they think that others may be laughing at them or finding fault with them. This may be accompanied by a lack of social skills due to lack of practice or a high anxiety level. The onset of the phobia may occur in adolescence and be associated with parental over-protectiveness or limited social opportunity. It can also be related with feelings of inferiority and low self-esteem. It is often accompanied by depression and substance abuse. Sufferers of social phobia may: -view small mistakes as more exaggerated than they really are, -find blushing painfully embarrassing, -feel all eyes are on them, -fear talking with people in authority, -fear using public restrooms or eating out, -fear talking on the phone or writing in front of others. Like specific phobias, social fear is recognized by adults as irrational, but the feared social situation is avoided or tolerated with extreme discomfort. Once the disorder is established, complete recovery is uncommon without treatment. Commonly, the intensity of the symptoms tend to waver depending on lifestyle demands and the stability of social relationships. Both males and females are affected equally by this phobia. There is no perfect prevention for social phobia, but improving a person's self-esteem and social skills are helpful.
EFFECTS OF ALCOHOL ON SOCIAL PHOBICS Social phobics are at an increased risk of alcohol problems. They can increase their risk for gross alcohol use if they drink to cope with anxiety-provoking social situations. A test was performed by psychologists to evaluate the effect of alcohol on the intensity of social phobia anxiety responses. They took 61 social phobics who gave two speeches in front of a group ("social anxiety challenge"), one occurring before and one after they drank either: 1) an alcoholic drink they were told contained alcohol ("alcohol group"), 2) a non-alcoholic drink they were told contained alcohol ("placebo group"), or 3) a non-alcoholic drink they were told contained no alcohol ("control group"). It was found that both the alcohol group and placebo group showed a great reduction in their performance anxiety from the 1st to the 2nd speech than the control group. The data also showed that the alcohol group showed greater reduction of performance anxiety than did the placebo group. It was concluded from the psychologists findings "that the pharmacological effects of alcohol and the belief that one consumed alcohol decrease social performance anxiety in an additive fashion." They also went on to say that "these results provide direct support for the negatively reinforcing properties of alcohol and are consistent with the view that symptom reduction may motivate alcohol use among socially phobic individuals." PERFECTIONIST PARENTS Parents can have an effect on a person's phobias. Parents with really high standards of achievement may make their children ill trying to meet their expectations. The child's self-esteem plummets and they begin to feel more and more awkward in situations of attention such as speeches for school or even a position on a baseball team. The person will naturally avoid these types of situations and as the avoidance continues in reinforcing their fear, a social phobia forms. Some children can also develop phobias like their parents because they grew and learned by copying the behavior of the parents that they saw at home. Perhaps sometimes mental disorders have more to do with observation and imitation than genetics.
PRIMITIVE FEARS & REASONS FOR PHOBIA Some people theorize that there's a reason why people have phobic reactions to snakes and spiders. They believe that back in primitive times it probably would have saved a lot of people's lives to panic and run away at the sight of a spider or snake because a large majority of snakes and spiders are poisonous. Nowadays, when a person has the same reaction whether there is any actual danger or not, it is as if it has been programmed into us, even if there has been no related traumatic experience in that person's life.
TECHNIQUES TO OVERCOME PHOBIAS A technique in overcoming phobias starts with getting accustomed to the internal sensations in your body when you are distressed. When you first notice you're feeling anxious, it may help to pretend you are a reporter and objectively note the sensations you are having. Objectively remind yourself that your fingers are tingling because an alarm has been triggered in your body and blood is diverting to your larger muscles. Notice the butterflies in your stomach, but also note that this is just a reaction to the increased amount of acidic juices. It may also help to write down the physical sensations you have and the first thoughts that come to your mind. When you feel your phobia taking control and the sensations of anxiety coming over your body, relax and observe these feelings; feelings that aren't being fought often lose control over you over time.
Systematic desensitization is another technique. It is the gradual elimination of obsessive fear by making gradual contact with the feared object or situation. This is often done with a therapist or a friend to act as a safe person or medication to mask the anxiety, although it is best to give up this "crutch" as soon as possible and attempt contact on their own. While the phobic works on their phobia it is helpful to visualize a scenario or scene that represents a safe, calming place.
HANDLING WITH MEDICATION With specific phobias Imipramine can be used to take care of panic attacks that accompany phobias. However, this medicine does nothing about the avoidance behavior that maintains the fears. Some people need Benzodiazepines to practice the behavioral techniques used to desensitize phobics. Benzodiazepines bring quick relief and blunt the feelings of distress. However, the use of Benzodiazepines should be a temporary measure and soon after attempts to desensitize yourself without the medicine should be made.
Inner ear dysfunctions can also cause anxiety symptoms, which a person then related to a phobia, just as a panic attack can be related to a phobia. If the doctor determines that a phobia is a result of an inner ear dysfunction, then antihistamines and decongestants may be prescribed (commonly Antivert and Sudafed). Once the phobic's symptoms dissipate, the phobia may as well.
With social phobias, benefit often comes from beta-blockers. Beta-blockers (propanolol or Inderal, and clonidine or Catapres) help control the manifestations of anxiety: a pounding heart, blushing cheeks, and a sweaty brow. Many people can only handle their potentially scary public encounters only if they're on medication first. Without the physical distress signs to react to, they do not develop further phobic symptoms.
Another type of medication is Busipirone. Unlike Benzodiazepines, it is not habit forming and has no abuse potential. Busipirone does not block panic attacks. It does not work well against obsessive-compulsive and post-traumatic stress disorders, but is most useful against generalized anxiety disorders. Busipirone takes 4 to 6 weeks for therapeutic effects to show and it has little value for patients if taken on an "as needed" basis.
Although medications provide quick and sometimes lasting relief, there are drawbacks to them. Using drugs to address your anxiety teaches you to rely on something other than yourself to solve your problems. Medications are useful in treating chemical disturbances, but they have no effect on a phobic's attitudes or ability to handle stress. Practicing cognitive and behavioral strategies best learns this lesson.