Phobias: when fears torment you – you escape the fear trap

by Olivia Romano August 21, 2018 at 11:33 am

In principle, fears can be developed against all conceivable objects or situations. In order to successfully treat anxiety disorders, it is important to find out what type of anxiety it is and what triggers the particular disorder.

Contents of this article:

Anxiety disorders briefly explained

The collective term anxiety disorder includes several mental disorders that are associated with fear. A rough distinction is made between fears that relate specifically to things and situations and are highly specific, as well as diffuse, non-specific fears. Alongside depression, anxiety disorders are among the most common mental illnesses. Women are affected more often than men. If left untreated, an anxiety disorder can worsen and become independent. Anxiety triggers are avoided more and more, which usually goes hand in hand with an increasing withdrawal from life. While fear is normal in certain situations, warns and protects us from dangers, fear with an anxiety disorder goes far beyond this protective function, occurs over a long period of time and is no longer related to the situation. Anxiety disorders not only express themselves through mental stress, but also through physical symptoms such as rapid heartbeat and profuse sweating. Anxiety disorders can occur alone, but also in connection with depression. Anxiety and depression are often closely related

Fear is quite normal and quite useful: it helps us to recognize dangerous situations and protect us in everyday life. In our normal life, however, there are rarely any major dangers. We often worry unnecessarily and lose quality of life as a result. In extreme cases, an anxiety disorder can even develop, which represents a serious psychiatric clinical picture. So that it doesn’t get that far, it makes sense that we face our fears and learn to deal with them and realistically assess when it is better to have respect than fear.

What is an anxiety disorder and how can it be diagnosed??

Only when a fear is pathological, that is to say unfounded and long-lasting, is it called an anxiety disorder. Distinctions between anxiety disorders and "normal" fears are not always clearly recognizable. An classification and diagnosis of anxiety disorders is carried out in Germany according to a classification system (ICD) of the World Health Organization (WHO). An anxiety disorder can indicate, for example, an anxiety that cannot be explained or influenced by the person concerned. An excessively long duration of the state of anxiety or a significant restriction in the life of the person concerned can also indicate an anxiety disorder.

What are the causes of anxiety disorders?

The causes of anxiety disorders can be divided into three groups. The learning theory approach is based on a multi-stage process. Through a bad experience, the person concerned first gets to know the fear of a certain situation. Because he avoids this situation from then on, the fear-triggering character remains. Avoiding the fear-triggering stimulus acts as a reward, which is why the avoiding behavior occurs more often. Often, these behavioral patterns are created in childhood, for example when people are afraid of spiders. If parents are already afraid of the animals, children may take on these fears.

The biological cause is considered to be the second cause of anxiety disorders. Experts suspect a connection between anxiety disorders and an unstable autonomic nervous system. Due to the instability of the nervous system, those affected apparently develop anxiety symptoms more easily.

The third possible cause of phobia is the depth psychological approach. This assumes that unresolved conflicts can lead to an anxiety disorder. This may particularly affect people who have not learned to deal with fears during their development. With anxiety disorders of any kind, psychotherapy often helps to achieve the desired treatment success.

Forms of anxiety disorders

Unspecific fears

Generalized anxiety disorder

In one second you worry about making a mistake at work and being fired, in the next you are worried that something may happen to your child on the way to school. The horror scenario is very real in your head: Your child was surely run over by a car when crossing the street. And your husband had an accident while hiking in the recover. The next moment you fear the plane crash on the way to vacation. And because you left with your friends at the last meeting, they will no longer want to be friends with you.

Such concerns and fears characterize a generalized anxiety disorder. Permanent, unrealistic fears that affect different areas of life are the main characteristic of this mental illness. These worries and fears are not a reaction to specific threats and situations. They can relate to everything, take a long time and seem absurd and exaggerated to outsiders. Fear is omnipresent – the concerns concern everything, even completely irrelevant things, but they can also relate to the fear itself: you worry that you worry too much. Affected people suffer very much from these feelings and recurring thoughts – everyday life becomes unbearable.

panic disorder

Heart racing, sweating, violent tremors, dizziness, the feeling of suffocation, the feeling of acute danger to life – all symptoms of a panic attack. If panic attacks occur more often, one speaks of a panic disorder. Affected people observe their body critically, they listen deeply to themselves. A vicious circle: The fear of another attack triggers the next one. Every tiny sign is interpreted as a harbinger of an attack, as a danger and triggers a stress reaction, what the next attack favors.

Often, those affected report to the doctor or the emergency room because they fear the pronounced physical symptoms, which usually last about half an hour, a life-threatening illness, such as a heart attack. The fear of fear is omnipresent. What if an attack comes again? Social isolation and even job loss can result.

The panic disorder is often associated with agoraphobia – a fear of public places. Affected people can develop the idea that their panic attacks are related to certain places, for example the supermarket or the bus, i.e. generally the place where the first panic attack occurred. This place is then avoided. The spiral of fear goes all the way to complete isolation, for example when you no longer leave your home. Therefore, a way out of fear is urgently needed to successfully cope with the panic attacks.

Specific fears – phobic disorders

Social phobia

Social phobia is actually not a certain fear, but a whole smorgasbord of fears. Up to twelve percent of people experience social phobia at some point in their lives. In addition to depression, it is one of the most common mental illnesses. It is not possible to give an exact figure for the number of people suffering from social phobia: they usually hide their illness and do not contact a therapist. Like all anxiety disorders, social phobia can be accompanied by physical symptoms. Even if the lines to simple shyness are blurred, social phobia should not be confused with sheer shyness. Because those affected are not always very reserved. Fear is often outplayed – the stress takes place inside the person concerned.

One of the main fears of social phobia is the fear of embarrassing or failing. Therefore, those affected avoid situations in which they attract attention or are even the focus. Typical for them is the distorted self-perception, in which those affected assess their behavior excessively critically. Others mostly do not notice the apparently bad mistakes. Outsiders also realize the great fear that those affected do not feel. The idea of ​​possibly not being able to meet the demands of others makes people who suffer from social phobia panicked. In extreme cases, they withdraw completely, become loners and lonely.

A typical sign of social phobia is withdrawal from social life. This often leads to problems at the workplace and also among friends. It is not uncommon for the “strange” behavior to be misunderstood even within the family.

Physical symptoms include flushing, stuttering, increased heart rate, difficulty breathing, dizziness and tremors. Many of those affected withdraw from fear of these physical reactions. They feel lonely, but cannot get out of their skin. The symptoms mentioned above, such as blushing or trembling, apply in a lighter form even when you are normally shy. However, shy people don’t avoid the public. It is not uncommon for people with social phobia to fight their fears with alcohol and tranquilizers. The only right way is to see a therapist. He tries to find out the causes of his patient’s fears and to show possible solutions. Confrontation therapy is a tried and tested remedy. Here, the person concerned must face the fear-triggering situations and learn that there is no need to panic.

Specific phobias

Fear of spiders, dogs, flowers, fear of heights – the list of specific phobias appears endless. Ultimately, there is almost nothing that cannot be the subject of a phobia. The things that are feared in a specific phobia can sometimes be very harmless to outsiders and sometimes as completely silly. Nevertheless: The fear for those affected is real and can often severely limit these people in everyday life, which is why it should not be underestimated. With an existing specific phobia, such as arachnophobia, sufferers experience an excessive and persistent fear of a certain thing, in this case spiders, or a certain situation. For example, fear may refer to certain animals, height, blood, or syringes.

Fear of seeing a doctor – Iatrophobia

Visiting a doctor or going for a checkup is completely normal for many. But what should you do if the idea of ​​making an appointment with a doctor triggers panic? Where can those affected find help, if not among the dreaded women and men in white? The sight of a medical center becomes a horror scenario for some of those affected. “Iatrophobia” is the technical term for the pathological fear of going to a doctor. "There are estimates that up to two million people in Germany are afraid of doctors or treatments," says Prof. Arno Deister, President of the "German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology" (DGPPN). Some are reluctant to go to the doctor, others hesitate to visit even with very serious illnesses – until it is too late. "The number of people with real phobia will certainly be lower," says Deister.

But how do you know if you’re just a little scared or have a serious problem? "A certain feeling of discomfort or rumbling in the stomach is completely normal, but sweating or a racing heart are signs of serious panic," explains Markus Beier. He is the deputy chairman of the "Bavarian Family Association". The patients are not necessarily afraid of a particularly bad diagnosis, but of visiting the doctor itself. "This is often accompanied by fear of losing control," explains Christa Roth-Sackenheim, chair of the "Professional Association for Psychiatry and Psychotherapy" from Andernach in Rhineland-Palatinate. "Those affected think they can no longer control their bodies, are worried that they will fall over, make their pants, or say something stupid."

Fear of germs – mysophobia

You never leave the house without disinfectant? Do you panic using a public toilet? Touching a handrail on the bus is out of the question for you and you spend hours with it every day hands wash until they are completely sore?

These are the things that often plague people who are afraid of germs. The fear of bacteria, viruses and dirt is called mysophobia and often restricts those affected. It is not a matter of mere love of order and a penchant for cleanliness, but of the fear of pathogens that can lurk everywhere, but above all, of course, in public spaces; wherever there are a particularly large number of people – such as public transport or self-explanatory worse public toilets or even hospitals. This specific fear can severely limit the everyday life of those affected, if there is already concern about using the bus or touching a doorknob, this is often associated with not being able to carry out many activities in this way.

Most of those affected keep themselves and their home meticulously clean. Outside of your own home, however, this becomes more difficult, which is why physicists often hardly leave the protective house. Things that represent something beautiful for people without this phobia can be a horror scenario for those affected: Sleeping in a hotel bed on vacation and using a third-party bathroom – often a terrible idea for a physicist.

These fears are mostly unfounded, since the likelihood of getting infected with a dangerous illness via the handrail on the bus or an ATM is very low. The need to wash, which usually goes hand in hand, actually favors the risk of infection by destroying the natural skin barriers, which otherwise protect us from germs.

test anxiety

Exam anxiety is the fear of getting a subjectively poor rating in an exam. The causes for this are multifaceted, because those affected usually suffer from a complex, negative self-image. The fear of exams can be classified both as a specific phobia and as a special form of social phobia.

People who are very self-critical, at the same time perfectionistic and very ambitious, who also have low self-esteem, are more likely to be scared of exams than people who have a lot of self-confidence. The reasons for fear of exams lie in the subjective view of an exam situation. Sufferers are terrified of receiving a negative rating in their eyes, which is tantamount to failure in their eyes.

The fear of exam situations can be exacerbated in people with the corresponding predisposition – a negative self-image – by failures they have already experienced and terrifying stories by others. A vicious circle arises in which those affected develop fear of fear. The downward spiral can go so far as to avoid the exam situation and not go to the exam or develop psychosomatic complaints that make you sick before exams.

The reasons for the negative self-image are complex and varied. An overly strict upbringing and parents who are keen to perform well can play a role. If the first failures occur, which lead to the corresponding anger, over time children can develop an exam anxiety that often torments them in adulthood. Early help can prevent those affected from falling into a vicious circle.

An examination anxiety manifests itself through various symptoms. For example, if your child notices that he or she regularly gets sick before the exams, gets a stomach ache or a headache, or appears disproportionately anxious, nervous, tense, perhaps even irritable and aggressive as soon as an exam is due, these are important warning signals. You should take these seriously and react in good time. Talk to your child and try to find out gently and understandingly what is going on in them and what is worrying them. If you notice in yourself that you react regularly before exams with sweating, psychosomatic complaints, poor mental health, poor performance, lack of concentration, excessive nervousness and tension, it is best to seek professional help.

What can you do about your fears??

People with an anxiety disorder often have a very high level of suffering and urgently need help to escape the oppressive spiral of fear. If the fear is very pronounced, the path often no longer leads past the psychiatrist or psychotherapist: The anxiety disorder is then treated with psychotherapy, often with the help of special prescription-relieving medication.

Self help for fears

With mild fears, you can often try very well alone to face the fears and to fight them. The first thing you should do is question your own thoughts when you feel anxiety coming up. Expose fear-triggering thoughts and try to substitute helpful thoughts for yourself. Instead of "If I don’t pass the exam, it’s a disaster" you could say to yourself, "I have prepared myself well, I can repeat the exam if necessary and even if I fail, my life goes on". If you’re afraid of spiders, make sure that this little spider won’t be dangerous for you.

In addition, you can counteract your nervousness and tension with relaxation techniques such as autogenic training or progressive muscle relaxation. If your fear goes far beyond normal worries and minor fears, persists for a long time and causes panic and cannot cope with it alone, it is time to see a doctor or psychotherapist and have this fear treated professionally. An anxiety disorder is a serious mental illness, so it doesn’t have to be uncomfortable for you to get professional help.

Therapy for anxiety disorders

For people with an anxiety disorder that requires treatment, behavioral therapy is often a good measure to “relearn” learned, harmful behavior patterns. Anyone who suffers from strong panic feelings in specific situations gradually gets used to avoiding the situations for fear of fear. Appointments are canceled at short notice, opportunities are not taken and those affected get caught in a spiral of fear. In behavioral therapy, the therapist gently introduces the affected person to the fear-triggering moments and practices alternative, constructive behaviors with him.

Psychodynamic therapy works longer, but more profoundly. You can get help by uncovering and solving internal conflicts that are reflected in external behavior.

In addition, people with anxiety can also do hypnotherapy. Hypnosis helps the patient to relax and to successfully get through the frightening situation in thoughts without fear.


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