Specific Phobias

Person holding small gray snake on hand

Persistent Fear Of An Object Or Situation

A phobia is a type of anxiety disorder that causes a person to fear a certain object or situation. It’s not known why phobias occur in some people but not in others, but it’s safe to say that genetics and the environment are at play once again. Genetics dictate our personality traits, so if your parent had a specific phobia towards spiders, there’s a good chance that you will too.

The environment plays a role as well. For instance, if you were bit or startled by a spider as a child, the environment has now conditioned you to be afraid of spiders from that point on. There are many different types of phobias:

  • Pteromerhanophobia: fear of flying
  • Claustrophobia: fear of enclosed spaces
  • Trypanophobia: fear of needles
  • Astraphobia: fear of storms
  • Gynophobia: fear of dogs
  • Agoraphobia: fear of places and situations that might cause panic, helplessness, or embarrassment

. . . and the list goes on. But just because you have a phobia does not mean that you cannot get rid of it. Therapy such as exposure and response prevention is exactly what it sounds like: a person is exposed to their phobia and are refrained from their ritualistic or compulsive behavior that functions to decrease their distress.

It’s also known as “flooding”: the person is placed in a situation that causes them to encounter their fear without escape. An example is a flight simulation room for people who are afraid of flying. The person is exposed to the flight simulator, causing them excessive fear and anxiety, but they are not allowed to leave the room until their fear and anxiety have dissipated.

Many people can have a fear or general discomfort to the most common phobias, but they do not allow them to affect their lives. But someone with a phobia cannot function when it comes to their fear. For instance, if a person is required by their job to fly to different conferences around the world, they will request from their boss to be reassigned another position.

Or worse, they will attempt to fly and have the worst panic attack of their life, possibly requiring a medical evaluation and disruption of public affairs. After one or two awful experiences, they will most likely quit their job. But someone with a general discomfort towards flying will continue to fly if need be, with no adverse effects.

That is the difference between a person with a general discomfort towards something and someone with a specific phobia. It almost always comes down to perception: how you view yourself and your surroundings dictates how you will interact with your environment. The best medication is you! You have the power to change how you think, and the objective almost always comes down to, “what can I do to change my perception of my reality?”

If you can figure that out, then you’re on the right path to defeating your phobia.

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Are you Ready? (This is Defeating Stigma Mindfully)

Escaping Panic Attacks

Anxious man holding his head during a panic attack

How To Help Someone With Panic Attacks

Anyone who has ever experienced a panic attack will tell you that it’s one of their worst experiences; maybe more terrifying than a natural disaster. Panic attacks are like intruders who invade your mental space and do not allow you to have peace. They disrupt everything about you during those 5-10 minutes. Escaping panic attacks must be done right!

The more that you fight a panic attack, the greater it becomes in strength. Panic attacks want you to fight them, because they strive on your fear, pain and struggle. Panic attacks are also very sneaky: they’re like snakes coming from behind you and snapping without your awareness.

But once you become cornered by a panic attack, you become more aware of them than anything else. Your surroundings quickly become irrelevant as all you can focus on is the war zone that has just erupted in the depths of your mind. And just as any war zone, you become fearful for your life and consider running away from your current location to hide in a safe haven.

But there is no safe haven outside of your immediate surroundings. Because if you do run away, you are actually beating yourself up. What do you accomplish by running away? You may be in an important meeting, in a room full of people or even seeing a patient in the office; running away will make your current situation awkward.

The safe haven lies in your mind; it always has and it always will. Panic attacks are just intruders that capitalize on the chemical imbalance in your brain; their high is your low! As long as your serotonin levels remain on the low side, panic attacks remain high and elated. So when you attempt to run, you are actually running away from yourself, because everything is happening within your mind.

Besides medications such as antidepressants or benzodiazepines and psychotherapy, such as CBT or psychodynamic, the real way of helping yourself or someone else from panic attacks is by learning how to become comfortable with panic attacks when they do strike. Medications and psychotherapy do help a lot, but if you cannot learn how to become comfortable in your own skin during the attacks, you will continue to struggle.

Experience is key. The more panic attacks you have under your belt, the more comfortable that you become at handling them. And the way to handle them is to remain calm in your present environment and continue to focus on what you were doing prior to the attack. This technique helps prove to yourself that you are still in control of your mind and that you do not have to get up and leave.

You can also try incorporating a technique such as massaging your hands without making it noticeable to those around you. For most people, hand massages feel good and put you in a state of relaxation. Hand massages can be a coping mechanism that you only perform when cornered by a panic attack: they help redirect your thoughts to the good feeling of your hands, and take away your focus from the uncomfortable sensations of the panic. Call it a “hand job” if need be.

Overall, the only way to properly escape a panic attack is by not reacting to it. No matter how difficult and uncomfortable it may be to ride it out, the more experience you have remaining cool, calm and collected during the attacks, the more control that you will gain over future ones.

Are you Ready? (This is Defeating Stigma Mindfully)

Illness Anxiety Disorder

Anxious brunette man with illness anxiety disorder sitting at table using MacBook

The Fear Of Having A Serious Disease

Illness anxiety disorder (formerly known as hypochondriasis) is the fear of having or developing a serious illness. Patients experience a misinterpretation of bodily symptoms and have heightened bodily sensations. They are also very anxious about the possibility of having an undiagnosed illness.

They’ll devote excess time and energy to health concerns and obsess over them, despite reassurance on multiple occasions by medical professionals that nothing is wrong with them. They’ll even obsessively research an illness which they think they might have, in order to gather more information that can somehow be connected to their bodily sensations.

Patients may or may not have a medical disorder. If they do happen to have one, it may or may not be related to the development of their illness anxiety disorder. They won’t deny their medical condition, but they’ll remain preoccupied with developing another one or having an illness that may be undiagnosed.

Their beliefs are not of delusional intensity, meaning that even if they are medically reassured, they will not go home believing that a cancer is growing in their pancreas. They’ll just end up going home anxiously worrying about the possibility of acquiring pancreatic cancer. There’s a difference between the two: delusions are fixed false beliefs and the latter is an extreme anxiety disorder regarding the acquirement of an illness.

Patients with illness anxiety disorder may experience extreme distress, impairment and life disruption. Imagine going to work and always worrying about having or developing a serious disorder. Imagine the distraction that this anxious thought process would bring upon your work productivity, communication and state of mind.

The duration of these symptoms must last > 6 months in order to be diagnosed with illness anxiety disorder. It commonly begins in early adulthood and has a chronic waxing and waning pattern, meaning that the symptoms may remit and come back at some point in the future. Prevalence in the general population is about 1-5%.

Treatment is centered on behavioral therapy, reassurance and the encouragement to continue living a normal and stress-free life. Medical appointments with a primary care provider (PCP) are recommended on a monthly basis, in order to maintain a therapeutic alliance with the patient and provide them with reassurance.

If you or someone you know is suffering from illness anxiety disorder, please try to understand where they are coming from. Don’t tell them “you’re crazy” or “you don’t have anything” because it’ll only backfire. Compassion and careful listening often go a long way to helping patients better cope with their mental illness!

Are you Ready? (This is Defeating Stigma Mindfully)

Agoraphobia With Panic Disorder

Blonde woman sitting along window suffering from agoraphobia

Fear Of The Marketplace

Imagine being trapped in your mind, not being able to function in the physical world because your confidence is handcuffed in your unconscious world. You open your eyes early morning and a flood of thoughts come rushing in: “you cannot go to the mall today”, “you will have a panic attack if you go to lecture”, “you cannot leave your home or else you will end up in the emergency room.”

This is the mental illness known as agoraphobia or the fear of being in public places. The patient’s rational is that a public place will cause humiliation or will be difficult to escape if a panic attack occurs. Usually, a person has experienced panic attacks prior to the development of agoraphobia, but the latest classification now lists agoraphobia as an independent disorder.

Some patients with agoraphobia cannot even leave their own home; stepping out of the front door brings upon a great fear. Can you imagine their quality of life? Try to put yourself in their shoes and experience the pain, suffering and depression that they go through on a daily basis!

How about patients who also have a comorbidity such as panic disorder? They muster up the courage to leave their house and attend a feared setting, only to be bombarded with a racing heart, a sense of doom and a feeling of detachment from their body! Their 911 alarm has rung again and they must now return to their prison cell known as “home.”

The important lesson learned here is that those of us who do not experience a mental illness, must remain thankful for being able to live our lives without worry and concern. And we must always be willing to offer help to someone who is suffering from a mental illness; they need all the support that they can get to defeat their struggles and enjoy life again as we do!

Are you Ready? (This is Defeating Stigma Mindfully)