Content

Introduction

Introduction

A phobia is the overwhelming and debilitating fear developed towards an object, place, situation, sensation or animal.

Phobias are more pronounced than fears and develop when a person feels an exaggerated or unrealistic sense of danger regarding a situation or object.

If a phobia becomes very severe, the person can organize their life in order to limit and / or avoid what is causing their anxiety. In addition to limiting the activities of daily living, it can also cause a lot of distress (Video).

A phobia is a type of disorder that falls under those of anxiety. In fact, no disorder (symptom) may present itself until you come into contact with the element that is causing the phobia.

However, in some cases, even thinking about the source of the phobia can make the person feel anxious or panicked. This phenomenon is commonly known as anticipatory anxiety.

Disorders (symptoms) can include:

  • instability
  • dizziness and lightheadedness
  • nausea
  • sweating
  • increased heart beat (tachycardia) or palpitations
  • shortness of breath
  • tremor
  • stomach upset

If you don't come in frequent contact with the cause of the phobia, your everyday life may not be affected. If, on the other hand, you have a complex phobia, such as agoraphobia, it can be very difficult to lead a normal life.

There is a large variety of objects or situations that can lead a person to develop a phobia. However, phobias can be divided into two main categories:

  • specific or simple phobias
  • complex phobias

Specific or simple phobias relate to a particular object, animal, situation or activity; they often develop in childhood or adolescence and may become less severe with age.

Common examples of simple phobias are:

  • animal phobias, such as dogs, spiders, snakes, or rodents
  • environmental phobias, like heights, deep waters and germs
  • situational phobias, like going to the dentist or flying
  • body phobias, such as blood, vomit, or injections
  • sexual phobias, such as performance anxiety or fear of getting a "sexually transmitted infection"

Complex phobias tend to be more limiting than simple phobias, develop during adulthood and are often associated with a fear, or anxiety, deeply rooted in relation to a specific situation or circumstance.

The two most common complex phobias are:

  • agoraphobia
  • social phobia

Agoraphobia is often seen as a fear of open spaces but, in reality, it is a much more complex condition. A person with agoraphobia will feel anxious to be in a place or situation where the possibility of moving away or, even, escape could be difficult if a panic attack occurs. Anxiety usually arises in situations such as:

  • to be alone
  • being in places open to the public like busy restaurants or supermarkets
  • travel on public transport

Social phobia, also known as social anxiety disorder, focuses on the appearance of an anxious state in social contexts.For example, feeling anxious or even afraid to speak in front of people can generate fear of being embarrassed and humiliated in public. In severe cases, this phobia can become so limiting that it prevents simpler daily activities such as eating out or meeting friends.

Symptoms

Symptoms

All phobias can severely limit daily activities and cause severe anxiety and depression. Complex phobias, such as agoraphobia and social phobia, are more likely to cause these disorders (symptoms).

People with phobias often purposely avoid coming into contact with what causes them anxiety and fear. For example, those who are afraid of spiders (arachnophobia) may obviously not want to touch a spider but also simply look at an image of it.

In some cases, a person may develop a phobia resulting from the very fear of having an anxiety attack. This condition derives from the awareness of the state of discomfort that one can feel and from the attempt to avoid panic attack disorders. The brain can, in fact, react to a situation that is only foreseen and hypothetical, even when one is not really in such a situation. condition.

Physical complaints (symptoms)

People with phobias often have panic attacks. Panic attacks can be very frightening and distressing. Disorders often occur suddenly and without warning.

In addition to an overwhelming state of anxiety, a panic attack can cause a number of physical ailments (symptoms) such as:

  • sweating
  • tremor
  • hot flashes or chills
  • shortness of breath or difficulty in breathing
  • feeling of suffocation
  • rapid heartbeat (tachycardia)
  • chest pain or tightness
  • feeling of butterflies in the stomach
  • nausea
  • headache and dizziness
  • feeling faint
  • numbness or tingling
  • dry mouth
  • need to go to the bathroom
  • ringing in the ears
  • confusion or disorientation

Psychological disorders (symptoms)

In severe cases, psychological disorders such as:

  • fear of losing control
  • fear of fainting
  • feeling of dread
  • fear of dying

Complex phobias

Complex phobias such as agoraphobia and social phobia can often have detrimental effects on a person's daily life and mental well-being. Agoraphobia often involves a combination of several related phobias. For example, a person with a fear of going out or leaving their home may also be afraid of being alone (monophobia) or being in places where they feel trapped (claustrophobia).

The disorders (symptoms) experienced by people with agoraphobia can vary in severity. For example, some may feel very apprehensive and anxious if they have to leave their home to go shopping. others may feel relatively comfortable traveling a short distance from home.

To a person suffering from a social phobia, the very thought of showing up in public or attending a social event can cause fear, anxiety and vulnerability.

Intentionally avoiding meeting people in social situations is a sign of social phobia. In extreme cases of social phobia, such as with agoraphobia, it is possible, due to too much fear, to make it impossible to leave one's home.

Causes

Causes

Phobias do not have a single cause, but are the result of a series of associated factors.
For example they can be:

  • associated with or resulting from a particular accident or trauma
  • responses or behaviors learned from a parent or brother / sister
  • derive from genetic characteristics, In fact, scientific evidence indicates that some people have an innate tendency to be more anxious than others

They can develop during infancy, adolescence or early adulthood. Often they are related to a fright or a particularly stressful situation; however, the causes at the origin of some phobias are not always clear.

Specific or simple phobias

Phobias, such as fear of heights (acrophobia), usually develop in childhood. Simple phobias can often be linked to a negative "childhood experience. For example, if you are trapped in a confined space when you are particularly young, you may develop a fear of enclosed spaces (claustrophobia)," which then persists into a younger age. It is believed that phobias can also be "learned" from an early age. For example, if someone in the family is afraid of spiders (arachnophobia), it is possible to develop the same phobia. A number of other factors present in the family environment. , such as the presence of particularly anxious parents, can be an example and guide how to deal with anxiety states in the course of life.

Complex phobias

The underlying causes of complex phobias, such as agoraphobia and social phobia, are not well known. However, it is believed that genetic predisposition, functioning at the level of biochemical processes in the brain and life experiences may play an important role in these types of phobias. The physical reactions (disturbances) that a person experiences in front of the object of their fear are real and are not limited to simply being "in their head". The body reacts to the threat by activating and releasing adrenaline, resulting in physical symptoms such as:

  • sweating
  • tremor
  • shortness of breath
  • rapid heartbeat (tachycardia).
Diagnosis

Diagnosis

Phobias are often not ascertained (diagnosed). Most people who have a phobia are fully aware of the problem and can choose to live with their fear, being very careful to avoid the object or situation that triggers it without ever going to the doctor. However, when there is one. important phobia, constantly trying to avoid what you are afraid of, can be very limiting for your life. In the presence of a phobia it is important to seek help from your doctor. He can refer you to a specialist such as, for example, a psychologist clinical.

Therapy

Therapy

Many people with a minor phobia don't necessarily need treatment. Sometimes, in fact, it may be enough for them to avoid the object of their fear to keep the situation under control.

However, in other cases it may be difficult to avoid certain situations and the related phobia, as occurs, for example, for the fear of flying. In these cases, it is advisable to ask your doctor for help to get information on treatment options.

Most phobias, in fact, are manageable, even if it is not possible to ensure a specific cure for all the different types. In some cases, a combination of different treatments may be recommended.

The main types are:

  • self-help techniques
  • treatments based on psychological therapy
  • medications

Treatments based on psychological therapy

Treatments based on psychological therapy, such as analysis of the causes and psychotherapy, represent very effective methods for the treatment of phobias. In particular, the therapy cognitive-behavioral (CBT) and the meditation or mindful attention (mindfulness) have also been found to be of considerable efficacy for the treatment of phobias.

CBT allows you to manage problems by actively modifying the person's way of thinking and behavior. It is generally indicated for developing practical ways of dealing with phobias. A part of the treatment process with CBT, especially in the case of simple phobias, involves a "gradual exposure to fear, in order to accompany the person to a less anxious approach, according to a technique known as desensitization or exposure therapy. For example, if you are afraid of snakes (ophidiophobia), the therapist might start by having books read about snakes, and then show a picture of a snake. A visit to the local zoo's reptile house to observe some snakes may then follow. from life The final step could be to touch a snake.

There exposure therapy it works by gradually increasing the level of exposure to fear, allowing you to gain control of the phobia and, as treatment progresses, to feel less anxious.

Specific or simple phobias

Medicines

Medicines are usually not recommended for the treatment of phobias, because treatments based on psychological-behavioral therapy are generally effective and do not give rise to side effects. However, it is sometimes possible that drugs are prescribed for short periods in order to control the effects of phobias, such as states of exaggerated anxiety. Three types of drugs are generally recommended for the treatment of anxiety: tranquilizers, antidepressants, beta-blockers.

Antidepressants
Antidepressants, including selective serotonin recovery inhibitors (SSRIs) are typically prescribed to treat anxiety, social phobia, or panic disorder and can include: escitalopram, sertraline, paroxetine.There venlafaxine, a serotonin and norepinephrine recovery inhibitor (SNRI) may also be prescribed for anxiety.

The most common side effects (side effects) of these treatments can include:

  • nausea
  • headache
  • sleep problems
  • stomach ache

They can also initially worsen anxiety and cause sexual problems.

Clomipramine is a type of tricyclic antidepressant (TCA) that is more specifically indicated to treat phobias.

Undesirable effects (side effects) can include:

  • dry mouth
  • drowsiness
  • blurred vision
  • tremors and shaking
  • palpitations (irregular heartbeat)
  • constipation
  • difficulty urinating

The moclobemide is a type of antidepressant from the group of monoamine oxidase inhibitor antidepressants (MAOIs). It is sometimes prescribed to treat social phobia. It interacts with certain types of food, so as described in the information leaflet that is provided, it is necessary to avoid certain types of food (read the Bufala).

Other possible side effects of moclobemide are:

  • sleep problems
  • dizziness
  • stomach problems
  • headache
  • restlessness
  • agitation

If antidepressants are prescribed, it is very important not to suddenly stop taking them. Suddenly stopping them can cause withdrawal symptoms. It is therefore advisable to always consult your family doctor who can gradually reduce the dose.

Tranquilizers
Benzodiazepines are a group of drugs classified as minor tranquilizers. They include drugs such as diazepam and are sometimes used for short periods to treat exaggerated anxiety conditions. Like antidepressants, benzodiazepines need to be phased out gradually to avoid withdrawal symptoms.

Beta blockers
Beta blockers are often used to treat cardiovascular problems, such as heart disease and high blood pressure (hypertension). Sometimes they are also prescribed to help reduce anxiety disorders, such as palpitations (irregular heartbeat). Beta blockers slow the heart rate and lower blood pressure. Propranolol is a beta-blocker commonly used to treat anxiety states.
Possible side effects are:

  • stomach problems
  • cold fingers
  • tiredness
  • sleep problems
Prevention

Prevention

Self-help

Each phobia is different and no specific self-help program appears effective for all types. You may decide to implement a self-help strategy or seek the support of a mental health specialist.

A self-help program can include:

  • lifestyle changes
  • cognitive behavioral therapy (CBT) course
  • attend a self-help group
  • apply exposure therapy in order to gradually overcome fear
  • a combination of these factors

Making a few simple lifestyle changes can reduce the ailments of a phobia, such as panic attacks.
Factors to consider may include:

  • regular physical activity
  • healthy and regular meals
  • get enough sleep
  • reduce or avoid caffeine and other stimulants

There exposure therapy (desensitization) involves a gradual increase in the length of time in which to expose yourself to the phobia. First, fears need to be analyzed to identify which situations cause the most anxiety. Then, gradually practice these activities until you observe a reduction in anxiety. It is good to start with small steps by setting daily or weekly goals, in situations that are not too demanding. The more you exercise, the less anxiety you will feel.

Below are some situations that can be considered to gain greater control over social phobias:

  • eating with a close relative, friend or acquaintance in a public setting
  • highlight eye contact and return greetings from others or be the first to say hello
  • to compliment someone
  • get help from a shop assistant to find an object
  • ask a stranger for directions
  • show an interest in otherssuch as asking them about their home, children, grandchildren, hobbies, or travel
  • contact a friend to arrange business plans

For example, for agoraphobia you can start by going away from home for very short periods of time, and then gradually increase the time you spend outside and the distance you walk from home. Exposure therapy can be a very effective way to allow you to cope with anxiety.

Other self-help techniques are:

  • relaxation techniques, a series of physical exercises that can help you relax and control your breathing
  • visualization, combines relaxation and breathing techniques with mentally visualizing how to successfully cope with a situation that could cause anxiety
  • self-help groups, useful way to meet other people with similar experiences and share with them ways of coping with the phobia
Bibliography

Bibliography

NHS. Phobias (English)

Mayo Clinic. Social anxiety disorder (social phobia) (English)

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