Along came a spider…

Experts agree that collectively, phobic disorders are the most common forms of psychiatric illness, surpassing rates of mood disorders and substance abuse.

“A fear is an automatic response that is triggered by our fight-or-flight survival mechanism in our brains. This is an essential tool necessary for our survival,” says Durban clinical psychologist Justine Bartlett, who specialises in treating specific anxiety disorders.

“When we are in danger, our autonomic nervous system is triggered and releases adrenalin – and this allows us to either flee the danger or to fight it. Phobias are intense and uncontrollable fears that are then followed by avoidance behaviours of the trigger/s of that fear.”

For some people, anxieties and fears are overwhelming and persistent. Normal coping mechanisms do not work, and the need to avoid the objects or situations that cause anxiety can be so intense that it drastically interferes with daily life.

According to the Anxiety Disorder Association of America, while some phobias develop in childhood, most seem to arise during adolescence or early adulthood. Their onset is usually sudden, and they may occur in situations that previously did not cause any discomfort or anxiety.

Scientists are learning more about the particular brain regions that are associated with phobic fears. Phobias are thought to be caused by a combination of biological factors and life events, much in the way other disorders are influenced by a person’s genes and lifestyle.

Phobias can take on three main forms. People who experience seemingly excessive and unreasonable fears in the presence of or in anticipation of a specific object, place, or situation have a specific phobia (most common being animals, insects, heights, thunder, driving, public transportation, flying, dental or medical procedures and lifts.)

A new paper published in Current Directions in Psychological Science, a journal of the Association for Psychological Science, reviews research with infants and toddlers. The study found that people were not born afraid of spiders and snakes, but learned these fears.

One theory about fear of spiders and snakes is because so many are poisonous; natural selection may have favoured those who stayed away from these dangerous critters. Indeed, several studies have found that it is easier for humans to learn to fear evolutionarily threatening things than non-threatening things. A social phobia, Bartlett explains, is an irrational anxiety in certain social/ performance situations that leads to avoidance behaviour. “This is an intense fear of becoming humiliated in social gatherings or in a situation where the individual has to give a speech or presentation.”

This should not be confused with shyness. Shy people can be very uneasy around others, but they don’t experience extreme anxiety. In contrast, people with social anxiety disorder are not necessarily shy.

Finally, agoraphobia (with or without panic attacks) is an irrational anxiety in places where it is believed that escape may be difficult, such as shopping malls, public transportation or sports arenas.

“Some people develop a fixed route or territory, and it may become impossible for them to travel beyond their safety zones without suffering severe anxiety,” says Barlett.

About one in three people with panic disorder develops agoraphobia. It helps to know that phobias are treatable, now that mindfulness techniques have been developed that can change the way the anxious brain is wired.

Bartlett believes that the best treatment option is often a combination of medication and cognitive behavioural therapy (CBT). “Because an anxiety response is so physical, a typical client of mine has usually sought out a medical explanation and once this has yielded no results, they are referred to a therapist.”

Medication to lower the level of physical activation is recommended when heightened anxiety is disrupting daily functioning.

“Treatment can then begin on a cognitive level. This involves working out which irrational thoughts are causing the anxiety, and developing tools together with the therapist to challenge those beliefs,” she says.

“Success of treatment varies among people. It may be complicated if people have more than one anxiety disorder or suffer from depression or substance abuse. This is why treatment must be tailored to the individual,” says Bartlett.

l Contact Justine Bartlett at 031 564 0443 or the South African Depression and Anxiety Group at 011 262 6396

Signs and symptoms of phobias

The symptoms of a phobia can range from mild feelings of apprehension and anxiety to a full-blown panic attack. Typically, the closer you are to the thing you’re afraid of, the greater your fear will be. Your fear will also be higher if getting away is difficult.

Physical signs and symptoms of a phobia: Difficulty breathing; racing or pounding heart; chest pain or tightness; feeling dizzy or lightheaded; a churning stomach; hot or cold flashes; tingling sensations; sweating; trembling or shaking

Emotional signs and symptoms of a phobia: Feeling of overwhelming anxiety or panic; feeling an intense need to escape; feeling ‘unreal’ or detached from yourself; fear of losing control or going crazy; feeling like you’re going to die or pass out; knowing that you’re overreacting, but feeling powerless to control your fear

Five Unusual Phobias:

Alektorophobia: Fear associated with chickens.

Catoptrophobia: Fear associated with mirrors.

Geniophobia: Fear associated with chins.

Logizomechanophobia: Fear related to computers.

Oenophobia: Fear related to wines. - The Mercury