Article 3 - Understanding Fear & Anxiety

To better understand the problem, let us explain what is fear / anxiety

Anxiety is a normal human emotion, a defensive reaction of the body to situations that we perceive as a threat. Sometimes however, anxiety can also occur when there is no immediate danger rather when we face oncoming problems which we find difficult to resolve.

Fear dissipates when we get used to the situation that caused it, when the circumstances change, or if you simply leave a dangerous place. However, sometimes it happens that a feeling of anxiety persists for a long time, or even when there is no specific reason for it. This in turn reduces our living comfort which affects our family relationships, our performance at work or our health. When we think that we are in the situation described above we should take more decisive steps and think about seeking out treatment.

The most recognised form of anxiety comes with the fear caused by ‘direct threats’ - such as standing upon a precipice or getting ready to face a dangerous dog. Another kind though is not always so immediate e.g. when our problem is connected with the difficult to solve financial situations or trying to overcome grief.

Although the fear / anxiety is an unpleasant feeling, it often plays a very useful role in our lives, because it is part of the so-called "fight or flight" response and it’s also purposed to assist in the acceleration of our essential, immediate activities. From the point of view of our psyche though the fear reaction makes us cautious e.g. When crossing the road, the physical side prepares us for the action ‘to escape from any danger.’

Fear / anxiety may occur in one of three forms:

Anxiety neurosis / generalized anxiety disorder (GAD):

the most important symptom is difficult to identify - the anxiety that accompanies us in situations that should not be a direct source of anxiety. We can not determine the nature of the threat but we live in chronic anxiety, which can last for many months, and it is characterized by constant worrying, even over the smallest things. No rational arguments help us overcome it, because our "catastrophic" way of thinking is leading the way.

Anxiety neurosis accompanied by a feeling of increased tension, irritability, as well as bodily symptoms, i.e. Heart palpitations, trembling hands, sweating, feeling of choking, headaches, muscle tension, sleep disorders.

Panic attacks, also called panic disorder:

This sudden, unanticipated, terrifying anxiety panic attack, accompanied by a strong fear of death, syncope, and severe somatic symptoms: shortness of breath, dizziness, increased heart rate.

Unreality of objects, distances or unreality themselves intimidated and fear of losing the senses.

Panic attacks are short, very intense and reach a peak within a few minutes, but because it can be repeated and so unexpected, they significantly contribute to the deterioration of our quality of life.

Panic attacks also cause fear of another attack, i.e. fear of fear itself. Therefore the panic of even getting to the doctor or hospital with a ‘suspected’ but undiagnosed one can even bring on the real thing. In many cases however, the anxiety of not understand what is happening to us causes emotional distress - particularly when the doctors say that we are healthy.

Panic attacks can lead to us making behavioural changes in our daily lives. Worrying about the onset of another panic makes us feel helplessness and confusion begins to grow. This often increases our feeling of loss of self-control over own body and life. The fear of another occurrence makes us shun many activities which we were before comfortable with doing e.g. going out alone from home even to the supermarket or church and afraid of travelling. Fear begins to spiral out of control and its subsequent episodes exacerbate it creating a ‘vicious circle’ of symptoms. Anxiety starts to govern our lives - we break off contact with the environment, avoid leaving home and avoid every situation that can in any way be related to experiencing anxiety or exposure to its survival. In extreme cases, we become prisoners of own fear and completely dependent on help coming.

Phobia:

Phobia is a feeling of fear of an object or a situation that is not actually dangerous and in most people does not cause any significant adverse reaction. Frequently the distance from the object of our phobia determines our reaction, the closer to the object of our fear the higher the level of our fear.

There are different types of phobias (2 of the most commonly treated are):

Agoraphobia

Fear of leaving the house is referred to as ‘agoraphobia’ originated from the Greek words agora - the market & phobia - fear. Dictionary of foreign words PWN defines the disorder as "a morbid fear of open spaces, agoraphobia," but agoraphobia is much more than mere apprehension of space: it is also a morbid fear of finding oneself in a situation which is difficult to get out of - where it is difficult to get immediate assistance in the event of a threat. You may be afraid to stay in crowded places, travel by public transport, participate in large gatherings - because that's where there is the greatest risk that something bad might happen. It actually prevents us from normal life, because the fear of leaving even for a cup of coffee, to go to the store, visit public places or a single solitary journey becomes an insurmountable obstacle.

In the above situations, we can feel: accelerated heartbeat, sweating, tremor, dry mouth, nausea, flushing, chills, feeling of numbness or itching. We can experience difficultly breathing, we feel chest discomfort, we feel that something in the back of the throat and we can not swallow - we have a feeling of choking. There is dizziness, loss of balance, fainting, and we feel a worrying sense of loss of connection with objects or our body. These symptoms worsen with our fear of loss of control and this reinforces the concern about the loss of the senses or even death.

Social Phobia

Social phobia as a phenomenon is very common and is characterized by the appearance of intense fear or discomfort in situations where there is a need to make contact with other people. The main problem we experience is our fear of how others perceive us, what others think of us and evaluate us. Fear of criticism, ridicule or embarrassment in the company causes huge discomfort, nervousness, and often severe bodily ailments such as. palpitations, dizziness, nausea and severe flushing. In company sufferers worry over their ability to control their speech, or even avoid speaking completely - critical severe social phobia sufferers avoid being around people. Altogether. Avoiding social situations reduces our sense of self-confidence and strengthens our low self-esteem.

Social phobia in the workplace can manifest itself by avoiding situations that represent a confrontation with colleagues or people perceived as an authority. Avoiding this type of situation, in turn, can dramatically affect our performance at work, promotion and can cause constant stress.

All the above-mentioned types of phobias leading consequently to a significantly reduced quality of life, heighten our problems with taking a job in line with our qualifications, restrict the group of our friends, which in turn further increase our problems and creates so-called. vicious circle of fear. Symptoms of phobia can occur unexpectedly at some point in our lives, if left untreated often last for years, causing that instead of using life withdrawing from it.

What are the most common cause of our anxiety?

Genes - According to genetic research, some of us are born with a predisposition to anxiety and these trends can be hereditary. However, even when not inherited innate tendencies can be subject to fears, when we are under pressure.
Psychology - From the psychological point of view our fears intensify when we begin to treat some of the physical symptoms as a harbinger of a serious physical illness. Concerns related to our health make us begin to worry even more, which exacerbates the severity of symptoms, leading to even greater worry and the formation of the so-called ‘vicious circle.’
Injury / trauma - In some cases, the root cause of our anxiety is obvious and when it disappears, even our feeling of anxiety subsides. But sometimes it happens that when we participated in a situation threatening our lives, or we witnessed the death or injury of others, we feel anxiety for many months and even years after the event.
Drugs - Using measures such as amphetamines, LSD or Ecstasy can cause anxiety. Sometimes a couple of cups of coffee and caffeine contained in them is enough to cause unpleasant concern.
Mental health problems or physical - Some mental disorders, I.e. Depression can in our cause anxiety or panic attacks, the physical ailments e.g. Thyroid disease, may be the cause of our fears.

Sometimes some of the above factors may cause our anxiety. However, in some situations, there is no way to determine what is the cause of our fears because it may be a combination of our personality, major life changes or catastrophic events in our lives.

Help available:

Cognitive Behavioural Therapy (CBT)

Often fear of social stigmatisation thinking others will classify us as a ‘psycho’ or a ‘lunatic’ makes us avoid contact with a specialist, and instead seek suffer in silence. There is no shame in seeking treatment from a professional in the same way you would seek treatment for a physical ailment. Please contact me at Select Healthy Mind to discuss with me whether or not therapy sounds like the right step forward to helping you. As one of the therapies I currently offer ‘Cognitive - Behavioural Therapy’ will help you understand how our "thinking habits" can impair your well-being, or even cause anxiety. This therapy will also help us to identify the causes of your anxiety and help divert thoughts about them and consequently change your behaviour associated with it.

Treatment is carried out through individually tailored sessions, usually arranged once a week and can continue for several weeks. After applying the techniques of CBT. You will begin to take control over your fears and learn to stop avoiding situations and places which previously were related to our unpleasant symptoms.

In milder anxiety computerized cognitive behavioural therapy may be helpful, which I will be able to recommend accordingly.

Pharmacological treatment

In the treatment of fears and phobias certain pharmacological treatments may also be advised through discussions with your G.P. Sedatives such as Valium - benzodiazepines, which include the majority of hypnotics may help particularly in acute, short-term cases. They are very effective in relieving anxiety, but you can easily become addicted to them. Therefore, these drugs should not be taken for longer than 2 weeks, and only during the period of acute crisis. Also, they should not be used in the treatment of panic disorder - panic attacks.

Some antidepressants acan lso help relieve anxiety, although usually theses are prescribed for the treatment of depression. Reducing anxiety usually appears after 2-4 weeks of regular intake.

Herbal Remedies

Studies suggest chamomile (lat. Matricaria recutita) and lemon balm (lat. Melissa officinalis) alleviate anxiety particularly in mild cases.

Organizations offering support in England:

Anxiety UK: Call: 08444 775 774. This is a charitable organization established 30 years ago, its founder suffered agoraphobia. They can help people with anxiety syndrome.

British Association for Behavioural and Cognitive Psychotherapies (BABCP) leads a register of accredited therapists of which ‘Select Healthy Minds’ is one.

Additional sources of information-publications:

Overcoming worry: A self-help guide using cognitive behavioural techniques (Overcoming worries: a guide based on cognitive-behavioural therapy). by Kevin Meares and Mark Freestone (2008). London: Constable & Robinson.

Overcoming anxiety: a five Areas Approach (Overcoming fear: approach five areas). by Chris Williams (2003). London: Hodder Arnold.

Stories and analogies in Cognitive Behaviour Therapy (stories and analogies in cognitive-behavioural therapy). by Paul Blenkiron (2010). Wiley Blackwell.

Available online source of cognitive-behavioural therapy

Living Life to the Full (Live life to the fullest): Free online course to help people and their carers in difficult situations in the development of life skills. It helps to understand why we feel this way and not otherwise, it helps to make a change in thinking and action to improve relations with others.

Fear Fighter (Conqueror of Fear): Free program available in England and Wales, it rewrites therapist or family doctor.

This article was prepared by Barbara Paczkowska, MSc., CBT Psychologist and Therapist - January 2014

If you are accompanied by a feeling of anxiety that persists for a long time or there is no specific reason, your problem may be

....... Anxiety Disorder, panic or phobia.

Understanding Fear & Anxiety