Presentation
A panic attack is the most common and disabling symptom of a phobia. With a panic attack, the individual presents with a pounding or racing heart, shortened breath, rapid speech or cessation of speech, dry mouth, nausea or upset stomach, elevated blood pressure, shaking or trembling, chest pain or tightness, choking sensation, dizziness or lightheadedness, excessive sweating, heightened expectation of disaster, etc. [6].
However, it is not compulsory for these presentations of panic attacks to be visible for accurate diagnosis. The intensity of the anxiety can also vary among people with phobias.
Entire Body System
- Severe Pain
Fissures typically cause severe pain and bleeding with bowel movements. Fissures are quite common in the general population, but are of... [fascrs.org]
Respiratoric
- Cough
HBF usually appear in the context of a florid infection, with fever and leukocytosis, abdominal pain in the right hypochondrium and occasionally pleuritic pain and cough. [elsevier.es]
Gastrointestinal
- Nausea
In addition, they were more likely to have a comorbid diagnosis of a physical health condition, to report more exaggerated danger expectancies, and to report fears that focused more on physical symptoms (e.g., faintness and nausea) in comparison to youth [ncbi.nlm.nih.gov]
Physical symptoms, including rapid heartbeat, lightheadedness, nausea, shortness of breath, and trembling occur. [pchtreatment.com]
SSRIs may initially cause nausea, sleeping problems, and headaches. If the SSRI does not work, the doctor may prescribe a monoamine oxidase inhibitor (MAOI) for social phobia. Individuals on an MAOI may have to avoid certain types of food. [medicalnewstoday.com]
Cardiovascular
- Tachycardia
The fight-or-flight response is characterized by an increased heart rate ( tachycardia ), anxiety, increased perspiration, tremour, and increased blood glucose concentrations (due to glycogenolysis, or breakdown of liver glycogen ). [britannica.com]
- Hypotension
Standing up too quickly can cause "postural hypotension." Postural hypotension can cause you to faint if you aren't careful, but it is not nearly as terrifying as the fainting caused by a vasovagal reaction. [needlephobia.com]
Psychiatrical
- Fear
"irrational fear, horror, aversion," 1786, perhaps on model of similar use in French, abstracted from compounds in -phobia, from Greek -phobia, from phobos "fear, panic fear, terror, outward show of fear; object of fear or terror," originally "flight" [thesaurus.com]
Among the more common examples are acrophobia, fear of high places; claustrophobia, fear of closed places; nyctophobia, fear of the dark; ochlophobia, fear of crowds; xenophobia, fear of strangers; and zoophobia, fear of animals. [britannica.com]
Eighty-one percent reported to have a certain amount of fear of TCS. [ncbi.nlm.nih.gov]
- Chronic Anxiety
Social anxiety causes chronic anxiety and fear over social situations. [socialphobia.org]
Neurologic
- Confusion
संबंधित सामग्री देखें English Quiz Confusables कोलिन्स से नया! Collins! [collinsdictionary.com]
Rehashed... remnants of the born Rehashed... life has no remorse Consistence to persistence Build your self-esteem Lifeless life has solitude Mentally can be confused Rehashed... remnants of the born Rehashed... life has no remorse Life is full of imbeciles [phobiaband.bandcamp.com]
Generally you notice the commitment of the team, which perhaps could have dared slightly more: some puzzles are too trivial, others require excessive backtracking and can confuse the player a lot. [metacritic.com]
The story is interesting but ultimately, purposefully, confusing. If you’re a fan of the exploration and puzzles element of these types of games then that’s where Fobia – St. Dinfna Hotel’s strength lies. [playstationcountry.com]
Now, Please Click on Registration What We Offer √ Access to the copyright 4PEP program with information on diet, nutrition, physical activity, sleep, stress management, vitamin B complex and vitamin D optimization √ 12 Articles to help understand the confusing [lymphomasurvival.com]
- Headache
Side effects may initially include dizziness, an upset stomach, restlessness, headaches, and insomnia. Taking a tricyclic antidepressant (TCA), such as clomipramine, or Anafranil, has also been found to help phobia symptoms. [medicalnewstoday.com]
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If this technique triggers headaches, make sure you are tensing ONLY your body, arm and leg muscles, and NOT your face and head muscles. [getselfhelp.co.uk]
They take several weeks to start working and may cause side effects such as headache, nausea, or difficulty sleeping. [web.archive.org]
- Agitation
Initially, this was because of difficult venous access but more recently because of severe distress and agitation when approached with a cannula. [ncbi.nlm.nih.gov]
"I get easily agitated." "I can be stirred up easily.". * Anxiety: " I worry about almost everything ." "I'm always fearful or on edge about bad things that might happen." "I always expect the worst to happen." "I am a very anxious person." [mentalhealth.com]
- Insomnia
Side effects may include an upset stomach, fatigue, insomnia, and cold fingers. Antidepressants: Serotonin reuptake inhibitors (SSRIs) are commonly prescribed for people with phobias. [medicalnewstoday.com]
- Stroke
A therapist (or a friend) could help by gently stroking the front of the person’s tongue until they get used to it, which might take half an hour or so; then work further back on the tongue, etc. [anxietycare.org.uk]
Workup
When it comes to diagnosis, there are no diagnostic laboratory tests for phobias. Diagnosis is most of the time dependent on the patient’s account of their experiences. [7]
To rule out anxiety secondary medical conditions however, some laboratory tests can be carried out. Some of this includes drug screening for substance-induced anxiety, fasting glucose to rule out hypoglycaemia, thyroid function tests to rule out hypo/hyperthyroidism and 24-hour urine for 5-hydroxyindoleacetic acid (5-HIAA) for pheochromocytoma.
Treatment
Treatment for phobias generally involves therapeutic techniques, medications and a combination of both. [8]
Cognitive behavioural therapy is the most commonly used therapeutic treatment for phobias. It involves an exposure to the source of the fear in a controlled environment. The treatment has deconditioning abilities and can reduce anxiety. The therapy focuses on identifying and changing negative thoughts, dysfunctional beliefs, as well as negative reactions to fear. Some of the newer techniques expose the patient safely to the source of the phobia.
Antidepressant and anti-anxiety medications can also help calm the mind and physical reactions to fear [9]. Most of the time, the best results are seen with a combination of medications and professional therapy.
Prognosis
Following proper resolution of symptoms, most phobia patients will respond to treatment [5]. The most positive outlook is seen in patients with a specific phobic disorder while those that have social anxiety disorders or agarophobia display residual symptoms. Such individuals also face the risk of a reoccurrence following successful treatment. However, patients who have social anxiety disorders with extensive deficits in social skills generally find it hard to respond positively to treatment.
Etiology
There is no singular etiologic factor for development of a phobia. However, there are several factors that may contribute to its development [2]:
Specific incidents or traumas
An individual that had a harrowing flying experience at a young age may end up developing a phobia about flying.
Responses picked up in early life
It is possible to develop the same specific phobia as a parent or an older sibling. Factors in the family environment such as worried or anxious parents can have an effect on the way you cope with anxiety much later in life.
Genetics
It has been proven that some individuals are born with the tendency to be more anxious than others.
When an individual has a strong reaction or panic attack following a particular situation or subject and people around react in an embarrassment inducing manner, he or she can develop intense anxiety about ever being in such a situation again.
Stress
Long term stress can lead to feelings of anxiety and depression making it harder for the individual to cope in certain situations. This will leave them feeling more fearful or anxious about being in such a situation ever again. Over a long period of time, this can lead to the development of a phobia.
Epidemiology
Phobias are a relatively common form of anxiety disorders [3]. Its distribution is heterogeneous by age and gender. In the United States between 8.7% and 18.1% of people suffer from phobias. It is also the most common mental condition among women across all age groups and the second most common illness among men that are older than 25. Around 10% of all children experience specific phobias during their lives and social phobias also occur in 1-3% of children and adolescents.
Studies have also shown that women have a higher incidence of phobias than males. Figures show 26.5% for females and 12.4% for males. Multiple phobias can be found in 4% of females and 1.5% of males. Women are 4 times more likely to have a fear of animals compared. This is the highest disparity in incidence amongst all other forms of social phobias. Other phobias such as situational and social phobias are also more common in girls than in boys.
Pathophysiology
The underlying mechanism in the development of phobia is an interaction between the amygdala, anterior cingulate cortex and insula hyperactivity [4]. This theory was put forward following research which showed significant reductions in site-specific neural activity in these areas following evidence-based exposure treatments. Neuroimaging studies have also shown an increase in amygdala activation following exposure to cues relevant to the phobia as well as heightened activity in the insula and the dorsal anterior cingulate cortex regions.
Prevention
The most common way to prevent phobic disorders is to tackle it at the bud by ensuring the individual receives psychotherapy or medication following any form of overwhelming exposure [10].
Summary
A phobia is a debilitating and overwhelming fear of a place, object, situation, feeling or animal [1]. The phobias are much more pronounced than fears. It develops when the patient has a heightened and totally unrealistic sense of danger about a situation or object.
Severe cases of phobias may lead to an individual reorganising their life to avoid the things that are responsible for the heightened fear. This will lead to a disruption of day-to-day life and also lead to considerable anguish.
A phobia is a type of anxiety disorder. This means that the individual may not show any symptoms until they come in contact with the source of the phobia. However, it is possible for an individual to feel anxious or panicky by just thinking about the source of a phobia, a condition referred to as anticipatory anxiety.
Patient Information
A phobia refers to an overwhelming and unreasonable fear of a subject, object, situation which poses small real danger but provokes the feeling of avoidance or anxiety in an individual. Unlike the small anxiety people feel with taking tests of addressing a crowd, a phobia lasts far longer and causes some form of intense physical and psychological reactions which often affect the patient negatively at work or at play.
There are various types of phobias. Some people are scared of large spaces while others cannot cope with some social situations. Others on the other hand have a specific phobia like the fear of dogs, heights or air travel.
Most phobias don’t require treatment but if it gets to the point of affecting your daily life negatively, therapies and treatments can be deployed to help overcome the fears permanently.
References
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Washington, DC: American Psychiatric Association Press; 2000.
- Mathew SJ, Coplan JD, Gorman JM. Neurobiological mechanisms of social anxiety disorder. Am J Psychiatry. Oct 2001;158(10):1558-67.
- Kendler KS, Karkowski LM, Prescott CA. Fears and phobias: reliability and heritability. Psychol Med. May 1999;29(3):539-53.
- Fyer AJ, Mannuzza S, Chapman TF, Liebowitz MR, Klein DF. A direct interview family study of social phobia. Arch Gen Psychiatry. Apr 1993;50(4):286-93.
- Van Houtem CM, Laine ML, Boomsma DI, Ligthart L, van Wijk AJ, De Jongh A. A review and meta-analysis of the heritability of specific phobia subtypes and corresponding fears. J Anxiety Disord. May 2013;27(4):379-88.
- LeBeau RT, Glenn D, Liao B, et al. Specific phobia: a review of DSM-IV specific phobia and preliminary recommendations for DSM-V. Depress Anxiety. Feb 2010;27(2):148-67.
- Bourne, Edmund J. (2011). The Anxiety & Phobia Workbook 5th ed. New Harbinger Publications. pp. 50–51.
- Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington D.C.: American Psychiatric Association. 1994. p. 406. ISBN 0-89042-062-9.
- Bolles, R. C. (1970). "Species-specific Defense Reactions and Avoidance Learning". Psychological Review 77: 32–38
- Kendall, P. C., Aschenbrand, S. G., & Hudson, J. L. (2003). Child-focused treatment of anxiety. In A. E. Kazdin, J. R. Weisz (Eds.) , Evidence-based psychotherapies for children and adolescents (pp. 81-100). New York, NY US: Guilford Press