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
- Pain
In addition, pain complaints have been found to correlate positively with postinjury anxiety disorders. [ncbi.nlm.nih.gov]
- Falling
These start-ups are working on alternatives," 8 July 2018 My phobia also seemed to go beyond just a fear of falling. — Ilana Strauss, SELF, "I Was Terrified of Falling, So I Tried Parkour," 9 July 2018 These example sentences are selected automatically [merriam-webster.com]
Somniphobes may fear falling asleep because they associate going to bed with dying. It may also result from a feeling of lack of control or from suffering repeated nightmares. [telegraph.co.uk]
[…] čeka da se spasim nema leka Ne, da se spasim nema leka, ne što te više gubim, više volim te Last edited by barsiscev on Mon, 02/12/2019 - 19:23 English translationEnglish Phobia Once I loved, I was broken love became like a phobia I feel like I can fall [lyricstranslate.com]
[…] of words Monophobia fear of being alone Necrophobia fear of death or dead bodies Nosophobia fear of disease Nyctophobia fear of night or darkness Ophidiophobia fear of snakes Paraskavedekatriaphobia fear of Friday the 13th Philophobia fear of love or falling [infoplease.com]
- Fatigue
Agoraphobia victims also are likely to develop depression, fatigue, tension, spontaneous panic and obsessive disorders. Social phobia involves overwhelming anxiety and excessive self-consciousness in everyday social situations. [psychologistanywhereanytime.com]
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]
Mentally, a person can become so worried about encountering or avoiding a particular situation that it can disrupt sleep, cause fatigue or irritability, or even make it difficult to concentrate on other matters. [medbroadcast.com]
- Fever
Fever related knowledge propaganda after admitted to hospital did not work effectively to improve the caregivers' understanding and management of fever and an effective way to alleviate 'Fever phobia'. [ncbi.nlm.nih.gov]
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]
Pyrexiophobia- Fear of Fever. Pyrophobia- Fear of fire. R Radiophobia- Fear of radiation, x-rays. Ranidaphobia- Fear of frogs. Rectophobia- Fear of rectum or rectal diseases. [symptoms-of-anxiety-depression.com]
Common findings leading to the diagnosis of a perirectal abscess are fever, redness, swelling and tenderness to palpation. [fascrs.org]
- Swelling
Phobia is a collection of 118 presets with many dark and evocative soundscapes, fx, swells and pads, bass, arps and sequences. The main focus-points of Phobia are the Oscillators and Comb filters. [originsofaudio.com]
I had an allergic reaction, and my skin started to swell. The swelling was so bad, I could see each individual pore on my leg and I freaked out. Since then, I have not been able to look at clusters of holes without getting the heebie-jeebies." Just. [web.archive.org]
Common findings leading to the diagnosis of a perirectal abscess are fever, redness, swelling and tenderness to palpation. [fascrs.org]
Symptoms Abscess Superficial abscesses (subcutaneous, submucosal, ischiorectal abscesses) show typical symptoms such as pain, swelling, tenderness, fever. Due to their anatomic location, they often cause discomfort on walking and sitting. [ncbi.nlm.nih.gov]
Respiratoric
- Dyspnea
They may present dyspnea of varying magnitudes and jaundice in some cases.5 The diagnosis is complemented with radiography and computed tomography (CT) studies. [elsevier.es]
Gastrointestinal
- Choking
We present a clinical case of choking phobia in a 32-year-old male patient after an episode of choke when eating chicken. An early diagnosis and distinction from other eating disorders is important for proper treatment and fundamental for prognosis. [ncbi.nlm.nih.gov]
Specify type: Animal Type Natural Environment Type (e.g., heights, storms, water) Blood-Injection-Injury Type Situational Type (e.g., airplanes, elevators, enclosed places) Other Type (e.g., phobic avoidance of situations that may lead to choking, vomiting [web.archive.org]
- 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]
- Vomiting
The volume and range of foods consumed by the participant increased, and observer-rated anxiety and vomiting decreased over the course of treatment. [ncbi.nlm.nih.gov]
Specify type: Animal Type Natural Environment Type (e.g., heights, storms, water) Blood-Injection-Injury Type Situational Type (e.g., airplanes, elevators, enclosed places) Other Type (e.g., phobic avoidance of situations that may lead to choking, vomiting [web.archive.org]
I’m not sure how long I’ve had emetophobia, a fear of vomiting or being sick, but I remember the first time I had a panic attack because of sick I was around 10. [time-to-change.org.uk]
So I’m not sure how, in the following decade, I managed to develop a semen phobia that’s gone from mild dislike to complete and utter disgust, one which has seen me literally vomit after giving head. [metro.co.uk]
- Diarrhea
Fistula between the small and large intestine Diarrhea Passage of undigested food Fistula between the intestine and the bladder Urinary tract infection Burning with urination Cloudy urine or blood in the urine Fistula between the intestine and the vagina [crohnscolitisfoundation.org]
Anxiety can also cause muscle pain or tension, and may even interfere with digestion, resulting in diarrhea, for instance. [medbroadcast.com]
Cardiovascular
- Palpitations
Read More Getting Help People with phobias or OCD have high anxiety and often experience panics - palpitations, ‘jelly' legs, queasiness and absolute terror. Sometimes depression is present too. [topuk.org]
The sensation of having a 'thumping heart' (palpitations). Feeling sick (nausea). Shaking (tremor). Sweating. Dry mouth. Chest pain. A 'knot in the stomach'. Fast breathing. [patient.info]
Physically, anxiety in the face of fear can make a person sweat, breathe heavily, or experience irregular heartbeats (palpitations), dizziness, or faintness. [medbroadcast.com]
- 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]
Skin
- Pruritus
Bland fistulae may excrete pus, sometimes serous fluid and rarely feces, leading to pruritus ani, itching and skin maceration. Severe symptoms occur only occasionally, when spontaneous closure of the fistula leads to recurrent abscess formation. [ncbi.nlm.nih.gov]
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]
Neurologic
- 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]
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