LIFE WITH PHOBIAS

“My mind is on a constant roller coaster ride. I can never quiet my thoughts.
These thoughts are so repulsive to me that I go through intense feelings of
anxiety and panic. When these thoughts begin, I feel like the world is closing
in around me. My body begins to shake and my nerves become raw.
I get instantly dizzy and feel like I could faint at any moment”

These words expressed by a patient at 4.00am shortly after awaking from a deep sleep, underlies the intense urgency and fear experienced at the time. The patient was describing an Acute Phobic Reaction, often called a Panic Attack, one of the most common forms of anxiety disorders.

The word “Phobia” is a term used to describe a persistent, irrational fear that causes a person to feel intense anxieties. It affects people of all ages and all intellectual, income and social levels. It has no respect of geographic or racial differences. They are the most common psychiatric illness among women of all ages and the second commonest among adult men.

Although they may be associated with global triggers, they are most often identified with a single one or common group, which appear to be consistently present. Sometimes the trigger may be easily identified such as heights, enclosed spaces, darkness or specific insects or animals, but most of the time it is not easily identified because of the intense emotional involvement associated. These triggers may arise from any aspect of human thought, behavior or relationship and more than 100 have been identified and named.

The response may vary widely from a mild symptom, easily managed and not causing significant inconvenience, to a full blown panic attack with severe manifestations such as restlessness, shortness of breath, irregular heartbeats, profuse sweating and uncontrollable shaking. In extreme cases these symptoms can immobilize the patient to such an extent that they become prisoners in their homes.

A variety of theories have been offered by Psychologists to explain the causes of phobias, but it is generally accepted that they result from a complex mixture of internal predispositions, external experiences, psychological and biological factors. In any single case a diagnosis is made after a review of the patient’s social, environmental, family and life history, as well as the heredity, genetic and biochemical consideration. All of these may have significant roles in the development and continuation the disorder and must be considered when formulating a treatment plan.

Because of the patient’s underlying fears and anxieties, the management of these disorders is often more difficult than they ought to be. Since the symptoms are invariably precipitated by triggers which may be real, anticipated or imagined. Clearly treatment to be successful, must be directed at their identification and neutralization. To this end, a large variety of techniques and programs have been developed, including desensitization and/or exposure therapy, behavior modification, psychotherapy, hypnosis and relaxation therapy. They have all had fairly good results and are often used in combination.

In addition, a large variety of drugs are available including both psychotropic drugs such as tranquilizers and antidepressants, and drugs designed to correct the brain chemistry such
As beta-blockers.

In the end however, real success can only be achieved by the patient only if he is able to develop good insight and understanding of the mechanisms that gave rise to the symptoms. For it is only by identifying the causative factors can you hope to neutralize and replace them. This requires patience, understanding and a willingness to learn, coupled with the support of a competent therapist with whom a good rapport is essential.

Also because of the nature of the condition and the ease of developing dependency, medications should be used with caution and for short periods, and under no circumstances should they be used on an "as needed" basis.