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What does fear mean?
Fear is a developmentally ancient emotion that protects us humans from dangers to this day and compels us to exercise caution. Almost no one is free of it. Natural fear helps us to avoid accidents or illnesses and to avoid or prepare for dangerous situations. It is closely interwoven with physical processes and can accordingly also be caused by organic disorders. The interplay of disposition and life story determines our personal willingness to fear, but this can be influenced, for example by psychological counseling or naturopathic measures.
Anxiety Disorders - A Brief Overview
Diseases associated with some form of exaggerated anxiety are common. Around 20 percent of all people in Germany develop at least one form of such a disorder in the course of their life. In addition to depression, anxiety disorders are the most common mental illnesses. Here is a brief overview:
- definition: In the case of an anxiety disorder, the natural emotion of fear is perceived to an abnormal extent and has a massive impact on the everyday life of those affected.
- Symptoms: Avoiding certain places, things or situations, isolation, dizziness, feelings of oppression, cold sweat, impaired consciousness, nausea, hot flashes, pallor, trembling hands, feeling of an impending disaster, fainting
- to form: Four often occurring forms of pathological fears are described in medicine, which can also occur in combination. These include panic disorders, generalized anxiety disorders, social anxiety disorders and specific phobias.
- Panic disorder: This form is characterized by the regular occurrence of panic attacks, which vary in length and frequency. Between attacks, sufferers suffer from constant fear of the next attack.
- Generalized anxiety disorder: The complaints are based on strong, lasting worries and fears, for which there is in most cases no reason. Affected people suffer from the constant feeling of an approaching catastrophe, inner restlessness, nervousness, restlessness and sleep disorders.
- Social phobia: This form focuses on the fear of dealing with other people. Conversations, exams and all kinds of social interaction can trigger violent physical symptoms such as rapid heartbeat, tremors, nausea and sudden urge to use the toilet.
- Specific phobias: These disorders are dominated by fear of certain objects, animals, situations or locations. Animal phobias, fear of heights or fear of syringes are typical examples of specific phobias.
Fear or fear - what's the difference?
Fear and fear are both emotions of humans and also of some animals, which are supposed to protect against danger. Fear is more forward-looking and ubiquitous than fear. For example, you are afraid of what might be lurking around the next corner or that a loved one who is in good health suddenly gets sick. Fear manifests itself as a perceived danger, which arises, for example, when you see poisonous animals such as spiders and snakes, or when you stop hard enough to prevent a car accident. Fear triggers rather oppressive feelings of inner tension, whereas fear is expressed through sudden and violent reactions.
The lovely world of fear
We live in a world full of charms. These constantly influence our senses as picture, word, writing, scent, smell, light, sound, color, taste, speed, volume, touch and crowding. While one perceives these stimuli as a safe framework for modern life, another feels over-stimulated, stressed, develops inner restlessness, tension and even feelings of fear. The interpretation of the situation as well as innate and learned personality structures mean that we perceive this arousal as fear or not. How our fear arises is still not sufficiently understood. The island cortex of the brain seems to play a central role in this.
When does fear become a disease?
So fear is normal and part of everyday life. If you are afraid of an exam, you are not automatically affected by morbid exam anxiety and if you are disgusted with spiders and avoid them, you do not necessarily suffer from fear of spiders in the morbid sense. Where is the line from which one speaks of an anxiety disorder? The German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN) has published a number of questions that can be used to determine whether you are suffering from abnormal anxiety. If the answer to one or more questions is "yes", medical or psychological advice should be given. The questions are:
- Do you think about fears about 80 percent of the day?
- Are fears significantly reducing your quality of life?
- Do fears limit your freedom of movement?
- Are you becoming increasingly depressed by fears?
- Have you ever considered suicide because of your fears?
- Do you tend to use alcohol, tablets or drugs to calm your fears?
- Is your partnership at risk because of the fears?
- Do you have problems in the job because of your fears or are you unemployed because of fears?
Anxiety symptoms
The process from the perception of an external stimulus to the perceived feeling of fear is complex. It runs through the sensory organs through different brain areas (especially the limbic system) and then triggers physical processes via the vegetative nervous system and with the help of hormones. These show up as arousal in the form of measurable physical changes that can increase up to a panic attack. Typical anxiety symptoms include:
- Increase in blood pressure (fluctuations in blood pressure),
- Dizziness,
- Difficulty breathing,
- excessive sweating,
- Drowsiness,
- Impaired consciousness,
- Racing heart,
- Nausea and vomiting,
- Hyperventilation,
- Hot flashes or cold sweat,
- Facial pallor,
- Tremble,
- in some cases even loss of consciousness or at least the feeling of fainting.
Possible causes of fear
Anxiety can also increase temporarily as a reaction, for example after the unexpected loss of a loved one, a car accident or in the first few weeks with a pacemaker that is suddenly needed. For the most part, this is still to be understood as a normal adjustment process, which decreases with increasing acceptance of the situation or the fading of the memory. An anxiety disorder can only be assumed if everyday life is permanently restricted by specific or general feelings of fear. As a result of heart disease or a heart attack, for example, a cardiac neurosis can manifest.
Physical illnesses can go hand in hand with fear
There are a number of physical illnesses that can lead to feelings of anxiety and even panic attacks. These include functional disorders of the thyroid gland (hyperthyroidism, hypothyroidism), a heart attack, angina pectoris and irregular heartbeat. Respiratory diseases, such as chronic bronchitis and asthma, often lead to hyperventilation and can lead to (sometimes panic) feelings of anxiety. Anxiety can also arise from low blood sugar (hypoglycemia) in the course of diabetes and from neurological diseases such as epilepsy or brain changes that are accompanied by dizziness.
A tumor of the adrenal cortex (pheochromocytoma), which produces excessive adrenaline, also causes anxiety and panic, among other things. Anxiety disorders as a result of psychoses such as schizophrenia can also be triggered. These diseases are sometimes associated with life-threatening consequences and should be treated and monitored by a doctor. Ultimately, drug or drug abuse and alcoholism can be mentioned as possible triggers for anxiety disorders. After a successful withdrawal, these fears often resolve.
Fears of Expectation - The fear of fear
If an anxiety disorder is left untreated, it can become independent and influence the life of those affected more and more. An anxiety disorder often creates a so-called fear of expectation as an additional burden. This fear of fear often leads to people increasingly avoiding certain areas of public life and becoming more isolated, which in turn can have a strong impact on work, family, partnerships and friends.
The different forms of anxiety disorder
In addition to depression, anxiety disorders are one of the most common mental disorders. In most cases, anxiety disorders can be divided into four categories. These include panic disorders, generalized anxiety disorders, social anxiety disorders and specific phobias. These four areas are explained in more detail below.
Panic disorder
This form of the disease focuses on panic attacks. These can be over after a few minutes or stop for several hours. In most cases, such an attack lasts less than 30 minutes. Not only the length, but also the frequency of the panic attacks fluctuates greatly among those affected. For some, the attacks occur only once a month, for others several times a day. The life of the sick is dominated by a constant fear of the next attack. Frequent visits to doctors or emergency rooms suspected of life-threatening conditions such as a heart attack, among other things, indicate a panic disorder.
Spread and course of panic disorders
According to the DGPPN, about two to three percent of the population in Germany is affected by panic disorders. Women suffer from this mental illness twice as often as men. The first symptoms appear in most people between the ages of 20 and 30. The strongest manifestation is between the ages of 30 and 40. The symptoms often decrease afterwards.
Typical triggers of a panic attack
Panic attacks can occur suddenly and unexpectedly in all possible life situations. In about two thirds of cases, panic disorders occur in combination with agoraphobia (claustrophobia). In these cases, certain locations or situations are considered to be the trigger. Typical triggers are, for example, crowds or queues when queuing, public places, long distances from home, elevators, buses, planes or cars. Affected people avoid more and more such situations and places where panic attacks could arise. In severe cases, they hardly ever leave their home.
Generalized anxiety disorder
Generalized anxiety disorder focuses on long-term and pronounced concerns and fears, which can encompass all possible areas of life. The basis of fear is often a real danger, but it is disproportionately exaggerated. These include, for example, fear of robberies, break-ins, loneliness, car accidents, illnesses, the death of a relative or one's own death. Often, those affected suffer from the constant feeling of an approaching catastrophe, which can be expressed by inner restlessness, nervousness, tension, muscle hardening, back pain and sleep disorders. In contrast to panic disorders, the symptoms do not show up in a sudden outbreak, but rather scattered throughout the day.
Frequency and course of generalized anxiety disorder
According to the DGPPN, up to six percent of people in Germany are affected by such a disorder. Women are affected a little more often than men. The disease can take a form similar to depression. Most of the time, the first symptoms appear around the age of 30, which can remain untreated even into the later years of life.
Social anxiety disorder
With social phobia, dealing with other people is the focus of the disease. In particular, situations in which one is potentially observed, evaluated, assessed or criticized by other people are horrible for those affected and trigger strong feelings of fear. Social anxiety disorder could be seen as a pathologically increased form of shyness. The main symptoms of this type of disorder are rapid flushing, rapid heartbeat, tremors, nausea and sudden urge to use the toilet. Typical situations that trigger such fears include:
- Speaking in front of other people
- are the focus,
- take a job, exam or exam (fear of exams),
- Conduct disputes,
- talk to strangers,
- talk to the boss, superiors or authorities,
- Flirt, or speak to someone who is considered attractive.
Frequency and course of social phobia
The DGPPN states that around seven percent of the German population is affected by social anxiety disorder. The first signs of this can often be seen in childhood and adolescence. Between the ages of 20 and 35, social phobia in most cases reaches its greatest form and then decreases.
Specific phobias
With a specific phobia, the fear of individual objects, animals or situations is at the forefront of the disease. The triggers often pose no actual or at least no great real danger. Animal phobias (e.g. dogs or mice) and fear of certain insects, such as fear of spiders, are common disorders in this area. An example of situation-related fear is fear of heights. Object-related fears include, for example, the fear of injections. The mere thought of the triggers makes those affected uncomfortable. An actual confrontation with the triggers can sometimes lead to panic reactions.
Frequency and course of specific phobias
There is no precise information about the exact frequency of specific phobias. It is estimated that between five and 15 percent of the population develop a specific phobia during their lifetime. For the most part, those affected know about their exaggerated fears and are ashamed of it. This type of anxiety disorder also affects women more often than men.
Diagnosis
In order to diagnose an anxiety disorder, it must first be ascertained in extensive medical consultations whether the anxiety has been operating within a normal framework or whether it has assumed pathological features. Many anxiety disorders also occur in combination with depression or are a mixture of the above categories. Furthermore, it must be clarified whether there are organic or physical causes of the fear. For example, thyroid diseases, tumors or neurological diseases are possible. Various measurements are routinely carried out during diagnosis using methods such as EKG, EEG or MRI.
Therapy
In conventional medicine, cognitive behavior therapy is often used in combination with drug treatment. The patient's cooperation and motivation largely determine the success of the therapy. In the course of treatment, sufferers have to face the fear-triggering factors and learn to deal with them. Confrontational exercises are a fundamental part of cognitive behavioral therapy to resolve anxiety.
Medication
For example, selective serotonin reuptake inhibitors (SSRI) and serotonin noradrenaline reuptake inhibitors (SNRI) are used for medication. In generalized anxiety disorder, the active ingredient pregabalin from the group of antiepileptics is often prescribed. Other medications used for anxiety disorders include:
- Tricyclic antidepressants,
- Moclobemide,
- Opipramol,
- Buspirone,
- Benzodiazepines (caution: risk of addiction).
Naturopathic treatment of anxiety
Naturally, the problem of increased inner tension and fear of fear can be tackled in a variety of ways. Traditional medicine essentially aims to treat those affected according to their constitution. Diagnostics are used for this purpose, as well as face and iris diagnosis, in which the individual, organically created weak points are determined on the basis of certain colors and signs. Lifestyle and eating habits should be adapted to the recognized constitution in order to maintain a constant physical and mental balance. Attempts are also being made to harmonize the constitution with suitable medicinal plants and herbal medicine.
Strengthen the vegetative nervous system and promote relaxation
In practice, it is often people who are open to irritation and have a vegetative reaction who tend to fear and withdraw. It is important to strengthen the vegetative nervous system and promote relaxation. In other cases, it makes sense to stimulate the digestive juices with liver, bile and intestinal therapeutic agents in order to achieve an optimal absorption of essential nutrients, minerals and vitamins. In traditional Chinese medicine (TCM), fear is considered an emotion belonging to the kidneys. Herbal herbs are prescribed and acupunctures of the kidney meridian are carried out accordingly.
Homeopathy
Classic homeopathy also takes more individual and emotional aspects into account, in which ideally the constitutional remedy is found through conversations and observations. For example, the homeopathic remedies Aconitum, Argentum nitricum, Coffea, Ignatia and Opium are used. Bach flower therapy can also restore mental balance, especially if it is accompanied by consultative discussions. The choice of means and potency should always be left to experienced therapists.
Medicinal plants
Various medicinal plants are used in naturopathic practice to combat panic attacks and other fears. Passion flower and valerian are particularly worth mentioning here. Other plants such as St. John's wort and hops have also proven useful in this area for relief.
Hypnosis
Through hypnosis and self-hypnosis, hypnotherapy can help you to take care of your inner feelings and perceptions and, moreover, to gain more calm and serenity in dealing with the outside world.
Stress relief
Breathing exercises to relieve stress are easy to learn and very effective because they can be used anywhere without aids. Various techniques can help to switch vegetatively to "rest", but also to increase well-being through better oxygenation. Coupled with the simplest meditation techniques, the effect can increase. Breathing exercises and meditation are also part of holistic approaches such as yoga, tai chi or qigong. Autogenic training and progressive muscle relaxation offer further relaxation techniques.
Energetic treatment options
Likewise, psychological counseling, for example systemic or client-centered, and energetic methods such as chakra work, Auro-Soma, therapy with healing stones from stone healing or tapping acupressure can help to react more relaxed to stimuli and requirements.
Annotation: The specialist literature often distinguishes between fear and anxiety. Fear refers to the justified reaction to a specific threat, while fear describes the same state without a "real" trigger. In this article, these terms are used synonymously and in contrast to anxiety disorder in the sense of the usual diagnostics according to ICD-10 / DSM-IV. (jvs, vb, updated on June 28, 2018)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Graduate editor (FH) Volker Blasek
Swell:
- Bandelow, Borwin et al .: German S3 guideline for treatment of anxiety disorders, (accessed August 21, 2019), DGPPN
- Fullana, Miquel Angel et al .: Risk and protective factors for anxiety and obsessive-compulsive disorders: an umbrella review of systematic reviews and meta-analyzes, Psychological medicine, (available on August 21, 2019), PubMed
- Vadakkan C., Siddiqui W .: Claustrophobia, StatPearls Publishing, (accessed August 21, 2019), PubMed
- John H. Greist: Panic Attacks and Panic Disorder, MSD Manual, (accessed 08/21/2019), MSD
ICD codes for this disease: F41ICD codes are internationally valid encryption for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.
