Phobias: Bad News... and Good
Isn't It Just Another Word For Anxiety?
A few years back, a friend asked me, "How can someone so anxiety disordered teach?"
My response: "My family doesn't have my phone number where I work." That response wasn't intended to be flippant; it was quite truthful. I have specific phobias -- specifically I have bad-news phobias. Having these phobias -- these narrow focused fears -- doesn't mean that a person also has performance anxiety or social anxiety or is generally high in vigilance. I'm actually pretty low in vigilance. When I limit my contact with telephones and other potential bearers of bad news, I don't experience acute anxiety. That's quite typical of phobic-type fear.
People often use the word "anxiety" like it referred to one quantitative thing, when in reality, it's a blanket term for multiple conditions which are distinct behaviorally as well as chemically.The thing about phobias is that they're very predictable, and one can (and often does!) plan their life around them. As long as a person avoids particular situations or objects, they may be quite high functioning. But when it's time to confront a specific fear, panic can shoot sky high.
The Zebra and the Lion: Phobias as Excess Memory?
There's an oft repeated saying that when the zebra is outrunning the lion, it can't be thinking about the past. Part of the function of stress hormones is to disengage people (and other living creatures) from the past and let them act in ways necessitated by dire circumstance.
Might phobias represent an access of memory? Researchers have turned to a surprising substance to help people overcome phobias: the stress hormone cortisol. No they're not trying to lower patients' cortisol levels; they're instead giving them a spike in cortisol to help with fear confrontation. Cortisol has shown some efficacy in phobia treatment. It is not beneficial, however, in treating generalized anxiety disorder -- further evidence that these conditions are chemically distinct.
Many people, though, continue to find relief from exposure therapy or cognitive therapy.
The Anxiety & Phobia Workbook
The Anxiety & Phobia workbook, now in its fourth edition, has helped many people work through phobias and other anxiety disorders. Advice on therapies, relaxation techniques, and more.
Syntaxin 1A and Fear Conditioning
Implications for Phobias?
I am not suggesting that the majority of phobic persons have a problem with the gene Syntaxin 1A. I want to cite the research into this gene to make the point that fear is a multi-faceted thing, and not a quantifiable one. Mice that have been knocked out for the gene Syntaxin 1A are mostly normal, and don't display signs of anxiety in daily functioning, but they do show abnormal fear conditioning. They are slow to relinquish fear memories -- and they're also slow to form them. Syntaxin 1A has a big role in exocytosis, the release of neurotransmitters from cells in response to stimuli. Evidently, a less than adequate release of key neurotransmitters keeps one from both unlearning and learning fear.
Bad News Phobias
There were points where I was misdiagnosed as GAD, probably because my phobias are not classic or stereotypical. The main one: a bad news phobia. It's a fear of things happening to people, yes, but it tends to focus on sources of information telephone, email, news. When I was a child, I was indiscriminate in my focus. I'd hear that some random person on the news was ill, and I'd build myself into a state of terror that they'd die. I'd go to great lengths to avoid being in the room with a television set. As I got older, the fear focused more on those I did know and love.
Like other phobic people, I do a great deal of planning around my fears. I maintain certain email addresses and communication channels that are used only for business and casual acquaintance; this is so I access them without fear. Most people that I communicate with on forums or via email would have no idea that I have issues around communication. I usually keep one channel open for communication with loved ones -- whatever channel I'm handling best at the time. The phone may be unplugged at night, or as needed to handle situations and give myself a rest.
Sure, my fears have cost me things along the way. I can be difficult to reach via phone, and this is not a good trait for someone who's in business and looking for clients. This has cost me money at times. Far more importantly, though, I've lost friends and loved ones over the years. The more time that passes between contact, the more terror I experience when I do try to reach them. There come times when it's too much for me to step across. There are a handful of people I've managed to hold onto through the years -- for this, I have to summon all the strength inside me.
Serious Humor: Please Don't Email the Drops
Thoughts on Phobias, from my Blog, Evening Nigh Reflections
I'm using a site called Drop.io to upload my audio readings to the internet. They call the uploaded files 'drops'. Some people use Drop.io for online collaboration (like a multi-media Google Document); I guess that's why they assign the drops their own email addresses and their own telephone numbers with five-digit extensions. They really do have those drops set up! Please don't email my drops, though. There are people who can attest to me not reading my own e-mail -- I'm afraid the chances are slim to none of my drops reading theirs...
Now I'm going to backtrack and briefly mention my bad-news phobia: A couple years back, I was explaining my telephone anxieties to my friend-whose-name-is-spelled-the-same-forwards-and-backwards. ("You can have your address put on a list so telemarketers don't call," he had said, showing a lack of undertanding of just what it was that made me startle when the phone rang. Of course it wasn't the telemarketers I had been worried about -- it was the people I knew. I was worried about things happening to the people I knew.)
Now, though, I'm wondering if telemarketers -- automated ones -- are going to call my drops up on the telephone. Do you suppose they might tell my drops they can save money on auto insurance, or that their new satellite dish will be installed tomorrow?
- Phobias: Introduction
A basic introduction to phobias, featuring video and well-organized text.
- About.com: Phobias
A fairly comprehensive resource from a trusted authority: About.com
- Treatment Research
Research in the use of cortisol in treating phobias.
- Treatment Overview
A brief overview of treatment options including medication, behavioral therapy, and cognitive therapy.
- Differentiating Phobias from Other Anxiety Disorders
An explanation of specific phobias and how they differ from more generalized anxiety
Video: Overcoming Phobias
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