Jan 13

Have you been scared lately? If your fears come back again and restrict your daily life, this could be a phobia, a specific form of anxiety disorders. The main symptom of a phobia is an intense and persistent fear of certain situations, activities, objects, animals or people – but usually this fear is irrational, and often there was no specific previous experience that could have triggered the phobia. Phobics often try to the utmost to avoid the fear-prone situations – often to such an extent that their fear begins to interfere with daily life and increasingly dominates their thinking.

A former client would feel uncomfortable in normal social situations such as parties or business meetings and tried to avoid them if possible. Also, the eating and drinking in public was a problem for him and led to great internal stresses. This special form of phobia is called ‘social phobia’, as it relates to other people or social situations. Performance anxiety (the fear of giving speeches or performing on a stage), is something that affects many people and also a form of social phobia.

The difficulty to get rid of phobias is that rational explanations and efforts of relatives and friends almost never help, but sometimes even increase the internal pressure. Also, ‘exposure therapy’, which is a popular for TV shows on the topic -, showed only limited long term success for most people. Good success, however, can be achieved with modern psychotherapeutic approaches, like methods of hypnotherapy and solution-oriented counseling. In severe cases of phobia, medication can help get started in therapy and counseling. Thereafter, continuous work on the problem is crucial to avoid falling back into the old patterns of fear.

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2011)

Sep 07

His heart starts to beat stronger with every minute, sweat starts to run down on his back and it becomes more and more difficult to get air, it is as if his lungs were blocked. Suddenly his heart begins to burn – is he finally having his first heart attack? He panics, he might die right here on the street if he doesn’t get immediate help – unbearable fear is climbing up his spine…

The effects of a panic attack vary – most sufferers feel intense fear they are having a heart attack, might ‘go crazy’ or have a nervous breakdown. Experiencing a panic attack can feel like one of the most intensely frightening, upsetting and uncomfortable experiences of a person’s life.
But unlike many might think, panic attacks are not necessarily related to high stress, but can even hit people with a very relaxed lifestyle. However, panic attacks are often indicators of anxiety disorders, depression or other psychological conditions that had been untreated (or treated improperly) for a long time. Other potential causes are side effects of medications, alcohol, medication or drug withdrawal or chronic illness.

If panic attacks are untreated, agoraphobia might develop, where a person develops a fear of having panic attacks in certain places. Concerned that they might feel trapped or run into a panic attack, they increasingly avoid any situation that might put them at risk, might avoid open spaces, to drive or even to leave their homes at all. It can also be related to social anxiety, where the fear revolves around social situations, interactions with others, or being evaluated or scrutinized by other people. This can result in one of the most harmful side-effects of panic disorder, as it can prevent sufferers from seeking treatment in the first place or to develop psychological dependence of drugs. However, treatment is possible and usually consists of regular psychotherapeutic sessions over an individually advised amount of time, sometimes combined with complimentary medication. That way, more than 90% of agoraphobics can achieve a full recovery.

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2010)