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“Fear has a large shadow but he himself is small” – Ruth Gendler
Fear, which is one of the human fundamental reactions, has a largely protective function in our lives. It is the body’s response to an external, possibly life-threatening danger. Phobias on the other hand, usually do not have much to do with life-threatening situations. In fact, they are a type of anxiety disorder. Thus, living with phobias could be really challenging. Some of them are quite easy to avoid, while others regularly and significantly disrupt human lives. But what are the main differences between fear and phobias? People can have phobias connected to interaction with others, or they may feel paralyzed by the presence of a certain animal, or a certain color. The world of phobias is extremely rich. Which phobias are the most popular and which one the most unusual? What happens to our brains when we experience phobias? Is it possible to provide a “normal” life with phobias? We try to answer these questions.
Image credit: Pixabay (Free Pixabay license)
Fear versus Phobias
Let’s imagine such a situation: you are alone at home and it is a dark, late evening. Outside it is raining and you are watching a movie. Suddenly, you hear that something hits the window. Your heart is starting to beat like crazy. Your breathing speeds up. All of the muscles in your body contract and tension increases. But in a split second, you realize that there is no burglar nor a murderer. This was just the wind. However, your body reacted as you were in real danger and prepared itself to “fight or flight”.
Frequently, people are afraid of things, sometimes more, sometimes less. The history of human fear begins when our species just arose. Fear is a primal instinct, as it plays a crucial role in survival. The natural reaction of each living creature in the face of danger is fear [1,2]. In a risky situation, a sudden burst of adrenaline, also called fear hormone, stimulates the organism/body to give it a nearly supernatural power to “fight or flight”. However, when the body reacts in this particular way to some irrational danger, it is called anxiety. Anxiety appears in response to some undefined stimulus, the memory of the danger, and/or its imagination [3]. Recurring anxiety that disturbs normal daily functioning and lasts longer than is required/justified by circumstances is called phobia [4]. A phobia occurs when a natural fear turns into a disorder. Both fear and anxiety keep our brain out of possibly dangerous situations, while phobias trick our brains into thinking that there exists a danger when in reality there is none.
This dysfunction of fear processing can lead to various severe psychiatric disorders. The word phobia comes from the Greek language where “phobos” means “fear caused by certain situations, activities, persons, and objects that are objectively regarded as not dangerous” [4]. Spiders, snakes, darkness, heights, clowns, and water are examples of “false dangers” that arouse such irrational fears in some humans. Often, the fear is so strong that the subjects are literally paralyzed by it and cannot function normally.
Image credit: M. Osial
Wealth world of phobias
It is common for some phobias to accompany us during childhood [5]. It is connected with the fact that fear is naturally linked with the sense of uncertainty and vulnerability. When kids are young, they are afraid of the darkness, being alone, or sleeping alone. Their imaginations tell them that there are monsters that live under their bed, in the wardrobe, or hide under the bathtub. During the kids’ growing process, with the help of adults, most children can slowly conquer these fears and outgrow them. And what about the phobias? Phobias are the most common mental disorders in the United States, affecting about 10% of all adults [6]. One can divide all phobias into two categories, i.e. simple, also called specific (caused by objects, animals, situations, or activities) [7,8] and complex (connected with deep-rooted fear or anxiety about a particular situation or circumstance).
Did you know that the 5 top common phobias according to a survey by Anxiety UK are: social phobia– fear of interacting with other people; agoraphobia – fear of open public spaces; emetophobia – fear of vomiting; erythrophobia – fear of blushing and driving phobia – fear of driving [17]. How ironic is that people are most often afraid of other people? Phobias related to the area of social life very often result from the cultural background. On average, women are more likely to be affected by social phobias than men.
The number of different phobias that exist is nearly unimaginable. Let’s take a closer look at the less common phobias. Who knows, maybe someone in your environment has one of those “weird” and rare phobias? Nomophobia is caused by the non-availability of a mobile phone or any other virtual communication device [9]. It has to be a nightmare in the electronics era that we live in today. Caligynephobia/venustraphobia is fear of good-looking or a beautiful woman [10], genuphobia is a fear of knees, while panophobia is a fear of hidden evil in everything, from people to everyday items. If you enjoy playing Scrabble, let’s keep in mind that someone might be scared of long words – hippopotomonstrosesquippedaliophobia. Others are terrified by the figure-eight – octophobia. Some people can’t play scrabble because of Q-phobia – fear of the letter Q [11]. Others refuse to travel by plane due to the barophobia – fear of gravity. Some are terrified of counting time, because of chronomentrophobia – fear of clocks [12]. Then there is also the fear of going downtown, due to the batophobia that is a fear of passing close to tall buildings or mountains. In our opinion, the most interesting fear is arachibutyrophobia – fear of peanut butter sticking to the roof of the mouth [13]. The list of phobias is much longer, but that is the story for another article.
Fear inside of the brain
There are many reasons for phobias, such as genetic, familial, environmental, or developmental factors. Phobias can also be caused by unfortunate experiences [2]. No matter the reason for having a phobia, it induces fear, that is, a spontaneous sequence of reactions. Fear begins in the brain under the influence of stressful stimuli, and ends with the release of some chemicals which increase the heart rate, cause the rapid breathing, stimulate the muscles and perform a range of other reactions known as the “fight or flight” response.
The region of the brain responsible for the fear reaction is called the amygdala [14], see Figure 1. It is an almond-shaped structure located in the medial temporal lobe, and it is associated with behavior and emotions – both positive and negative. It means that in case of danger, or negative emotions caused by someone or something, the amygdala is activated. In turn, this causes the activation of some other parts of the brain, to prepare the body to “fight or flight”. It is like a stockroom of excessive fear in the brain. In other words, when we are exposed to stimuli that induce phobia the amygdala is highly active.
Did you know that this area of the brain is modulated by the neurotransmitter called serotonin? Normally, this chemical compound influences our mood, when it is released from the nerve cells into space between cells called the synaptic gap, where it is transmitted to the brain as a signal [15]. When a phobia occurs, serotonin stays between the nerve cells for longer, and it is recaptured by the first nerve cells that send the signal, causing serotonin imbalance and the spread of the fear reaction across the whole human body. This fear may manifest itself as an increased heartbeat rate, shaking, rapid breathing, sweating, dizziness, or many other symptoms.
Figure 1. The fear regions in the brain. Image credit: M. Osial
Body reaction
Fear or phobias arise in the human brain, but they influence the whole body, initiating several physiological changes. Within the avalanche of impulses from the brain, the whole body overreacts. Heartbeat and breathing rates increase. The central blood vessels around vital organs dilate themselves to pump more oxygen and nutrients. Muscles are also pumped with blood and ready to react to the danger. Goosebumps occur, due to the sudden tightening of muscles. From the metabolic point of view, the level of glucose in blood increases. The levels of calcium and white blood cells in the bloodstream also increase.
Treat it or not – that is the question
Usually, people are fully aware of having a phobia, and if it is not treated, living with one might be difficult. Plenty of phobia types can be fully cured. How? There are many therapies [16] like, for example, cognitive-behavioral therapy (CBT), where a person confronts the feared situation to change the phobia reaction improving tolerance against stimuli. Another treatment is done by prescription of medications that reduce the reaction of the body to stimuli, including antidepressants, anti-anxiety drugs, or beta-blockers. Depending on the type of phobia, and its source, all patients require individual treatment. Some phobias can be completely cured, but that process depends on many factors, including one’s attitude to the phobia problem. Usually, regular exercises and eating (of course healthy food), getting good sleep, and reduction in intake of coffee/other stimulating substances support the phobia treatment.
Summary
Phobias are irrational fears, which can have far-reaching consequences, such as even causing depression. The most common phobias are connected with animals, the environment (including deepwater or heights), situations like dental visits, body, sex, open spaces, or social situations. The main reason we may suspect a phobia is present is the frequent panic attacks, which occur suddenly and without a warning. Phobias can be provoked by traumas, accidents or even human genetics i.e. some people may be born with phobic tendencies. They can also be a learned response, developed early in childhood, by the observations of parents or siblings. Phobias can affect everyone regardless of age, sex, and social background. The diagnosis process is difficult, but most phobias can be successfully treated with therapy or medicines.
This article is a joint work of Magdalena Warczak (Intitute of Physical Chemistry, Polish Academy of Sciences), Jakub Lewandowski (Faculty of Chemistry, University of Warsaw), Agnieszka Pregowska (Institute of Fundamental Technology Research), and Magdalena Osial (Faculty of Chemistry, University of Warsaw) as a part of Science Embassy project. Figures – M.Osial
References
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