Psychiatry: Approaching Mental Health Problems

Grappling with phobias

A form of anxiety that occurs only when you’re in a certain situation is called a phobia. If you suffer from a phobia, you typically try to avoid the situation that provokes your symptoms and you may become anxious even just thinking about getting into that situation. Some examples of phobias are as follows, starting with simple phobia and followed by the more complex ones:

• Simple phobia: You’re inappropriately anxious when faced with an object such as a spider or mouse, or in certain situations such as flying or being in enclosed spaces. Simple phobias commonly start in the early years of life following a stressful situation or some frightening life event, although experts don’t always know why this type of phobia occurs.
• Agoraphobia: You feel panicky or may even faint when you’re part of a crowd, out of the house or in a situation from which escape is difficult. To avoid these situations, you may avoid going out altogether, which can sometimes lead to depression and other mental health problems. It is thought that life experiences, genetic reasons and changes of chemicals in the brain may all play a role in causing agoraphobia.
• Social phobia: You have a strong and persistent fear of being negatively seen by others, and so you try to avoid social situations such as talking to groups, speaking on the telephone or going out with friends. In contrast to just being shy, social phobia can be quite disabling. Previous anxious or intense experiences in certain social situations may cause social phobias, particularly if you’ve always been shy since childhood and haven’t been able to fully develop your social confidence.

To avoid a phobia getting out of hand, consult your psychiatrist to discuss the many forms of treatment and therapy that are available. If you’re in a situation and start to feel anxious, try to relax and take control of your breathing. Open and stretch your hands, which can help release tension – our natural reaction to stress and anxiety is to close our hands or make a fist.

Handling panic attacks

Panic attacks are when you suddenly experience an intense feeling of apprehension or impending disaster. You’re likely to become anxious very quickly – often without warning and for no apparent reason. These attacks affect a lot of people and can be very frightening. Nobody really knows why panic attacks occur, but experts think that traumatic life experiences like the death of a close family member, unpleasant childhood experiences or changes in the chemicals within your brain, for example, may play a role.

If you suffer from panic attacks, you may recognise some of the following symptoms, at least four of which typically show during an attack:

• You suffer from a fast heart rate or palpitations.
• You feel short of breath or that you’re choking.
• You notice chest pain or discomfort.
• You feel dizzy, unsteady on your feet or faint.
• You feel sick or have stomach pain.
• You feel flushed or suddenly cold.
• You feel shaky and tremble.
• You’re afraid of doing something that you can’t control or that may seem crazy to other people.
• You feel like you’re not yourself.
• You may feel as if you’re about to die.

During a panic attack, try to tell yourself that you’re not coming to any harm, and that the symptoms you experience are due to anxiety. Remind yourself that attacks will pass, and ‘ride it out’. Try not to leave the situation that is causing you to have a panic attack and ‘confront’ your fear. By staying in the situation you give yourself the opportunity to discover that nothing serious is going to happen to you.

If you feel that you may suffer from panic attacks and that these attacks impact on your life, consult your psychiatrist. She/he can then exclude any potential underlying physical causes and discuss the different management options with you.