An anxiety disorder is a psychological disorder in which severe anxiety is experienced. These fears are often not rational and have no real basis, which means that a person is disturbed. There is a phobia here. There are different types: stress disorder and PTSD, simple phobia, panic disorder, obsessive-compulsive disorder, social phobia and generalized anxiety disorder.
Characteristics
- One has a persistent and irrational fear of a particular object or situation, such as snakes, spiders, heights, thunder;
- Anxiety reaction occurs when exposed to the object or situation, whereby a person shows typical anxiety reactions such as sweating and palpitations (possibly a situation-related panic attack);
- The object or situation is avoided by the patient. When confronted with the object or situation, there is intense fear;
- The patient is able to recognize that the fear is factually unfounded. However, it is not possible to suppress the fear. You sometimes see that children do not yet realize that their fear is irrational;
- The duration is at least six months (for persons under 18 years old);
- The anxiety and avoidance behavior interferes with daily activities and social relationships. For example, someone with a fear of heights avoids climbing tall buildings, and this can become a problem when they have to take a class on the tenth floor or attend a meeting on the third. Especially when there is a view from the window;
- This fear cannot be explained by any other anxiety disorder. A fear of getting dirty is not a simple phobia, but is a form of obsessive-compulsive disorder, namely fear of dirt. Children’s fear of going to school and leaving their parents behind has to do with separation anxiety. When there is a fear of social situations, we do not speak of a single phobia, but of a social phobia.
Particularly for animals, closed spaces (claustrophobia), heights (acrophobia), fear of flying, thunder, blood and/or medical procedures. Exposure leads to arousal, except in the case of blood phobia (in which case there is a decrease in heart rate and blood pressure, which can possibly lead to fainting).
Prevalence
10%. Fears are fairly common in the population, including children.
Scientifically found causes
Classical conditioning is responsible for learning fear (e.g. little Albert), and operant for learning avoidance. This means that we learn fear by pairing something fear-inducing with a neutral situation or object (e.g., a rabbit in Little Albert’s case), and by being ,rewarded, with operant conditioning when we learn it. If we avoid a scary object (because nothing happens at that moment), we never learn that it can NOT happen either. For the latter reason we continue to avoid the object or situation.
Modeling would also play a role (learning by seeing someone else in fear).
Therapy
Behavioral therapy according to the fear reduction model: Avoidance behavior must be broken and long-term/frequent exposure also leads to therapeutic effects. The usual therapy is exposure through imagination, or in vivo (actual exposure). For example, someone with a spider phobia will be confronted with a spider step by step, having to get closer and closer. It is important that the patient himself is willing to cooperate.
A fear hierarchy is drawn up, starting with the easiest step and working towards an increasingly difficult step. It doesn’t necessarily mean that someone with a fear of spiders will end up holding and petting a tarantula, as is often used as an example. The point is that the patient is no longer hindered in daily life, so being able to be near a spider without panicking can be enough. After all, people are not easily confronted with a tarantula (in Western countries).
In many cases, a single phobia can be treated in one or a few sessions. A BBC documentary shows how a woman with a phobia of birds is treated. At first she shows extreme fear at the presence of a feather. By the end she is able to simply hold the feather.
Sometimes medication is given, such as SSRIs (often used for depression).
Prognosis
With adequate treatment, the prognosis is favorable.