Fear - Friend or Foe?

There are many kinds of fear. Fear always pertains to the future and to potential events that may, but do not have to happen. Fear prevents you from assessing a given situation rationally and from drawing logical conclusions. Margaret Thatcher said that 90 percent of our worries never happen. Everyone fears something - death, flying, spiders or losing a job. Fear is omnipresent and unavoidable. Sometimes it spurs you to action and sometimes it advises you to back down. However, when fear becomes unbearable and impedes normal life, you have a problem. Various fear-related disorders are the most common psychological conditions. It is estimated that close to 25 percent of population suffers from some form of fear-related disorders.

People often confuse fear and anxiety. Fear is a natural physiological response to threat and danger. The difference between fear and anxiety is that fear is usually proportional to the degree of danger. If you are frightened, your body prepares for a fight or flight response. Your heart rate increases, your breathing becomes faster and shallow, your pupils dilate (hence the East European saying “Fear has big eyes”), and the level of glucose (i.e. your body fuel) increases. People who find themselves in life-threatening situations, for example an accident, an assault or a flight from danger, experience all of these symptoms first-hand. Later, they often recall that when they were being chased, they run much faster than they could have expected, even though they were not particularly fit. It was fear that boosted their physical abilities.

Two American psychologists, Yerkes and Dodson, have discovered that intense fear impedes action, while moderate fear is motivating. Moderate fear energizes and helps you to get to the top of the mountain. Kierkegaard said that fear may be paralyzing, but “anxiety is the dizziness of freedom”, which spurs human development. Hence, we need fear, but only in the right doses. When fear becomes disproportionate to threat, it is no longer motivating, but it impedes rational thinking and negatively impacts behavior.

Sometimes, anxiety appears regardless of a perceived threat. It can take a form of a panic attack, general anxiety or a specific fear of something, i.e. a phobia. Although this type of fear seems ungrounded to an average person, people who experience anxiety disorders, actually suffer. In a book “Nie bój się lęku” [Don’t be Afraid of Fear], Łukasz Święcicki and Iwona Koszewska, psychiatrist from the Institute of Psychiatry and Neurology in Warsaw tell a story of a patient suffering from general anxiety. “Everything change, when I got married. I began to imagine various scenarios. If my husband was late from work, I would immediately think that he was in an accident. It seemed to me that stories of tragic accidents appeared in every magazine I was reading. For example, a story that the wife was waiting at home, while the husband was lying on the street, crashed by truck. I tried to tell myself that it was silly, that most likely it was not the case, but it was harder and harder to convince myself. Then I began to feel various physical symptoms, such as chest pain, trouble breathing, and feeling lightheaded.”

According to the International Classification of Diseases (ICD-10), anxiety is diagnosed, when a person subjectively feels that they are not able to control their emotions and when psychological symptoms are coupled with somatic symptoms. These symptoms are a signal that something is not right. You may experience headaches, chest pain, trouble sleeping, stomach pain, diarrhea, coughing or wheezing. The more symptoms you experience, the stronger your discomfort. Anxiety can often occur in disguise as somatic symptoms and make people go from one medical specialist to another, have a variety of medical tests done and try different therapies, before they finally visit a psychiatrist.

The history of fear is the history of human race. An analysis of current fears helps to develop a picture of the contemporary society. Nowadays, we are mostly afraid of an economic crisis, fuel price increases, terrorism, cancer or swine flu. Mass media exacerbate our fears by spreading information about various disasters, accidents and political or economic crises. However, there are fears that we all experience, regardless of the world developments. For example, the fear of being alone, which paradoxically, is often accompanied by the fear of closeness. An exaggerated fear of being abandoned may be the reason why some people never develop close relationships, while others torture themselves by imagining “what if” scenarios, although they are in seemingly successful relationships. If these types scenarios are recurring and you do not know how to break away from this viscous circle of fear, conjecture, and negative thinking, you might want to consider therapy.

In some cases, psychotherapy is combined with pharmacotherapy. Often, anxiety is only “the tip of the iceberg” and other unresolved problems or past traumas are hidden below the surface. You need time to work through them, but therapy allows you to look at yourself from a different perspective, without fear. Psychotherapy is a long process that requires strong engagement of the client and sometimes pharmacotherapy must precede psychotherapy. The aim of therapy is to develop individual methods of coping with anxiety. It takes a long time, but it is very effective and reduces the risk of recurring anxiety episodes. Woody Allen said that laughter was the only way to tame the fear of death. Nevertheless, sometimes fear is so intense, long-lasting and draining that it prevents not only a rational self-assessment, but also a rational assessment of reality.

Well meaning attempts at humor, encouragement or straight talk, offered by loved ones of the person who suffers from anxiety, will not help. The vicious circle of anxiety is rooted in the fear of recurring anxiety episodes. When everything goes well, we imagine the worst, for example an illness, an accident or death. There are people who for years live in fear of death, their own death or death of their loved-ones. Every day in their heads, they replay films of disasters, accidents or fires, where they or their family members play the victims. When anxiety increases to the level, which impedes normal living and functioning in society, you might consider seeing a psychotherapist or a psychiatrist.