All vertebrates feel frightened. Mice are afraid of cats, antelope of lions and people of small and large animals, darkness, height, lifts, pain and more. It is not for nothing that the sensation is so universal and extensive: for those who are afraid to live longer. "Fear helps us to avoid dangers," says Michael Rufer, head physician of the psychiatric department University Hospital Zurich,
In some people this natural protection mechanism gets out of hand. Those who freeze when they see a spider, palpitations and faltering, react with extreme fear. That is of course not in relation to the actual situation. Many spider phobics know that their fear is unfounded, especially in Europe, where there are no dangerous spiders. However, you can not stop the fear, avoid cellars and pastures and do not camp.
Frequent mental disorder
Doctors speak of an anxiety disorder in such cases. The fear is disproportionately strong, too often and takes too long. Anxiety disorders are the most common mental illness: 14 percent of the European population, or more than 61 million, becomes ill. A distinction is made between phobias related to the object or situation, such as claustrophobia or the fear of spiders, and undirected anxiety disorders such as panic attacks or generalized anxiety disorder, in which people are constantly worried.
"People often avoid the frightening situation, which can seriously limit their work and private life," explains Rufer. If someone is afraid to speak to an audience, but in the profession it should do it regularly. Or who experiences the first panic attack in the cinema and now also avoids theaters, concerts and supermarkets. "In some patients, anxiety dominates daily life, and suffering is very high," says Katharina Domschke, head of the psychiatry and psychotherapy department at the Freiburg im Breisgau University Hospital.
Intended as a survival tool
The physical symptoms associated with severe anxiety help us to survive: does someone hold a knife against our throats or do we encounter a snarling predator that suddenly sets our body in high alarm. The stress hormone adrenalin overflows the body, the blood vessels narrow, the heart pumps faster, the muscles tighten. All this with only one goal: the body is now fully alert and capable of fighting or fleeing.
But if that happens in an elevator, in a queue or even out of nowhere, it is terribly tiring. Even weaker fear reactions are debilitating in the long term. But why does fear become independent in some people?
"There are always several factors involved," says Katharina Domschke. The causes of an anxiety disorder are therefore complex. First of all, biological factors play a role. Researchers at the Max Planck Institute for Human Cognitive and Brain Sciences in Leipzig showed in 2017 that the fear of spiders and snakes could be in us: six months old babies reacted to photos of these animals with stress, on photo & # 39; s of flowers and fish do not.
"The fear is not removed, but you learn a new way to deal with it."Michael Rufer, head physician Psychiatric University of Zurich.
Researchers interpret this as an evolutionary legacy: since the fear of snakes and spiders in our tribal history offered a survival advantage, many still react sensitively to the animals of today. Experts also speak of the "biological readiness" to develop a certain fear. "There are also indications that fear of spiders is taught faster than a fear of sockets, evolutionary biology represents a very young danger," says psychologist Johanna Lass-Hennemann of the University of Saarland.
Even monkeys show this readiness: rhesus monkeys, raised in captivity, are not afraid of snakes. However, if they observe peers who are afraid of snakes, they quickly take over the fear. On the other hand, they learn not to be afraid of flowers or rabbits.
In humans, learning has a significant effect on the development of anxiety disorders: if a child observes the anxious reaction of the mother to a dog, it can take over the task. "It makes a difference whether a child learns that it must always be cautious, because the world is dangerous and lurking on every corner, or that it learns that it usually feels safe and can overcome fears," says Zurich Psychiatrist Rufer. .
In addition, environmental factors also play a role: the divorce of the parents, abuse, but also personal experiences: if you were bitten by a dog as a child, this can cause an anxiety disorder. The link to certain life events is typical of panic disorders: financial problems, job loss, death of parents. "But even the birth of a child or promotion can be triggers, because that increases responsibility," explains the expert Domschke, based in Freiburg.
Good to handle
Fortunately, anxiety disorders can be treated very well, as head physician Rufer of psychiatry explains: "For specific phobias the success rate is a maximum of 90 percent. Even with generalized anxiety disorder, which is the most difficult to treat, the pass rate is 60 to 70 percent."
The established standard treatment is "cognitive behavioral therapy": the victims learn how fears arise and why they do not want to disappear again. Patients then have to analyze their own daily lives and identify the anxiety situations. In the heart of the therapy are confrontation exercises: patients repeatedly go into the anxiety situation, for example in an elevator. They learn that they can get through the situation and regulate their fears. "The fear is not removed," says Rufer, "but you learn a new way to deal with it, which then reduces anxiety."
Last option: medicines
When the anxiety disorder is pronounced and other problems such as depression are added, medications are also used. "Many patients only come after years, often trying to fight their anxiety with alcohol or sedatives, which makes the treatment more complicated," says Rufer. "But even patients who have had an anxiety disorder for a long time have a good chance to benefit from the therapy."
Created: 30.09.2018, 17:55 clock