Anxiety, fear or phobia?

Fears and anxiety are inevitable parts of life. Everyone experiences them at one time or another. Anxiety generally occurs as an occasional temporary reaction to the stresses of everyday life.

Fear

Fear can be described as an unpleasant emotion that occurs in response to a consciously recognized source of danger, real or imaginary. The physical symptoms that occur during fear are rapid pulse rate and breathing, raised blood pressure and increased muscle tension.

Anxiety

Anxiety is a disturbing feeling of impending doom, when there is no specifically feared object or circumstance. Physical symptoms include shortness of breath, dizziness, a sinking feeling in the stomach and rapid heart beat.

Panic attacks

Panic attacks are sudden spells of intense anxiety that usually come on without warning. They seem to last from one minute to one hour and occur on an average two to four times a week.

Panic attacks involve the following symptoms:

• dizziness or faintness
  
• difficulty breathing
  
• choking or smothering sensation
  
• unsteadiness or shakiness
  
• rapid, pounding or skipping heartbeat
  
• chest pain or pressure
  
• tingling or numbness
  
• nausea or diarrhea
  
• feelings of strangeness or unreality
  
• fear of dying, going crazy or losing control

Several million Americans are affected by panic attacks. The attacks usually begin during late teens or early 20’s but many people also experience them later on in life. Seventy-five percent of those affected are women, probably because of some chemical or biological factors that are not yet fully understood.

Phobias

A phobia is an excessive fear of an object, activity or situation that disturbs a person's functioning by leading them to avoid the cause of that fear. Some of the more common simple phobias are fears of animals, insects, heights, enclosed spaces and flying. According to data from the National Institute of Mental Health, phobias affect as many as 25 million people in the United States.

Obsessive compulsive disorder

Obsessive compulsive disorder is characterized by involuntary obsessions and compulsions that interfere with normal life. Obsessions are unwanted ideas, worries, thoughts, images or impulses that occur repeatedly. Compulsions are behaviors that are repeated over and over again in a very set way. Obsessions often cause anxiety and compulsive behaviors or rituals seem to occur as a way to reduce this anxiety.

Obsessive thoughts or compulsive behaviors can become so time consuming and disturbing that it becomes difficult for the person to lead a normal life. The person's family relationships, social life and work or school performance can suffer.

Getting help

To assess the severity or persistence of a person's problem, the rule is to seek professional help promptly when...

• the fear begins to generalize from the situation where it originated, or
• the anxiety becomes so severe or frequent that it interferes with a person's ability to function.

Anxiety disorders can be treated effectively with counseling, medication or both.

• Therapy can help a person explore and gradually deal with the psychological factors that may be contributing to the anxiety symptoms.
• Relaxation, biofeedback and meditation may also be used to lessen anxiety.
• Several medications are available that can help some people with symptoms such as excessive restlessness, muscle tension and inability to fall asleep.

Related Links

Anxiety inventory

Allina Behavioral Health Services

Obsessive compulsive disorder

Panic disorder

First published: 09/13/99
Last updated: 04/22/2005

Reviewed by: Tim Gibbs, MD, medical director, Outpatient Clinic, Abbott Northwestern Hospital Behavioral Health Services; Paul Goering, MD, medical director, United Hospital Behavioral Health Services; Donna Krzmarzick, RN, director, Cambridge Medical Center Behavioral Health Services; Susan Tabor, RN, BSN, director, United Hospital Behavioral Health Services; Dianne Timmer, RN, behavioral health services lead, Abbott Northwestern Hospital; Mark Zipper, PhD, behavioral health services director, Allina Medical Clinic