Understanding and Overcoming Fear, Anxiety and Anxiety Disorders: How much fear is healthy?

We all know the feeling: fear. A constricting feeling that can cause heart palpitations, sudden sweating or a dry throat within seconds. Each of us experiences fear in different situations and the threshold to be afraid, as well as the triggers for our fears, can be different. Some of us are afraid of failing in exams, being at a high altitude, or speaking in front of a group, others only when it is a matter of life or death. Fears are as individual as all of us – but for all of us fear has a function.

Function of fear: Why is fear important?

Fear is very functional. It is like an alarm bell that sounds when we get into dangerous situations, alerting us and making us more attentive. The feeling of fear is our biological warning system and prepares us for protective reactions. Without fear, we might risk our lives in life-threatening situations.

In evolutionary terms, fear prepares us for situations in which we have to be careful – more precisely for fight-or-flight situations that include situations in which we have to fight for our lives or in which there is still a chance to escape (flight). Fear makes us more alert and triggers a series of physical reactions that serve as a protection and as a survival mechanism. For example, our pupils dilate, our eyesight and hearing become more sensitive and our attention is increased. Our muscles become tenser and as a result, our reaction speed increases. Fears are triggered by situations, circumstances or stimuli in the environment. In most cases, however, the state of our fear is not permanent but disappears again after a period of time.

The development of fear: How does fear affect the body?

Our fear is biologically anchored. It triggers a series of physical reactions. Some of us may experience sudden outbreaks of sweat, a dry throat or mouth, damp hands, or similar physical reactions when we find ourselves in an oppressive situation. The fear center is located in our amygdala, a small almond-shaped complex in the center of our brain. The amygdala first assesses our surroundings. If it registers a perception of danger, it controls a cascade of fear reactions in our body and activates the sympathetic nervous system, a part of the autonomic nervous system, which in turn ensures that we are physically prepared to fight. We become more alert. Our blood pressure rises and our muscles tense up to be physically prepared for a fight or escape (fight-or-flight situation) in dangerous situations. The fear also releases the neurotransmitters adrenaline, noradrenaline, and dopamine, which can put our body in a state of alarm and increase our performance within seconds.

How does fear affect performance?

Fear serves as our survival mechanism and can make us more alert, increase our ability to react, and thereby improve performance. However, it can only fulfill this purpose if it is appropriate. If the fear is too strong, it has a paralyzing effect; if it is too weak, possible risks are underestimated. If the fear is not only of short duration and accompanies us in the long term, it can have a negative influence on our daily life and even develop into an anxiety disorder, which can significantly restrict our life.

Individual differences: What causes anxiety and why are some people more anxious than others?

Although fear is ingrained in all of us, some people react more fearfully to situations than others. Some are afraid of being bitten by a dog or a spider and others do not even feel fear when climbing mountains completely unsecured without a climbing rope. Anxiety, however, is more diffuse than fear. In opposite to fear it is not a reaction to a specific observable danger, but more a kind of unfocused, objectless, future-oriented fear. Anxiety as a trait varies from person to person – but how do these differences in anxiety come about? On the one hand, our genes play a decisive role, on the other hand, our experiences and life circumstances.

Our genes: Is anxiety passed through genes?

We have a genetic disposition for anxiety, i.e. an inherited predisposition to how anxious we react in certain situations or circumstances – some individuals are more easily aroused than others. If one parent suffers from severe anxiety, it is more likely that their children will be more anxious. Further, our fear is biologically anchored. Scientists have found out that anxious people show a higher activity of the amygdala (fear center in the brain) and that higher activity of the amygdala is associated with more subjectively perceived fear. Moreover, people with an anxiety disorder show a hypersensitive activity of the amygdala and have fears in many everyday situations, triggering a chain of fear reactions. Since the amygdala classifies a stimulus as dangerous or harmless and triggers a cascade of fear reactions, this may explain why some of us react more quickly to fear than others.

Our experiences: Can past experiences influence anxiety?

Also, our experiences determine our anxiety. For example, if we are bitten by a dog and feel severe pain, a neutral stimulus – the dog – is classified as a dangerous stimulus because of this painful experience. If we encounter this dog again, our body probably reacts with symptoms of fear at the mere sight of the dog. This reaction is also called learned fear through conditioning. Even if we observe another person, such as our own mother, being bitten by a dog and reacting negatively, we store this experience. Our brain is an association machine and helps us to assess “dangerous” situations through our fear and to prepare ourselves physically for danger. In addition, other factors, such as difficult living conditions, influence the development of persistent anxiety. Stressful life events such as the death of a relative or a sudden loss of a job can also be a trigger for severe anxiety. We learn fears based on individual experiences. But just as we learn many fears in the course of our lives, we can also unlearn fears again or work on them. This is of particular importance when we tend to be anxious in many situations or when the fear limits us in everyday life.

Anxiety disorder: How does fear make me sick?

Anxiety takes on an exaggerated dimension in some people. When anxiety prevents you from managing your daily routine, going to work, or having dinner with friends, this level of anxiety can severely limit your quality of life. If you or even the people around you are heavily burdened by your own fears, this can take up a large part of your everyday life. In this case, an anxiety disorder is likely. Anxiety disorders are among the most common mental illnesses. If people affected by anxiety feel a severe psychological strain or have psychosocial limitations, i.e. are unable to cope with their everyday life – privately or professionally – it is important to contact an expert (such as a psychologist, a psychotherapist, or a psychiatrist) to clarify a possible diagnosis and to do something about the anxiety.

Expert diagnoses are made using an internationally recognized classification system that describes several symptoms and criteria for each disease, the ICD10-GM.

The most common anxiety disorders

Generalized anxiety disorder

A generalized anxiety disorder includes a state of excessive and uncontrollable worry and anxiety without a specific trigger. It is not limited to a specific situation but encompasses a generally persistent feeling of worry, tension, restlessness, and nervousness. The symptoms of anxiety are present on most days for several weeks or months. Often affected individuals are concerned about themselves or others being involved in an accident or being ill.

Panic Attacks

Panic attacks describe recurrent severe anxiety attacks with severe physical and psychological symptoms, such as shortness of breath, feelings of suffocation, nausea, the feeling of fainting or the fear of dying. This is accompanied by an extreme feeling of loss of control. These anxiety attacks can last several minutes or even hours. They usually last up to 30 minutes and recur several times a day or month. Those affected are usually afraid of the recurrence of such attacks. The triggers for this can be completely unpredictable and spontaneous. Panic attacks are often accompanied by agoraphobia (known as claustrophobia). As a result, sufferers often avoid public places and rarely leave their homes.

Specific phobia

A specific phobia includes a fear caused by individual objects or situations that are usually harmless, such as spiders or height. These triggers can also lead to a panic reaction. The mere thinking about a triggering situation can cause physical fear reactions. Women are more often affected than men.

Social phobia

A social phobia includes the fear of situations in which affected individuals might be observed or judged by fellow human beings. This fear can occur in various social situations, such as eating in a restaurant, giving a presentation at school or visiting a doctor. Avoiding these situations can lead to social isolation.

What happens if anxiety disorders are left untreated?

If anxiety disorders are not treated, the anxiety often increases. Those affected report “fear of anxiety” and avoid certain situations in which the anxiety could become more intense. This often has an impact on relationships with others, everyday situations, and the quality of sleep. Sometimes affected people compensate their anxiety with alcohol or tranquilizers, which alleviate or suppress the fear in the short term. However, alcohol and cannabis can also promote anxiety, depending on the individual. If those affected are suffering from severe distress or psychosocial limitations, it is important to take long-term action against the anxiety to reduce the burden.

How common are anxiety disorders?

Anxiety disorders are the most common mental disorders. The risk of developing an anxiety disorder in the course of life – depending on the study – ranges between 14 and 29%. It is therefore very likely that you or someone close to you will develop an anxiety disorder. However, women suffer significantly more from an anxiety disorder than men.

Fear and anxiety: What can I do about them? Tools, tips and techniques for everyday life

There are many techniques to reduce fear or anxiety in everyday life and in stressful situations, such as before exams, job interviews, or lectures. These do not replace therapy for an anxiety disorder! In the following, different approaches are shown to better control fear and anxiety in everyday life.

The different approaches to reduce anxious feelings in everyday life either start with the frightening thoughts – so that anxiety reactions do not arise in the first place – or with alleviating the physical reaction of fear.

2 Tips for dealing with (anxious related) thoughts

Before every feeling we have, there is a thought that triggers the feeling. Therefore it is important to work on your own thoughts and evaluations of your own fear. In the following, a few techniques are presented.

• Psychoeducation: Psychoeducation aims to translate complicated medical-scientific facts in a way that is well understood by everyone. This method comes from therapeutic practice, but it can also be applied to everyday fears and is very helpful. The ability to understand one’s own mental state is the basis for dealing with one’s own fears and overcoming them successfully. The more we know about the circumstances of our fears, the sooner we can work on them specifically. Psychoeducation helps us to deal more with our own fears, to change our attitude towards fears, and to reassess them. The knowledge about fears in general and one’s own fears in particular is the foundation for working on one’s own fear. So if you have read the article up to this point, you are already well on the way to better understand and classify your fear.

• Acceptance: It is important to accept your own feelings – including feelings of fear. It does not help us to suppress our own feelings or to try to eliminate emotions because in some moments your fear can still spread uncontrolled. Avoiding anxiety can even lead those affected to avoid certain situations (such as meeting friends) and to be severely restricted in their everyday life. Therefore it is important to tolerate and accept frightening experiences. Because fear as a feeling will accompany us throughout our lives – therefore it is important not to regard it as an enemy, but as a helper that gives us clues about our mental and physical condition.

4 Tips on how to fight fear and anxiety

Due to our fear, a number of physical symptoms occur which in turn increases the fear. Therefore, it helps to work not only on one’s own thoughts and evaluations but also on the physical fear reactions with the help of calming and relaxation of the body. In the following, a few techniques are presented.

• Breathing: Breathing determines our life. We are all able to breathe. But shallow, superficial breathing can aggravate our anxiety symptoms. On the other hand, healthy deep breathing can alleviate our symptoms. The differences between the forms of breathing are very small but subtle and many of us use breathing in a non-functional, even pathological way. Therefore, it is worth working on a conscious breathing technique. Do you breathe healthy and sustainably? Background information on healthy breathing and also breathing exercises can be found here.
  
• Exercise: Regular exercise and in particular endurance sports have been proven to help with anxiety. Exercise ensures that the tense muscles and stress hormones that are activated by the fear reaction are released again. Therefore, exercise and endurance sports are helpful in reducing fears and anxiety and breaking the anxiety cycle.

• Relaxation: The physical chain reaction as a result of our fear leads, among other things, to muscle tension. In order not to carry this tension within oneself for too long, relaxation techniques can help to relax and escape the vicious circle of fear. Do you know how to relax quickly and effectively? You can find more about relaxation techniques here.

• Posture: Our posture and muscular activity have a direct influence on our mood. Taking a different posture or even smiling consciously seems like a marginal change – but often we don’t use this knowledge for ourselves. When and how you use your posture exactly for yourself and a detailed instruction can be found here.

Treatment of anxiety disorders

If an anxiety disorder is present, these methods are not sufficient and should be supplemented by therapy. To clarify a possible diagnosis, one should consult a psychiatrist, psychologist, or psychotherapist.

Types of Therapy at a Glance

• Cognitive behavioural therapy: Cognitive behavioural therapy is about becoming clear about one’s thoughts, attitudes and expectations, recognising and changing stressful beliefs and adapting behaviour.
  
• Psychodynamic psychotherapy: Psychodynamic psychotherapy is about resolving the patient’s unconscious conflicts through new experiences.
  
• Pharmacotherapy: For the treatment of anxiety disorders, in addition to counselling or conversational therapy, there is always the possibility of pharmaceutical treatments to alleviate anxiety and its symptoms. Depending on the type of anxiety disorder there are different pharmaceutical solutions.
  
• Patient self-help groups: Self-help groups work without professional guidance, but occasionally specialists are called in for advice. They make use of the experience of the affected individuals, the special understanding for each other, solidarity, and mutual support. Many members of self-help groups have previously used psychotherapy (individually or in groups) and use self-help groups as a form of aftercare. Others take advantage of individual therapy and are in a self-help group as a supplement.

Self-care challenge

In the coming days, pay attention to situations in which you feel anxious. In this way you can identify your fearful thoughts, your environment and you have a first clue to counteract your fears.

What are your best tips for overcoming anxiety? If you have any feedback, questions or additions to today’s article, please feel free to message us here or on instagram (@psychologyjungle). The anonymous comment function allows for an exchange of content. Make sure you treat everyone with respect, even when we are on the Internet 🙂