By: Abhinav Malhotra, Bureau Chief ICN Punjab & Corporate Brand Manager ZDL Zodiacal Pharmaceutics Pvt Ltd
The thin demarcation that demands spotlight
In the words of the Revered Swami Vivekananda Ji
“The whole secret of existence is to have no fear”
CHANDIGARH: Beginning the article on a positive yet pragmatic note, we will dive deep into the mystery of “fear” and the modern misused term “anxiety”. First, let us learn the basic definition of both the terms and understand the semantics.
| Fear | Anxiety |
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As per the definition extrapolated from the National Centre for Biotechnology Information, ‘fear’ arises from the imminence of an unpleasant event. |
On the other hand, ‘anxiety’ comes from being in a context when an unpleasant event will occur but with uncertain timing and perhaps not imminently. |
The subtle difference in both the terms often leads to the misuse of each.
As per WHO, Anxiety disorders are the world’s most common mental disorders affecting roughly 301 million people in 2019 , where women are more affected than men. Out of the 301 million patients, only 27.6% receive any treatment. Well a disorder that is roughly hitting 1 in every 4 individuals on this planet surely needs more clarity and understanding to be treated in the right manner.
Hence, to shed some more light on this, we will share the opinions and advice of a renowned young psychiatrist, Dr.Vinay Bansal who is successfully running a private psychiatry setup by the name ‘Vishwas Hospital’ Located in Zirakpur (Dist.Mohali) Punjab. The questions mentioned below were directed to him and the replies have been recorded concisely.
- Explaining Anxiety and Fear in a single example
Anxiety and fear can be understood through the example of public speaking.
Imagine you have to deliver a presentation in front of a large audience. Anxiety might manifest as a sense of unease or worry about the upcoming event, perhaps causing physical symptoms like a racing heart or sweaty palms beforehand. You may experience intrusive thoughts about potential mistakes or negative outcomes, such as forgetting your lines or being judged harshly by the audience.
Fear, on the other hand, arises at the moment of stepping onto the stage. It’s a visceral reaction to the immediate threat perceived – in this case, the fear of embarrassment or failure. Your body might tense up, your voice might tremble and your mind might go blank as you face the daunting task of speaking in front of others.
In this example, anxiety encompasses the anticipation and apprehension leading up to the event, while fear encapsulates the intense emotional response triggered by the actual situation. Both emotions are intertwined and can profoundly impact one’s ability to perform effectively in such a scenario.
- Types of Anxiety an individual may experience
- Generalized Anxiety Disorder (GAD): Individuals with GAD experience excessive worry and anxiety about a wide range of everyday events and activities. This anxiety is often disproportionate to the actual circumstances and persists for an extended period.
- Panic Disorder: Panic disorder involves recurrent and unexpected, sudden episodes of intense fear or discomfort that peak within minutes. Panic attacks can be accompanied by physical symptoms such as heart palpitations, sweating, trembling, shortness of breath, and feelings of impending doom.
- Social Anxiety Disorder (Social Phobia): People with social anxiety disorder experience significant fear or anxiety in social situations where they may be scrutinized or judged by others. This fear can lead to avoidance of social interactions, public speaking, or performance situations.
- Specific Phobia: Specific phobia involves an intense and irrational fear of a specific object, situation, or activity. Common phobias include fear of heights (acrophobia), fear of spiders (arachnophobia), fear of flying (aviophobia), and fear of enclosed spaces (claustrophobia).
- Obsessive-Compulsive Disorder (OCD): OCD is characterized by the presence of obsessions (intrusive, unwanted thoughts, images, or urges) and compulsions (repetitive behaviors or mental acts performed to reduce anxiety or prevent perceived harm). Individuals with OCD may engage in rituals such as hand washing, checking, or counting to alleviate their anxiety.
- Post-Traumatic Stress Disorder (PTSD): PTSD can develop after exposure to a traumatic event, such as combat, natural disaster, or physical assault. Symptoms may include intrusive memories, flashbacks, nightmares, avoidance of trauma-related triggers, hypervigilance, and mood disturbances.
7. Separation Anxiety Disorder: This disorder involves excessive anxiety about separation from attachment figures, such as parents or caregivers. It is commonly diagnosed in children but can also affect adults.
- Phobia and its connection with anxiety or fear
A Phobia is an extreme and irrational fear of a specific object, situation, or activity. It is characterized by a persistent and intense fear that is disproportionate to the actual danger posed by the feared stimulus. Phobias can lead to significant distress and impairment in daily life, often causing individuals to go to great lengths to avoid the object of their fear.
The connection between phobias, fear, and anxiety lies in the exaggerated fear response that phobic individual’s experience. Fear is a natural and adaptive response to real or perceived threats, triggering the body’s “fight or flight” response to help ensure survival. In contrast, phobias involve an intense and exaggerated fear response that is out of proportion to the actual level of danger. This disproportionate fear can lead to significant anxiety, as individuals with phobias may constantly worry about encountering the feared stimulus and experience anticipatory anxiety even when the threat is not present.
For example, someone with a fear of flying (aviophobia) may experience intense anxiety and panic at the thought of boarding a plane, despite knowing that flying is statistically safe. This fear can lead to avoidance behaviors, such as refusing to travel by plane or experiencing significant distress during flights.
The anxiety associated with phobias often manifests as physical symptoms such as rapid heartbeat, sweating, trembling, shortness of breath, and nausea. Over time, these symptoms can become conditioned responses to the feared stimulus, reinforcing the phobia and further exacerbating anxiety.
Treatment for phobias typically involves exposure therapy, cognitive-behavioral therapy (CBT), and relaxation techniques aimed at helping individuals gradually confront and overcome their fears. By gradually exposing themselves to the feared stimulus in a controlled setting, individuals can learn to manage their anxiety and reduce their phobic responses.
- Depression and its link to anxiety or fear
Depression, fear, and anxiety can often be interconnected and influence each other in various ways:
- Co-Occurrence: Depression commonly co-occurs with anxiety disorders. Many individuals with depression also experience symptoms of anxiety, such as excessive worry, restlessness, and irritability.
- Shared Symptoms: Depression, anxiety, and fear can share similar symptoms, such as fatigue, difficulty concentrating, and sleep disturbances. This overlap can make it challenging to differentiate between the three conditions.
- Negative Thought Patterns: Depression often involves negative thought patterns, such as feelings of worthlessness, hopelessness, and guilt. These negative beliefs can contribute to anxiety and fear, as individuals may worry about their future or fear that things will never improve.
- Avoidance Behaviors: Individuals with depression may engage in avoidance behaviors to cope with their negative emotions. This avoidance can reinforce anxiety and fear by preventing individuals from confronting their fears and learning effective coping strategies.
- Biological Factors: There may be underlying biological factors that contribute to the co-occurrence of depression, fear, and anxiety. For example, abnormalities in brain chemistry or neurotransmitter imbalances can influence mood regulation and contribute to the development of both depression and anxiety disorders.
- Environmental Stressors: Stressful life events or traumatic experiences can trigger or exacerbate symptoms of depression, anxiety, and fear. These stressors can create a cycle of negative emotions and behaviors that reinforce each other.
- Treatment Implications: Effective treatment for depression often involves addressing symptoms of anxiety and fear as well. Cognitive-behavioral therapy (CBT), which focuses on identifying and challenging negative thought patterns and behaviors, is commonly used to treat both depression and anxiety disorders.
Overall, depression, fear, and anxiety are complex and multifaceted conditions that can influence each other in significant ways. Understanding the interconnectedness of these conditions is essential for developing comprehensive treatment strategies that address the unique needs of each individual.
| Tips to counter Fear | Tips to reduce Anxiety |
| · Acknowledge Your Fear: Recognize and acknowledge your fear rather than trying to ignore or suppress it. Accepting your fear is the first step towards managing it effectively.
· Practice Relaxation Techniques: Engage in relaxation techniques such as deep breathing, progressive muscle relaxation, or visualization exercises to help calm your mind and body when feeling fearful. · Challenge Negative Thoughts: Challenge negative or catastrophic thoughts associated with your fear. Ask yourself if there is evidence to support these thoughts and whether there are more realistic and balanced perspectives to consider. · Focus on the Present: Stay focused on the present moment rather than worrying about what might happen in the future. Mindfulness techniques can help you stay grounded and reduce anxiety about uncertain outcomes. · Seek Support: Reach out to friends, family members, or a therapist for support and reassurance. Talking about your fears with others can provide perspective and help alleviate feelings of isolation. · Take Small Steps: Break tasks or situations that trigger fear into smaller, manageable steps. Gradually exposing yourself to the source of your fear in a controlled way can help desensitize you to it over time. · Use Positive Affirmations: Use positive affirmations or self-talk to challenge fearful thoughts and build confidence. Repeat affirmations such as “I am strong,” “I can handle this,” or “I am safe” to counteract negative thinking patterns. · Stay Active: Engage in activities that you enjoy and that promote a sense of well-being. Physical exercise, hobbies, and spending time with loved ones can help distract you from fearful thoughts and boost your mood. · Educate Yourself: Learn more about the object or situation that triggers your fear. Understanding the facts and dispelling misconceptions can help reduce anxiety and increase feelings of control. · Seek Professional Help: If your fear significantly interferes with your daily life or functioning, consider seeking help from a mental health professional. Therapy, such as cognitive-behavioral therapy (CBT), can provide effective strategies for managing and overcoming fear. · Remember that coping with fear is a gradual process, and it’s okay to take small steps towards facing your fears. Be patient with yourself and celebrate your progress along the way.
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· Practice Deep Breathing: Deep breathing exercises can help calm the body’s stress response and reduce anxiety. Try taking slow, deep breaths in through your nose, holding for a few seconds, and then exhaling slowly through your mouth. · Stay Present: Practice mindfulness techniques to stay grounded in the present moment and reduce worrying about the future or ruminating on the past. Pay attention to your senses and focus on the sensations of your breath, the sounds around you, or the feeling of your feet on the ground. · Engage in Regular Exercise: Physical activity can help reduce anxiety by releasing endorphins, which are natural mood lifters. Aim for at least 30 minutes of moderate exercise most days of the week, such as walking, jogging, biking, or yoga. · Limit Caffeine and Alcohol: Caffeine and alcohol can worsen anxiety symptoms, so try to limit your intake or avoid these substances altogether. Opt for decaffeinated beverages or herbal teas. · Get Adequate Sleep: Lack of sleep can exacerbate anxiety symptoms, so prioritize getting enough restful sleep each night. Stick to a regular sleep schedule, create a relaxing bedtime routine, and limit screen time before bed. · Set Realistic Goals: Break tasks down into smaller, manageable steps and set realistic goals for yourself. This can help prevent feeling overwhelmed and reduce anxiety about accomplishing everything at once. · Practice Relaxation Techniques: Experiment with different relaxation techniques, such as progressive muscle relaxation, guided imagery, or visualization exercises, to help calm your mind and body. · Seek Social Support: Talk to friends, family members, or a therapist about your feelings and concerns. Social support can provide reassurance, perspective, and practical help in managing anxiety. · Limit Exposure to Stressors: Identify triggers that contribute to your anxiety and try to limit your exposure to them when possible. This may involve setting boundaries, saying no to additional commitments, or avoiding stressful situations. · Consider Professional Help: If your anxiety persists or significantly interferes with your daily life, consider seeking help from a mental health professional. Therapy, medication, or a combination of both may be recommended to effectively manage your anxiety. · Remember that overcoming anxiety is a process that takes time and patience. Be kind to yourself and celebrate small victories along the way. If one technique doesn’t work for you, don’t hesitate to try another until you find what works best for you.
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Well, we can summarize the differences stated above in the following manner:
Fear being a natural and adaptive response to real or perceived threats should not be confused with anxiety where even biological factors can be a contributor. Overcoming both, anxiety and fear have several common examples which are extremely easy to adapt and implement in our busy schedules too.
Further, there should be no hesitation in seeking help from a qualified professional. Mental Health has garnered great attention in the past few years where destigmatization of mental illness has played a vital role. The Government of India had promulgated the Mental Health Act (2018), which even mentions in the Chapter V that a person with any form of mental illness shall be provided with free legal aid to exercise any of his rights given under this act.
Hence after this detailed description of fear and anxiety, we surely believe that it is extremely important to “DECODE” such terms and bring about more clarity and context in all aspects of Mental Health.
References:
- https://www.merriam-webster.com/dictionary/fear
- https://www.who.int/news-room/fact-sheets/detail/anxiety-disorders
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9616241/
- Kaplan and Sadock’s Comprehensive Textbook of Psychiatry
- indiacode.nic.in
