Emerging from our COVID Bunkers

UNMASKING PHOBIA

So many of us find ourselves with phobias.  Are you afraid of closed-in spaces, spiders, or flying in an airplane?  For most people, a negative experience starts the phobia.  

Pandemic anyone?  In countries that seem to have beaten COVID,  researchers have found that a significant number of people have developed agoraphobia and are afraid to leave their houses even though it is now safe for vaccinated people to go out.  This is not too surprising, after all, the message that was not safe to leave the house was pounded into our brains by the news, public service announcements, and social media.  Now some people will need help to unlearn that fear.

Like most anxiety disorders, phobias like agoraphobia are related to the fight or flight response,  This response is part of our body's survival mechanism.  

When our caveman ancestors were faced with physical danger, a part of the brain called the amygdala was activated in seconds to prepare for a threat.  It started motor functions to fight or run away.  Heart pounded, hands, and feet got cold, pupils dilated and the pain response was blunted.  The amygdala also triggered the release of stress hormones and the sympathetic nervous system.  Despite our much safer environment in the modern world our amygdalas still work the same way.

There are three main ways that phobias develop 
A lot of phobias develop as a result of having a negative experience.  People who have been trapped in elevators and feared that somehow they would not be able to breathe or that the elevator would fall down the shaft can develop claustrophobia.  I have several clients who have told me a stuck elevator was what started their fear of enclosed spaces.  Of course, there is little real danger because modern elevators have all kinds of breaking and fail-safe systems to protect occupants so that fear is actually unrealistic, most phobias are actually irrational when you look at them logically.  Nonetheless,  claustrophobia results when the mind generalizes the initial fear felt in the elevator to a fear of being in any small space.

  
Phobias can also beset people who have panic attacks.  If they have a panic attack in a movie theater, for example,  their brains oftentimes will generalize the fear to that theater or even all movie theaters instead of just identifying the unrealistic catastrophic thoughts they had that caused the panic attack.   If they avoid every place where they had a panic attack they might be unable to go to many places that they used to enjoy. 

Nature or nurture?  An anxious disposition can make a person more likely to develop a phobia and there is some evidence that anxiety can be inherited. In twin studies, identical twins were found to be more likely to both have an anxiety disorder than fraternal twins.  Identical twins have the same genes and fraternal twins share only 1/2 of their genes. Researchers think that this shows that anxiety may be linked to a gene.  But no anxiety gene has been discovered.  

There is also evidence that phobias can be learned from your environment.  Your parents' or siblings' phobias can become yours if they act afraid of certain stimuli and avoid them.  For example, you can become scared of snakes if those around you tell you how ugly and slimy they are, even if you have never really seen a snake in your life (actually they are not slimy at all, snakes are smooth and dry) In the pandemic environment we may have inadvertently learned that it is not safe to go outside without a mask from the frequent warnings to mask up and stay safe!

Changes in brain functioning also may play a role in developing specific phobias. For example, Having a traumatic head injury can make you more vulnerable to anxiety disorders, including phobias. A certain kind of dementia called frontotemporal dementia also makes you more likely to develop phobic reactivity.   Luckily there are behavioral treatments and medicines to treat these symptoms. 

Change is difficult.  The Pandemic has put us through so many stressful ones.  With the reduced restrictions on gathering and mask-wearing for vaccinated people, we might experience a small international wave of agoraphobia and contamination phobias. 

In any case, it is probably best to re-emerge from our quarantine state with baby steps.  We can use CDC guidance to reality-test unrealistic catastrophic thoughts

  

It is comforting to know psychologists have a lot of data and research in the field of phobias and that includes evidence-based treatments such as exposure therapy and cognitive-behavioral therapy.  If your phobia about re-emerging from the pandemic persists,  get in contact with a mental health professional.  We can help manage your anxieties and fears.