PHOBIAS

 

PHOBIA

This is a minor mental illness or neurotic illness in the sufferer has persistent irrational fear of specific object or stimulus or situation and recognising that it is unfounded.

There are two main types of phobia, namely:

A)    SOCIAL PHOBIAS

This is characterised by fear of other people or social situations such as performance anxiety and fear of embarrassment of scrutiny of others.

Social phobias are subdivided into:

i)                 Generalised social phobia

ii)               Specific social phobia in which anxiety is triggered only in specific situations. The symptoms may extend to psychosomatic manifestations of physical problems, e.g. patients of paruresis find it difficult to urinate in reduced levels of privacy. This goes far beyond mere preference when the condition triggers the person physically cannot empty the bladder.

DIAGNOSIS OF SOCIAL PHOBIAS

1.     A marked and resistant fear of one or more social or performance situations in which the person is exposed to unfamiliar people to possible scrutiny by others. The individual fears he will act in a way that will be humiliating or embarrassing.

 

2.     The person recognises that the fear is excessive or unreasonable.

 

3.     The feared social or performance situations are avoided or else endured with intense anxiety or distress.

 

4.     Exposure to the several social situations almost invariably provokes anxiety which may take the form of a situational bound or predisposed panic attack.   

 

5.     The avoidance anxious anticipation or distress in the feared social situation interferes significantly with the person’s normal routine occupational or academic functioning or social activities or relationships or there is marked distress about having the phobia.

 

iii)              AGORAPHOBIA

This is a generalised fear of leaving home or small safe familiar area for an open and crowded area. This may lead to a panic attack.

 

SPECIFIC PHOBIA     

 

This is marked by persistent fear of an object or situation that brings about an excessive or unreasonable fear when in the presence of or anticipating a specific object, such as, spiders, snakes, dogs, water, height, flying or catching a certain disease.

 

Specific phobias may also include concerns with losing control, panicking and fainting which are the direct result of an encounter with the phobia. Specific phobias are defined in relation to objects or situations, whereas social phobias emphasise on social fear and the evaluations that might accompany them.

 

DIAGNOSIS OF SPECIFIC PHOBIA

 

-        Marked and persistent fear that is excessive or unreasonable caused by the presence of or anticipation of specific object or situation e.g. flying, heights, spiders, animals, blood, etc.

 

-        Exposure to the phobia stimulus almost invariably provokes an immediate anxiety response which may take the form of a situational bound or situational predisposed panic attack.

 

-        The person recognises that the fear is excessive or unreasonable

 

-        The phobia situation is avoided or else endured with intense anxiety or distress.

 

-        The avoidance anxious anticipation or distress in the feared situation interferes significantly with the person’s normal routine occupational or academic functioning or social activities or relationships or marked distress about having the phobia.

 

Phobias differ in intensity and severity among individuals. Some individuals can simply avoid the object/stimulus of their fear and suffer relatively mild anxiety or that fear. However, others suffer full fledged panic attacks with all the associated disabling symptoms. Most individuals understand that they are suffering from irrational fear, but are powerless to overcome their panic reaction.

 

MANAGEMENT

 

Cognitive behavioural therapy (CBT) allows the patient to challenge dysfunctional thoughts or beliefs by being mindful or their own feelings with the aim that the patient will realise that the fear is irrational. CBT can be conducted in a group setting.

 

Give antidepressant medication such as Benzodiazepine that can be used in acute treatment of severe symptoms.

 

Prolonged exposure (flooding) is used in psychotherapy when the patient is exposed to objects that he fears for long period.

 

Hypnotherapy may be used to improve common phobias, such as social, dental, driving, hospital, etc. It aims at getting the individual in a relaxed state of mind where the subconscious can be engaged.

 

NURSING CARE

 

Take all the vital on daily basis.

Conduct psychological care

 

COMPLICATIONS OF PHOBIA

 

·       Flight myocarditis

·       Depression

·       Respiratory distress

·       Mental retardation

·       Peptic ulcers