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Phobias
Important!
If a person suspects that he or she or a loved one is suffering from phobia, it is important to remember that the condition is treatable and seek the help of a professional as soon as possible.

GENERAL

What is a phobia?

A phobia is an anxiety disorder and usually occurs as a persistent, illogical fear of a specific object or situation. The person who suffers from it will go to the limit to fix these objects or situations avoid. That fear is usually too unrealistic and is thus seen by the person experiencing the fear.

If the person fails to avoid the situation or object (eg a spider or a meeting), it causes intense discomfort or anxiety and the person struggles to complete his / her current activity. Phobias are generally divided into three categories:

  1. Specific phobia: Fear of something specific, e.g. spiders, heights, snakes, nuts, etc. Most people experience some fear of these things, but someone with complete phobia will do anything to avoid these objects or situations.
  2. Social Phobia / Social Anxiety Disorder: Fear of other people or social situations, e.g. embarrassment or self-awareness in other people's presence, avoidance of public situations or conversations with others.
  3. Agoraphobia: A common fear of leaving one's home or a specific "safe" area, with possible panic attacks that may follow. This anxiety can also be triggered by specific phobias, such as a fear of germs, public places, shopping malls, etc.

SPECIFIC PHOBIA

symptoms

What are the symptoms of a specific phobia?

The following symptoms are indicative, based on the Diagnostic and Statistical Manual of Mental Disorders (DSM – 5), accepted worldwide as the most authoritative source:

Important
Note that an official diagnosis may only be made by a qualified person.
  1. To be diagnosable, there must be a repetitive pattern of clear and persistent irrational fear being triggered by a specific object or situation (eg, flying, animals, injection).

    (In children, this fear can be expressed by crying, a rage [tantrum] to "throw", freeze or cling to someone.)

  2. Exposure to these situations or objects causes immediate anxiety, which is physically detectable (eg crying, panic attacks).
  3. The situation or object is actively avoided or endured with intense fear or anxiety.
  4. The fear or fear reaction is disproportionate to the real danger posed by the object or situation (cultural norms taken into account).
  5. The fear / anxiety / avoidance is long-lasting and has been occurring for at least six months.
  6. The fear / anxiety / avoidance causes considerable discomfort and / or adversely affects the person's functioning (at home, school, work, social, etc.).
  7. The disorder is not better explained by another diagnosis, e.g. including those of agoraphobia, post-traumatic stress or separation anxiety.

Phobia triggers (triggers)

A person may exhibit a phobia for one or more of the following:

  1. animals (eg spiders, snakes, insects, dogs, etc.)
  2. natural environment (s) (e.g. altitudes, storms, water, thunder)
  3. injections, injuries (eg needles, certain medical procedures, blood)
  4. a particular situation (eg in aircraft, lifts, when [enclosed] places)
  5. others (e.g. situations that can lead to choking or vomiting, loud noises, costume characters - mostly in children)

Therapy

Treatment of a specific phobia

Why is treatment needed for a phobia?
A phobia is a more serious degree of anxiety. In some cases, there is even an inability of the person to walk out of his / her front door without fear. Help and support from a clinical psychologist, or another category of psychologist with experience in treating this condition, is extremely important in treating this disorder. Appropriate psychotherapy is also often used in combination with medication to treat a phobia.

How is a phobia treated?
As with most psychological problems, it is necessary to seek professional help. A registered psychologist with experience in the treatment of phobias can work out a treatment plan with you to discuss the psychological approach that can be followed, as well as the other professionals to be involved. Often medication is needed and for that the psychologist can refer you to a psychiatrist, who will then do a full assessment and consideration for the appropriate medication. Some psychologists will also, depending on the process and stage, make / recommend practical suggestions that a client can try at home.

As a basis for working on the specific phobia, it is always necessary to make healthy lifestyle choices that promote mental health, e.g. regular exercise, healthy sleeping habits and balanced eating.

How do I support someone with a phobia?
It is important to remember that the person does not actively choose to have a phobia, or be afraid of a specific object or situation. He / she usually knows that fear does not make rational sense. It doesn't help to mock them or argue with them about it. The best thing one can do is encourage the person to get professional help for the phobia, especially if it impedes their functioning. The therapeutic process may be difficult and exhausting for them and it is precisely then that encouragement and support can be valuable.

Support

How do I support someone with a specific phobia?

It is important to remember that the person does not actively choose to have a phobia, or to be afraid of a specific object or situation. He / she usually knows that fear does not make rational sense. It does not help to mock them or reason with them. The best thing one can do is to encourage the person to get professional help for the phobia, especially if it limits their functioning. The therapeutic process may be difficult and exhausting for them and it is precisely then that encouragement and support can be valuable.

SOCIAL DISEASE DISORDER

symptoms

What are the symptoms of a social anxiety disorder?

The following symptoms are indicative, based on the Diagnostic and Statistical Manual of Mental Disorders (DSM – 5), accepted worldwide as the most authoritative source:

Important
Note that an official diagnosis may only be made by a qualified person.
  1. A notable fear or fear of one or more social situations where someone is exposed to possible judgment by other people, for example:
    1. social interaction (meeting new people or having conversations with strangers);
    2. to be observed (eg while eating or drinking); or
    3. to act in front of others (e.g., to deliver a speech).
    4. (In children, this anxiety should happen in peer situations and not just in adult situations.)

  2. The person fears that they will show symptoms of anxiety or reveal certain behaviors that can be negatively assessed (ie they will be humiliated or embarrassed, which will result in rejection or offending).
  3. Social situations will almost always result in fear or anxiety (in children, this fear or anxiety will usually be expressed by crying, "throwing" an anger attack [floor nut], freezing, clinging to someone, recoiling or to be bot still).
  4. Social situations are avoided or endured with intense fear / anxiety.
  5. The fear / anxiety is disproportionate to the real threat posed by the social situation.
  6. The fear, anxiety or avoidance is long-lasting and is present for six months or longer.
  7. The fear, anxiety or avoidance causes considerable discomfort or impairs the person's functioning in different situations, e.g. at work, socially and in other important areas.
  8. The fear, anxiety or avoidance is not due to the effect of a drug (drug or medication) or some other medical condition.
  9. The fear, anxiety or avoidance is not better explained by another psychological condition, e.g. panic disorder, autism spectrum disorder (OSV) or something else.
  10. If another medical condition is present (eg Parkinson's disease, obesity, etc.), the fear, anxiety or avoidance is excessive but unrelated.
Did you know?
We specify someone's social anxiety as "action only" when it is limited to situations where the person has to speak or act in public.
It is predominantly limited to people who have to act in public as part of their profession, e.g.
  1. musicians
  2. dancers
  3. athletes
  4. people who need to talk in public on a regular basis
These symptoms can also occur in academic situations. People with anxiety who are "only action related" do NOT fear other social situations.
Interesting
Two-thirds of people with social anxiety disorder experience a different psychiatric condition at the same time (we are talking about comorbidity, ie disorders that occur together).
Disorders that are frequently associated with social phobia are:
  1. agoraphobia
  2. alcohol abuse or addiction
  3. depression
  4. other addictions, e.g. to drugs or medication
  5. eating disorders

Situations that are accelerators

Situations that can trigger symptoms

Below are some triggers. There may be many more, but these are the common ones:

  1. to be introduced to new / strange people
  2. eye contact
  3. to be mocked or criticized
  4. to be the center of interest
  5. to be watched while doing something, e.g. make calls, write, eat, etc.
  6. to have to say something in public
  7. to meet people in positions of authority
  8. to feel uncomfortable or insecure in social situations
Did you know?
MYTH: People with social anxiety disorder / social phobia are always shy.
FACT: People with social anxiety disorder are NOT always shy people. They can often be very comfortable between people, but their anxiety is accelerated in specific situations.
Remember!
Social anxiety disorder or social phobia is the third biggest mental health problem in the world.

Therapy

Treatment of social anxiety disorder

Why is treatment necessary for social anxiety disorder?
Just as with a specific phobia, social anxiety disorder / social phobia is a more severe degree of anxiety. In some cases, there is even an inability of the person to walk out of his / her front door without fear or have contact with other people. In addition to the negative impact that a social anxiety disorder has on someone's functioning, it can also lead to, or be related to, other disorders such as eating disorders or addiction to alcohol, medication or drugs.

Good news!
Social anxiety disorder responds very well to treatment, provided that the client remains motivated to work on this.

Family problems, a lack of personal relationships and difficulties in finding and retaining work, are problems that are also associated with social anxiety disorder.

Help and support from a registered psychologist is extremely important to treat this disorder. Psychotherapy is also often used in combination with medication to treat a phobia.

How is social anxiety disorder treated?
As with most psychological problems, it is usually necessary to seek help from a professional. The following are the most common:

  1. Medical research
    A thorough evaluation by a medical doctor can be a valuable first step in making sure that there are no medical triggers for the anxiety. If not, the next step is to investigate the psychological nature of the anxiety.
  2. Psychotherapy
    A registered psychologist with experience in the treatment of disorders in this field can draw up a treatment plan with you to discuss the psychological approach that can be followed, as well as the other professionals to be involved.
  3. Support groups
    A support group can be invaluable to someone suffering from social anxiety disorder. Within the group, people share their “stories” and challenges and learn from each other's skills and experiences. However, finding a support group in one's environment is not always easy. Online searches sometimes produce good results. More information can be found on the SADAG website found.
  4. Medication
    Medication is often needed and for this the psychologist can refer you to a psychiatrist who will do a full assessment and consider and prescribe appropriate medication if needed. If someone is at all sensitive to addiction (in other words, can easily become addicted to something), it is of cardinal importance to inform the psychiatrist, medical practitioner, psychologist and all others involved.
  5. Lifestyle
    As a basis for working on social anxiety disorder, it is always necessary to make healthy lifestyle choices that promote mental health, e.g. regular exercise, healthy sleeping habits, balanced eating, and time to think and relax. Rest and routine promote mental health.

Support

How do I support someone with a social anxiety disorder?

It is important to remember that the person does not actively choose to be anxious. He / she usually knows that the anxiety / fear does not make rational sense. It doesn't help to mock them or argue with them about it. The best thing one can do is encourage the person to get professional help, especially if it hinders their functioning. The therapeutic process may be difficult and exhausting for them. This is precisely when encouragement and support will be very valuable.

Courage!

Courage!

Do not give up if you do not quickly see an improvement in your symptoms. Change requires time, especially when working at a deeper level. It may also take some time to work out the right medication and dosage for you. Stay in touch with your treatment team and keep track of your appointments consistently. It can also help set goals for yourself to attend certain social situations where you may be challenged or exposed.

AGORAPHOBIE

General

General

“Agora” / (æɡərə) [GRK]) is the Greek word used for the market square or place of public gathering.

Agoraphobia is therefore the irrational fear of public or open spaces. The person fears situations where they can lose control, get trapped and / or not get help.

symptoms

What are the symptoms of agoraphobia?

The following symptoms are indicative, based on the Diagnostic and Statistical Manual of Mental Disorders (DSM – 5, accepted worldwide as the most authoritative source:

  1. A noticeable fear or anxiety for two or more of the following:
    1. the use of public transport (eg cars, buses, trains, ships, aircraft);
    2. to be in open spaces (eg parking areas, market squares, bridges);
    3. to be in enclosed spaces (eg in shops, theaters, movie theaters);
    4. to stand in a row or be part of a crowd; and / or
    5. to be alone outside the house.
  2. The fear or avoidance of the above situations because:
    1. the person thinks that escape may be difficult;
    2. help may not be available;
    3. he / she may panic; and / or
    4. he / she may experience other symptoms that may be embarrassing to him / her, (eg falling or losing bladder control).
  3. The above situations almost always provoke fear or anxiety.
  4. The dreaded situations are actively avoided; the person longs for a companion or the situations are endured with intense fear or anxiety.
  5. The fear or anxiety is disproportionate to the real danger in the situation and the cultural context.
  6. The fear, anxiety or avoidance is ongoing and lasts for six months or longer.
  7. The fear, anxiety or avoidance causes noticeable discomfort and restriction in social, work and other important areas of functioning.
  8. Even if there is any other medical condition present, the anxiety is still extremely intense.
  9. The fear, anxiety or avoidance is not better explained by another psychological condition.
Important
Note that an official diagnosis may only be made by a qualified person.
Remember!
The person is convinced that something terrible will happen if he / she is exposed to the dreaded situation.
Did you know?
Agoraphobia can occur with or without panic attacks.

Therapy

Treatment of agoraphobia

Why is it necessary to treat agoraphobia?
Agoraphobia can greatly limit one's life. It prevents you from learning and experiencing new things, meeting new people, or even performing everyday tasks because there is too much fear and discomfort associated with doing them. One with agoraphobia can become increasingly isolated, which in turn can lead to other physical and mental health problems. In extreme forms, it can prevent someone from doing their job, which can have serious financial implications. It is therefore essential to obtain the necessary professional help.

How is agoraphobia treated?

  1. Diagnosis
    An accurate diagnosis is very important. Therefore, start by requesting a complete medical examination from your GP to make sure there is no other medical explanation for your symptoms. If not, the next step is to make an appointment with a psychologist or psychiatrist, who can fully assess and diagnose you.
  2. Psychotherapy / psychological therapy / talk therapy
    Psychotherapy is an effective way to treat agoraphobia. In therapy, a person will learn the skills to deal with their anxiety symptoms, challenge their fears and systematically learn to deal with certain situations. If it is difficult for a person to leave the house and keep an appointment, there are therapists who will do consultations by telephone or through the electronic media. If the condition is so severe that the person cannot benefit from the above services, admission to a psychiatric hospital is an alternative option.
  3. Medication
    In many cases, medication in combination with therapy is used effectively to treat agoraphobia. For this, your psychologist will be able to refer you to a psychiatrist who will assess and consider you for prescribing medication, if necessary. It may take "try-and-hit" to get the right medication and dose that works for you. Stay in touch with your doctor and communicate any changes or side effects you may experience.
  4. Lifestyle
    As a foundation for working on agoraphobia, it is always necessary to make healthy lifestyle choices that promote mental health, e.g. regular exercise, healthy sleeping habits, balanced eating habits and time to think and relax. Rest and routine promote mental health. It usually helps to limit the use of alcohol and caffeine.

Support

How do I support someone with agoraphobia?

It is important to remember that the person does not actively choose to be anxious / scared. The person usually knows that the anxiety / fear does not make rational sense. It does not help to mock them or reason with them. The best thing one can do is to encourage the person to get professional help, especially if the condition limits their functioning. You can also offer to accompany the person to his / her first appointment or provide transport to appointments.

Important
It does not benefit to mock someone with agoraphobia or argue with them about their fears.

The therapeutic process may be difficult and exhausting for them. This is exactly when encouragement and support will be very valuable.

Courage!

Courage!

Do not give up if you do not quickly experience an improvement in your symptoms. Change takes time, especially if one is working on a deeper level. It may also take some time to work out the right medication and dosage for you. Stay in touch with your treatment team and keep your appointments consistent. It can also help you set goals for yourself to attend certain social events where you may feel challenged or exposed.

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EMERGENCY MEASURES

If you or a loved one is struggling with mental health problems, we suggest the following options:
  1. call your GP (if available);
  2. go to your nearest hospital emergency room;
  3. call one of the following emergency numbers: SADAG (the South African Depression and Anxiety Group) 24-hour helpline: 0800 12 13 14 or suicide crisis line: 0800 567 567; or
  4. contact Wie is ek?