Have no fear treating phobias

By Harold Ayodo

Drinking from a bottle is normal and ordinary for most people but not Philister Mwangi. She is filled with overwhelming, irrational dread by the sight of a person drinking from a bottle.

It doesn’t make any more sense to her than it does to others but Mwangi, 26, believes that the fear stems from a bad childhood experience. "I once mistook vinegar for water while in Standard Four and took a gulp. The unexpected, sour taste was too much," she says. The househelp had put the vinegar in mineral water bottle but forgot to change the label. That’s what a phobia is: a fear that has nothing to do with logic or common sense. It is a persistent and irrational trepidation of a specific object, activity or situation resulting in a compelling desire to avoid the dreaded.

Into a panic

Some people are scared of lizards, or heights or flying or more dangerous things. Pauline Atieno, 20, cannot stand the sight of cobwebs and spiders. "I have always feared spiders. Just the sight of a cobweb sends me into a panic," she says.

Nicholas Kamau dreads woollen sweater soaked in water and heights. "I fear heights (acrophobia) and avoids lifts and elevators…I travel by road or rail to annual company meetings in Mombasa while my colleagues fly," Kamau says.

The Head of Mental Health Services at Kenyatta National Hospital Margaret Mak’anyengo says there are all manner of phobias including Papaphobia — fear of the Pope. Weird fears include being out of mobile phone contact (nomophobia), fear of teenagers (ephebiphobia), being looked at (scopophobia) and mirrors (spectrophobia).

Doctors say Mwangi, Atieno and Kamau suffer from different kinds of phobia that are common in people who are between age 18 and 40.

These fears are experienced across the globe. In the US alone, 18.1 per cent of people over the age of 18 have a specific phobia, according to the National Institute of Mental Health. The study found that the anxiety disorders were the most common mental illness among women in all age groups and second most common among men over 25.

"Many people suffer from social phobia — fear of embarrassing themselves in public," says Dr Mak’anyengo. They avoid situations where they have to perform a task in front of people or interact with others.

Mak’anyengo has dealt with severe cases where patients are completely housebound, fearful of leaving home without a companion or staying home alone.

Psychiatrists say that some phobias are debilitating. For instance, agoraphobia — the fear of being in open or public places.

Specific phobias can be traced back to a specific triggering event, usually a traumatic experience at an early age.

But social phobias and agoraphobia have more complex causes that are not entirely known in the medical world. "Heredity, genetics, and brain chemistry combined with life-experiences play a major role in the development of anxiety disorders, phobias and panic attacks," Mak’anyengo says.

Phobias are linked to the amygdala — an area of the brain located behind the pituitary gland in the limbic system. It secretes hormones that control fear and aggression. When the fear or aggression response is initiated, the amygdala releases hormones into the body.

"Most phobias start with spontaneous panic attacks that may continue and develop into a series of anticipatory anxiety attacks," Mak’anyengo says.

A panic attack is a period of intense fear and discomfort in which a patient experiences pounding or accelerating heart, sweating, trembling or shaking.

Others are shortness of breath, feeling like choking, chest pain or discomfort, nausea or abdominal distress, feeling unsteady and light-headedness.

Exposure to fear

"Some phobias may end up in depression or chronic anxiety, if not treated early," Mak’anyengo says. Most patients can face the feared situation in the company of a trusted partner, spouse or friend. Mak’anyengo says most phobias can be successfully treated. "The treatment for a phobia mainly involve deliberately, systematically exposing the patient to the fear as part of Cognitive Behavioural Therapy (CBT)," she says. CBT is a practical therapy that views the symptoms as a set of learned behaviours and bad habits that you can be trained to give up.

"Treatment lasts six months to one year as there could be follow up treatments – in extreme cases – that involve medication," Mak’anyengo says.

She says children can be helped to avoid social phobia be teaching them to be confident early in life.

Medical researchers in the Japan say it may soon be possible to cure phobias by a simple injection, which ‘re-programmes’ the brain to overcome some fears. Researchers at New York University have gone beyond CBT. According to a study published in Nature, when a person’s phobia gets activated, there’s a period immediately afterward when the traumatic memory that the phobia is based on becomes vulnerable. During that time you can rewrite the memory in a way that removes the fear.