Phobias (Nursing)

00:01 Another type of anxiety related diagnosis are phobias.

00:07 Phobias are persistent, irrational fears.

00:10 They are connected to a specific activity, object or situation.

00:15 They can be sparked by a thought.

00:18 And a phobia can induce a panic attack.

00:25 Now there are different types of phobias.

00:28 And they go from A to Z and then some.

00:31 For example, Agoraphobia is fear of the marketplace, fear of crowds.

00:37 A lot of the phobias, if we look back at the Greek words, agora is the town center, the marketplace, and the phobia is fear.

00:47 So agoraphobia is fear of the marketplace or going into a crowded space.

00:53 There's also social anxiety disorder.

00:56 And that is when a person is so frightened about going and embarrassing themselves in public, they cannot bring themselves to have the social connection for the performance that is required in a social interaction.

01:13 So you also have all these specific phobias, like a specific object, for example.

01:21 If you know what an Arachnoid is, that's a spider.

01:24 So if you have an arachnophobia, you got it, you have a fear of spiders.

01:32 Now, phobias are diagnosed when the fear becomes debilitating when it is affecting many aspects of that person's life.

01:40 And it is interfering with the activities of daily living.

01:44 This is always the caveat we have to keep in mind having a phobia.

01:50 "I am afraid of heights, but it doesn't keep me from flying on a plane.

01:54 It doesn't keep me from very carefully climbing a ladder." We have phobias for whatever experiences we may have had in our past.

02:05 But it is only when that phobia gets to a level of severe, and that you are not going to be going on a plane or getting up on a chair, because you're so afraid of heights, that that is now a diagnosable phobia.

02:25 So let's think about the etiology and the classification of the kind of diagnosis which is phobia.

02:35 Well, the etiology is truly unknown.

02:39 We don't know where phobias come from.

02:42 There are some theories that include that cycle analytic theory, which means we have an unconscious fear, and we have repressed the experience, and now it's coming out in another area being a fear of something else.

03:00 We also have the theory, the learning theory, that says it's a conditioning.

03:06 So if we grew up in a home, where every time we went to go for the soda on the table, we got our hands hit.

03:15 When we see soda as a older person, we might have a fear of reaching out to have that soda.

03:24 And then there is the cognitive theory.

03:27 Now, what is the cognitive theory say? The cognitive theory says that we have a faulty belief system, that our belief system is telling us that we are going to die.

03:38 If we get up on that ladder, that's a faulty belief system.

03:43 We're not going to die if we get up on the ladder.

03:46 We are not going to die even if we are afraid of spiders.

03:49 We are not going to die if we have a spider that walks into the room that we're in faulty belief system.

03:58 We also have to take into account a person's biological temperament.

04:04 That is their personality, also their neuroanatomy, that there are some people who their neurological wiring makes them much more sensitive to fear.

04:18 And of course, life experiences when we have negative repressed childhood experiences, experiences of trauma and abuse.

04:28 These can in later life come out as specific phobias.

04:34 So how do we classify our phobias? We classify them related to the stimulus that is causing them.

04:41 So a person can become phobic to almost any stimulus at all.

04:48 But it is considered a phobia.

04:51 When is it? When that level of fear interferes with the activities of daily living.

05:01 So, if you think about that, that anything at all could be a phobia.

05:08 The list of phobias, it's limitless.

05:15 Anxiety disorders due to medical condition or substance use, that could be intoxication or it could be withdrawal.

05:24 Intoxication is the taking in of the substance to get a level of euphoria, or it could be the withdrawal of that substance from the body can produce an anxiety disorder.

05:38 And the signs and symptoms have to be more than what we're just seeing when a person is either using abusing misusing or withdrawing.

05:48 So there is a certain number or amount of anxiety that you are going to see in a patient who is withdrawing.

05:58 But we want to be clear that it for it to be a concurrent anxiety disorder.

06:05 It has to be even more than what we normally would see with use, misuse, abuse and withdraw.

06:14 And that might be with alcohol, with cannabis, with hallucinogenes, with amphetamines, cocaine, caffeine.

06:22 The use of sedatives and misuse and abuse and withdrawal, hypnotics, anxiolytics.

06:31 We can see anxiety disorders that are given birth by the lack of the use of or the withdrawal from these substances.

06:46 Now medical conditions can increase a person's anxiety.

06:50 And if we leave those conditions untreated, it can result in an ongoing anxiety disorder.