Phobias!!!

A phobia is essentially a human being's irrational fear of something -- it could be an object, an animal, a situation or an environment. Such fears are persistent, intense, excessive and unrealistic, which is primarily why phobias are deemed irrational. A clinically phobic person's reactions to what scares him/ her may seem extreme and the fright may not appear to be justified.

Types of phobias

Phobias can be broadly classified into three groups, depending upon the situation that brings on fear:

~ Social phobias: Acute fears involving a host of social situations are collectively classified as social phobias. These fears are often mistaken for just shyness, but in fact involve a constant terror of public humiliation, self-consciousness and of being in the limelight. Someone suffering from a social phobia may either have social anxiety disorder, or then react to a particular social trigger.

Such people often avoid social situations and become particularly uneasy when in the company of unknown people. Fear of public scrutiny may cause the person to avoid people to the extent of not eating in restaurants or using public restrooms. Social phobias seem to run in families. People who have been shy or solitary as children, or who have a history of unhappy or negative social experiences in childhood, seem more likely to develop this disorder.

Want healthy bones? Calcium tablets may not help

~ Specific phobias: These are related to a specific object, animal or insect, people, environment or situation. Presented here are a few common specific phobias:

Cynophobia: Fear of dogs or rabies
Ophidiophobia: Fear of snakes
Batophobia: Fear of height
Tachophobia: Fear of speed
Claustrophobia: Fear of closed spaces
Coulrophobia: Fear of clowns
Latrophobia: Fear of doctors, or of visiting the doctor

~ Agoraphobia: This is a generalised phobia individuals tend to have, of leaving home or a small, familiar comfort zone and of panic that might be brought on by making such a move. This is the only phobia that is treated as a medical condition.

Causes of phobias

Although the definite cause of phobias remains a mystery, these conditions are believed to be at least partly inherited and seem to run in the family. Specific phobias may develop from past experiences, especially in childhood. A bad experience with an object or situation is recorded in the brain by a substance called 'amygdale'. The past encounter invokes fear in a person when faced with a similar situation in the future. Amygdale keeps track of memory and emotions and signals that something is dangerous.

Social phobias also seems to run in families. People who have been shy or solitary as children, or who have a history of unhappy or negative social experiences in childhood, seem more likely to develop this disorder.

Agoraphobia is brought about by similar causes -- a person is likely to become phobic if he/ she has grown up seeing a parent or family member suffering from a phobia. Also, when parents are overcautious and exaggerate danger, children tend to become phobic. Phobias are a little more prevalent in women and very subjective. While some people have a natural tendency to be more cautious, others are bold and uninhibited. When cautiousness rises to the point of sheer panic, there is need for professional help.

Symptoms of phobias

The symptoms of a phobia can be severe and often cause an individual to be caught up in an embarrassing situation. A few of them are outlined here:

~ An individual suffering from a phobia experiences an unexplained, irrational fear of a specific element in his or her surroundings.

~ When the individual in question is suddenly faced with the trigger, he or she will immediately plunge into a state of panic. Severe anxiety may cause the person to escape such a situation at the first opportunity.

~ The individual knows that the fear is irrational, but is unable to control it -- if he/ she is unable to run away from what is feared, he/ she undergoes great distress and trauma.

~ The individual's extreme behaviour interferes with his/ her ability to function normally in any situation. In extreme cases, he/ she is unable to lead a normal life.

~ When the panic attack occurs, the individual is unable to control the fear. There is profuse sweating, palpitation, avoidance behaviour, difficulty breathing, intense anxiety, trembling and hot flushes.

~ Besides irrational fear, the other symptoms of phobic neurosis are physical reactions like headaches, tension, back pain, dizziness and stomach upsets.

Diagnosis of phobias

If you feel that your anxiety is bordering on a phobia, seek professional help at the earliest. When fear begins to interfere with you work and daily routine and relationships, going to a psychiatrist is the only solution. In very few cases, the phobia goes away on its own without professional help. When you go to a psychiatrist, both a physical and psychological evaluation will be conducted. The physical exam can help rule out any physical causes of your anxiety. The psychological exam will tell about your family's history and whether other family members have had phobias. It will also tell the doctor about any experience or trauma that may have triggered the phobia. Then the mental health professional will ask you to explain your symptoms and when and how they occur.

One of the biggest problems with diagnosing a phobia is to distinguish it from other psychological disorders like schizophrenia, obsessive compulsive disorder and paranoia. As there are no laboratory tests for phobias, it makes them very difficult to diagnose.

Most people are able to overcome their phobias at some point or the other. The most common form of treatment is behavioural therapy.

The therapist gradually makes the patient face the object of fear. This is done slowly and tactfully. At the same time, the patient is made to relax. Relaxation techniques include relaxed breathing, muscle relaxation training, self-talk, or soothing guided mental imagery. The two elements of fear and relaxation help the brain neutralise the fear and treat the phobic stimulus as any other object which doesn't induce fright. Sometimes, hypnosis is also used. For temporary relief, the doctor may prescribe anti-anxiety pills or anti-depressants too.

Prevention of phobias

There is are no preventive measures one can take when it comes to phobias. However, it is advisable to reduce anxiety levels if you are naturally inclined to be nervous. To do this, avoid substances that make you high-strung -- these include tea (tannin), coffee and cola drinks (caffeine), cigarettes and other tobacco products (nicotine). To avoid children from becoming prone to phobias, never overemphasise danger. Keep the legendary 'boogeyman' away -- scaring a child can have adverse effects on his/ her psyche.

Treatment of phobias is crucial -- if left untreated, they can lead to other illnesses like other anxiety disorders, depression and substance abuse. It is better to seek help when the problem is small. After all, the only thing we have to fear is fear itself.

Snoring & sugar levels

Dr S Ramnathan Iyer, Consultant Sleep Medicine, Hiranandani Hospital

Sleep and diabetes -- recent links for better management of diabetes

We have often heard that you are what you eat. But isn't it surprising to know that how and when we sleep tells a lot about our overall health. Ironically in most health check ups -- sleep patterns are seldom brought into focus.

Many people suffer from sleep disorders of one kind or the other, little realising that good sleep is essential for good health. Sleep is a metabolic regulator. But with today's fast paced life, sleep deprivation is fast becoming a common complaint. Sleep deprivation (sleep loss) can result in impaired glucose tolerance ,diabetes and obesity. Sleep deprivation also results in snoring and obstructive sleep apnoea (OSA).The prevalence of sleep disordered breathing (snoring and OSA) increases with age.

OSA is a life threatening disorder. There is repetitive collapse of the pharynx (a part of the upper airway) in sleep, resulting in fall of the oxygen concentration in the blood -- a condition called hypoxia. Hypoxia triggers the release of stress hormones in sleep, which cause metabolic errors like rise in blood sugar levels and rise in blood pressure.

If this condition persists over a prolonged period of time, it affects the cardiovascular system and metabolic systems; this in turn leads to the development of hypertension and diabetes!! Genetically prone individuals are more likely to develop these disorders.

Recent studies have shown that treating OSA results in better blood sugar control. The co-relation is simple, hypoxemia in sleep interferes with insulin action (insulin resistance) resulting in high blood glucose levels.

Sleep disorders is common in diabetic subjects. It can precipitate and aggravate diabetes. Diabetic subjects often experience difficulty in initiating sleep, maintaining sleep and excessive daytime sleepiness.

All diabetic subjects should be evaluated for their sleep and if necessary sleep study or polysomnography should be done.If OSA is detected and treated by Continuous Positive Airway Pressure (CPAP) it increases the insulin sensitivity thereby reducing the blood sugar levels. This is reflected in better management of diabetes and the overall well being of the patient.

Management of OSA in a diabetic subject is highly rewarding since the doses of diabetic medication can be reduced and it is possible that in some cases that required diabetic medicine be withdrawn.

Sweat Towels: The Importance of Using a Sweat Towel

When working out at home or in a public gym, hygiene should be your top priority. Germs and bacteria love to lurk around gyms. This is especially evident with public gyms, where so many people pass in and out of those doors -- the spread of germs and bacteria is almost inevitable.

But before you cancel your gym membership, there is a way to keep yourself protected and it's as simple as using a sweat towel. Use your sweat towel to wipe the sweat off your face and body as apposed to your hands. Your hands are exposed to loads of bacteria from contact with the gym equipment. If your hands do manage to pick up bacteria, you could transfer the infection to your face through your fingers and end up with nasties such as pimples or other fungal infections.

If you can, try to carry a second smaller towel to use for wiping your face and use your standard gym towel to put over the equipment when using it.

You'll also notice that many gyms have spray bottles and paper towels that you can use to wipe the equipment before you use it. Don't be shy -- wipe down and then lay your gym towel over the bench or mat for added protection. If you're naturally sweaty, please don't leave your sweat lying on the bench or mat -- rather wipe it down and be courteous to other members.

Another very important factor is to remember to wash your gym towels each and every day as towels soaked in sweat attract unwanted bacteria.