Fear, an emotion that typically occurs when one perceives a threat to personal well-being, can prompt action against the threat. A common emotion that is experienced by most individuals at some point or another, fear is considered to be a normal, natural part of life.  However, fear can lead people to experience a wide array of physical and mental changes, and irrational or intense fear may interfere with a person’s happiness, sense of security, and ability to function effectively.

When fear is persistent or has a negative impact on daily function, a therapist or other mental health professional may be able to help an individual address this challenge.

Understanding Fear

Without fear, an individual's chances of day-to-day survival would likely diminish. Thus, fear can be healthy, because it helps people keep away from dangerous or harmful situations. Fear can often affect physiology when a threat is perceived. One's heart rate, breathing, brain activity, muscle tone, and startle response are all likely to experience temporary changes. Typically, fear also elicits a "fight or flight" response, which is a biochemical reaction to stress. 

All people are likely to experience fear of some sort. Humans and animals typically possess innate fearful reactions to some stimuli (such as unexpected or loud noises), and some of these stimuli may differ from one person to the next, although some fears may occur frequently in the general population. For example, a great number of people report a fear of death. New fears are often learned when fear-inducing stimuli are paired with objects or events not ordinarily frightening. When this occurs, those objects or events may then come to cause the experience of fear. 

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A phobia, or a fearful reaction that is disproportionate to the possible danger, is a type of fear that may often interfere with one's ability to function. A phobia might develop for no clear reason, but it might also develop after an experience causes a strong fear reaction in an individual. Therapy can often help an individual overcome a phobia. 

The Effects of Fear on the Brain

A person’s response to danger generally involves many different areas of the brain, but researchers have identified the amygdala as pivotal to the processing of fear. When an individual is confronted with a potentially dangerous situation, the amygdala sends excitatory signals to other brain areas to ensure that these areas also become more alert. Evidence of the amygdala’s importance to the processing of fear has been highlighted in many studies. When monkeys and rats with damaged amygdalas were exposed to snakes in one study, the animals demonstrated no fear of their natural predators.

Another study followed SM, a woman with Urbach-Weithe disease—a condition that results in the shriveling and hardening of parts of the brain. In SM's case, parts of her amygdala had wasted away, and she felt no fear when faced with haunted houses, large spiders, or venemous snakes. Further, researchers found that events that most individuals would find traumatic, such as a past experience of being threatened at knifepoint, did not register in her brain as bad or dangerous, either at the time or later in life. 

While the amygdala does play a critical role in triggering and processing fear, research found that its effective functioning was not absolutely essential for a person to experience fear. The 1995 study of SM also showed alternate brain pathways that played roles in fear learning and processing: SM did not demonstrate signs of fear when exposed to fear-inducing objects, but she did experience strong fear and panic when asked to inhale carbon dioxide (a gas that causes choking). It was clear to the researchers that while potentially dangerous external factors did not trigger a fear response, internal threats to her health and safety did cause SM to experience fear.

The Physical and Emotional Effects of Fear

The experience of fear generally leads people to experience bodily and emotional changes. One might experience a enhanced perception of space and time, and one's senses of sight, hearing, and smell may be heightened. In life-threatening situations, fear can also reduce the ability to notice finer details while increasing the capacity to distinguish large or blurry objects. These adjustments in perception greatly increase one's chance of survival in a dangerous situation.

An example of this might be when a camper notices a grizzly bear. The camper is not likely to focus on small details such as specific markings or other characteristics that distinguish the bear. Instead, fear generally works to sharpen the camper’s senses of perception in order to better identify the bear’s location and movement, which can help the camper best determine how to escape the dangerous situation. 

A person may experience a variety of physical responses when experiencing fear, such as:

  • Trembling, temporary paralysis, an erratic heartbeat
  • Stomach pain, muscle tension or twitching, head pain, nausea, dizziness
  • Crying
  • Stuttering
  • Erratic sleep patterns
  • Loss of appetite
  • Rapid, shallow, or erratic breathing

The mental effects of fear might include repetitive negative thoughts, intrusive or distracting thoughts, a loss of focus, and confusion. One might also experience a variety of emotional effects, including terror, anxiety, anger, despair, numbness, or helplessness. 

Mental Health Issues Associated with Fear

Fear has been linked with numerous behavioral and mental health concerns. For example, anxiety issues generally involve some measure of fear of a future event or occurrence. Those who hold on to ideas that frighten them and those affected by hallucinations or delusions may also experience high levels of fear. Individuals affected by negative moods may become afraid of certain events such as death, breakup, loss, or failure. Some people may even experience a type of fear known as a phobia, which may be described as an intense and sometimes irrational fear of a specific place, object, or animal. The fear one experiences with a phobia is often disproportionate to the threat of the thing feared. 

Fear is listed as a contributing factor or symptom of conditions such as:

Managing Fear

Day-to-day fears may cause a person to experience some level of anxiety or panic. Feeling frightened can be an unpleasant experience, but attempting to completely suppress fearful emotions is not always a helpful solution. Instead, a person might find relief by finding a distraction from fearful thoughts or by taking time to consider the fear rationally, examining the thoughts that are causing the fear. 

A person might also consider the following questions:

  • What am I afraid of?
  • Is this fear realistic?
  • What is the worst that can happen?
  • What can I do protect myself from that outcome?
  • Is the worst-case scenario really so disastrous?
  • Where in my body do I feel fear?
  • How do I feel when I take a few deep breaths?

Avoidance tends to make fear stronger, and slowly exposing oneself to objects and situations that cause fear can often help reduce the level of distress experienced, leading one to achieve relief from fear. The process may take time, and fear may persist, but support from family and friends can often be helpful. In the case of chronic fears or phobias, it may be helpful to seek out a qualified therapist or mental health professional, as phobias and chronic fear can often interfere with well-being and typical daily function if left unaddressed. 

How Therapy Can Help with Fear

Persistent or intense fear may lead to anxiety, worry, stress, and other mental health concerns. Some individuals may fear something unlikely to happen, such as being struck by lightning, while others may fear a more realistic threat, such as being mugged or burglarized. A person might fear many different things, and some people may feel afraid without knowing the cause of their fear at all. Talking to a therapist about one's fears may help to clarify and resolve these issues.

Specific phobias, paranoia, and other intense fears may be debilitating, and sometimes, they may exist as the result of an underlying concern. When this is the case, the issue may often be addressed and examined in therapy. Therapy can help people manage fear by helping them to understand reasons for the fear, put the fear into perspective, and set realistic expectations for the future. Therapeutic strategies, such as exposure therapy, can often lead to a reduction in fear and may also often have the effect of empowering the person in treatment. Those who often feel fearful may find that therapy can help them transform any maladaptive behaviors into positive thoughts and actions. Additionally, a therapist may also be able to teach those affected by fear how to recognize triggers for fear as well as the skills needed for effective fear management.

 

Case Examples

  • Therapy to address fear of death: Isaiah, 37, enters therapy because, as he reports, he is afraid of “almost everything.” He has taken time off from work because he recently he has become unable to go out in public. Loud noises cause his heart to race, and he has trouble falling asleep because of fearful thoughts that "keep looping" in his head. When he does sleep, he wakes frequently, and he admits to the therapist that his fatigue is likely making his fear worse. Throughout the therapy session, he is restless and jumpy, and the therapist first teaches Isaiah some simple meditation techniques to help him calm down enough to focus on their conversation. Once he is calm, they begin to discuss his fear. At first, he cannot state what is actually causing his fear, but after the therapist and Isaiah address various areas of concern in his life, it becomes apparent that the majority of Isaiah's fears stem from an intense fear of death. The therapist helps him to realize that many people fear dying, although death is an inevitable part of life, and helps him to see that avoiding any situation that might potentially cause death will only diminish his quality of life. Isaiah and the therapist work together to explore strategies that will help reduce Isaiah's fear in order to allow him to resume work and go out in public easily. 
  • Fear experienced after leaving religious cult: Rachel, 17, sees her school guidance counselor after a teacher reads a journal entry she wrote for class and encourages her to talk to the counselor. In the entry, Rachel wrote that she is unable to stop thinking about "the end of the world" and that she is afraid of burning in hell for her "sins." She finds it difficult to sleep or eat and feels anxious and nauseous almost constantly. Rachel tells the counselor that her family belonged to a Christian cult until a year earlier, when her parents broke away. They told Rachel and her sister that the teachings were wrong, that they no longer believed in them, but Rachel was raised in the cult and has found their sudden departure difficult to accept. She reports being overwhelmed by the new freedoms she is allowed and tells the counselor that she does not know what is "right" anymore and that she is afraid of committing sins. The counselor refers Rachel to a therapist, who begins helping Rachel explore the causes of her fear and anxiety. The therapist encourages Rachel to discuss her feelings with her family, and this leads to several family therapy sessions that are helpful for both Rachel and her sister, who was beginning to act out as a result of overwhelm similar to Rachel's. Rachel's distress begins to ease slowly, and after a few months, she finds herself able to choose to do things forbidden by the cult, such as attend a school dance, without significant anxiety or distress. 

References:

  1. Adolphs, R., Tranel, D., Damasio, H. & Damasio, A. R. (1995). Fear and the human amygdala. The Journal of Neuroscience, 15(9), 5879-5891. Retrieved from http://emotion.caltech.edu/papers/AdolphsTranel1995Fear.pdf
  2. Bocanegra, B. R. & Zeelenberg, R. (2011). Emotional cues enhance the attentional effects on spatial and temporal resolution. Psychonomic Bulletin & Review, 18(6), 1071–1076. http://doi.org/10.3758/s13423-011-0156-z. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3219868
  3. De Groot, J. H. B., Smeets, M. A. M. & Semin, G. R. (2015). Rapid stress system drives chemical transfer of fear from sender to receiver. PLoS ONE, 10(2): e0118211. doi:10.1371/journal.pone.0118211
  4. King, N. J., Muris, P. & Ollendick, T. H. (2005). Childhood fears and phobias: Assessment and treatment. Child and Adolescent Mental Health, 10(2), 50-56.
  5. National Health Service. (2014). Ten ways to fight your fears. Retrieved from http://www.nhs.uk/Conditions/stress-anxiety-depression/Pages/overcoming-fears.aspx