Fear is in principle something beneficial, because it warns the individual of danger. It is our in-built alarm system. However, if fear causes loss of control, panic attacks, or paralysis, an anxiety disorder is present - the most common mental health condition of our time.
We all know fears from childhood onwards. Fear of being alone. Fear of the dark, fear of exams, fear of thunderstorms, in later life, fear of illness, loneliness, or death. Fears belong to our normal development. They come and go, sometimes more pronounced than others. In normal cases we learn to live with our fears.
25 percent of the population are affected
More and more people - estimated 25% of the population - are afflicted by anxiety disorders. Women are three times more commonly affected than men. It means that in total there are around 13 million people affected in Kenya. These figures make for high government costs. Included in that on one side is doctor costs, which add up to a high amount by the time a reliable diagnosis can be made. If an anxiety disorder can’t be treated effectively and on time, there is the threat of a long-term affliction, job-loss, and with that, high welfare and insurance costs for the State.
Anxiety becomes a disorder when it occurs repeatedly in situations in which there is no real danger or threat according to human reasoning - i.e. when it is disproportionate. The anxiety manifests often through bodily symptoms, for example, heart palpitations, dizziness, tremors, sweating, decreased exercise tolerance, or gastrointestinal discomfort.
Multiple causes
There are various findings about the causes of anxiety disorders. In general it seems that some individuals are particularly susceptible to the development of anxiety disorders. With anxiety disorders it is assumed that stressful life circumstances have a strong influence, such as accidents, separations or job losses, traumatic experience in childhood or adulthood, childhood experiences and developmental factors. There is also a suspected inherited predisposition to experiencing anxiety disorders.
It has been shown that various causes and triggers must come together in order for an anxiety disorder to arise. Only rarely is there one individual cause. Anxiety disorders can also be fostered through severe experiences of fear. This is how, for example, flight turbulence could lead to the development of a fear of flying.
‘Phobic disorders’ and ‘other anxiety disorders’
Anxiety disorders are coded in the ICD-10 (International Classification of Disorder) classification system as neurotic, stress and somatoform disorders. The ICD-10 differentiates between ‘phobic disorders’ (agoraphobia, social phobia, specific phobias, other phobic disorders) and ‘other anxiety disorders’ (panic disorder, generalized anxiety disorder).
Agoraphobia: “I am trapped”
The most common phobia is the so-called agoraphobia. This is present in individuals who feel great discomfort, or even fear, in certain places. Included in this are public places, shops, or crowded areas. It can also occur during long journeys. What these situations have in common, is that the individual believes he/she will not be able to escape quickly enough if a panic attack occurs, or that help won’t get to him/her quickly enough, or that he/she could get into an awkward situation.
The feeling of being at the mercy of other people triggers a physical stress response, which can lead to the aforementioned anxiety symptoms, or even panic attacks. The individual will display strong avoidance behaviours, which often leads to reclusion - with the consequences being new fears of isolation and the loss of trusted social support.