Fears, phobias, panic and hyperventilation in depression


In almost everybody who suffers from depressive illness, anxiety/fear/tension becomes a prominent symptom.  Furthermore, marked loss of self-confidence also develops, so that people become nervous in social situations and general interactions that previously would not have made them nervous.


A large number of people with depressive illness develop phobias during depressive illness, ie totally unreasonable fears to such a degree that they are forced to avoid certain situations.


AGORAPHOBIA is a fear of leaving the house alone, and commonly develops in people who have depressive illness.  Agoraphobia can develop without depressive illness, but this typically occurs in young adults.  A person, in their thirties or later, who develops agoraphobia for the first time, must be considered as very likely to have underlying depressive illness as a cause of his or her agoraphobia.  The agoraphobia typically will disappear once the depressive illness has been brought under control.  Apart from fear of leaving the house, some people’s agoraphobia manifests itself as becoming extremely anxious in enclosed spaces, such as public transport, shopping centres or cinemas.  If you have depressive illness, and you are tempted to avoid places that make you anxious, or tempted to stay indoors because of your anxiety, it is important you try to fight off these fears and do the opposite as much as possible, to minimise this complication of your depressive illness. It helps if you regard your symptoms as an enemy trying to control you, with you determined to fight back.


SOCIAL ANXIETY OR SOCIAL PHOBIA is the development of symptoms of extreme anxiety and embarrassment in social situations, and again develops in some people as a result of depressive illness.  Again, fighting the symptoms off as soon as they appear, by doing the exact opposite and mixing more than ever before if possible, is helpful in avoiding this complication.  Again, the social phobia is likely to subside once the depressive illness has been brought under control. IN OTHER PEOPLE, THE MAIN PROBLEM IS SOCIAL ANXIETY, WITH DEPRESSION DEVELOPING AS A COMPLICATION.


PANIC DISORDER is a common complication of depressive illness, in which people get sudden and terrifying episodes, which may go on for up to an hour or longer, and may occur very frequently.  The person becomes terrified that they are about to die, lose control or lose their mind, or becomes convinced some terrible catastrophe is about to happen to them.  The symptoms can be controlled temporarily by the use of powerful tranquillisers, until the underlying depressive illness is brought under control.


HYPERVENTILATION (over-breathing) often happens to people who are anxious, without the person involved being aware that they are in fact over-breathing in response to stress or anxiety.  While slow deep breaths may be calming in certain situations, especially if accompanied by a deliberate decision to relax one’s muscles, rapid breathing clears out all the carbon dioxide in your body, which in fact disturbs the chemical balances within the blood stream.  As a result, people develop tingling of both hands, both feet, or the face, especially around the mouth.  If the over-breathing continues, people may develop nausea, chest pain or dizziness.  All of these symptoms can simply add to the fear, and in turn add to the hyperventilation.

If you do suffer from this condition, the understanding that you are breathing too rapidly is the major step to solving the problem.  Hold your breath for as long as you can, let it out, and hold it out for as long as you can, and then take in the next breath and hold it in for as long as you can.  You may have to repeat this process for the next 10 or 20 breaths to correct the problem, as your body automatically produces more carbon dioxide, and reducing your breathing prevents the carbon dioxide from escaping too rapidly.  While textbooks may suggest people with hyperventilation rebreathe their own expired air from a paper bag, cupping your hands and holding them in front of your mouth will achieve the same effect without making you look strange.


There is considerable research evidence to suggest that many forms of anxiety are very similar to depressive illness, and indeed that antidepressant medications have a major role to play in the treatment of many anxiety related symptoms and phobias. Antidepressants, especially the modern agents, very effectively put a lid on the severity of anxiety, and are non-addictive.


Of course, particularly when depressive illness is less severe, and particularly in cases when phobias develop without depressive illness, using one’s logic to fight off fear, and forcing oneself to confront feared situations step by step are very useful approaches, being the fundamentals of what is known as Cognitive Therapy.


Important Disclaimer:  This site is medical information only, and is not to be taken as diagnosis, advice or treatment, which can only be decided by your own doctor.


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