Phobia and its homoeopathic management

Dr Keerti Rathod

ABSTRACT:
Phobic anxiety disorders (PAD) are common disorders of distressing and disabling type that reduce the quality of life (QOL) of an individual. Clinical trials of phobic disorders in conventional treatment are not yet being substantiated with too many positive results.

Homoeopathy is a well established system of therapeutics with potential relevance to psychiatric disorders but has a less database and its effectiveness in certain disorders such as Phobic disorders is yet to be explored. Phobia cases, which have been cured with homoeopathic practice remain unreliable. Hence, this very article indicates the usefulness of homoeopathy in the treatment of various phobic disorders.

KEYWORDS: Agoraphobia, Nosophobia, Homoeopathy, Phobic anxiety disorders, Social phobia, Specific phobia.

INTRODUCTION:
Phobia is defined as “an irrational fear of specific object, situation or activity, often leading to persistent avoidance of the feared object, situation or activity.” The word phobia originated from a Greek word “phobos,” meaning panic, fear and terror. ICD 10 classifies Phobic Anxiety Disorders (PAD-F40) under neurotic stress-related and somatoform disorders. As per DSM-5 phobias are considered as a sub-type of anxiety disorders. Phobic disorders are common distressing and disabling psychiatric disorders. The global burden of anxiety disorders represents 10.4% disability adjusted life years. Lifetime prevalence of specific phobias around the world ranges from 3% to 15%.  Females have a high rate (2.4%) when compared to males (1.5%).

CLASSIFICATION:

Phobia classified into two types

• Related to external stimuli: agoraphobia, social phobia, specific phobia
• Related to Internal stimuli : Nosophobia

Around world  specific phobia is about 7% to 12.5%;

In Canada: 73% of children have fears like dark and spiders.

In South Korea: 47% of children have fears like monsters and ghosts.

In New Zealand: 38% of children have fears like heights and sharks.

In India: 4.2% of children have specific phobia.

In India, Specific Phobia : females – 7.4%; Males: 4.9%.

In case of statistics of fear of specific things, it is as follows:

Fear of insects stand first followed by fear of darkness then fear of strangers followed by fear of animals and at last fear of heights.

Which gender has more fear?

1. Girls – 40%
2. Boys – 45%
3. Others – 15%

TYPES OF PHOBIA ACCORDING TO ICD 10 (F40 to F40.9)

1. Agoraphobia:

With or without panic attack.

Fear being alone, leaving home, suddenly can’t leave home with companion.

2. Social phobia:

Fear of and compelling desire to avoid situations in which individual may be exposed to scrutiny by others & they will humiliate them.

3. Simple(Specific) phobia: Fear of specific object or thing – Claustrophobia, Acrophobia.

4. Other phobic anxiety disorders.
5. Phobic anxiety disorder, unspecified.

Psychopathology:

Psychoanalytical theory: Freud

Conditioned reflex theory: Conditioned stimuli & unconditioned stimuli or response = phobic object – noxious experience.

Biological theories: Genetics, surge in Serotonin and GABA inhibition, and Norepinephrine and Epinenphrine.

AETIOLOGY OF PHOBIA:

Biological Factors:

• Genetic:e.g.in schizophrenia.
• Neuropathological:e.g.dementia.
• Endocrinological:e.g.hyper/hypothyroidism.
• Biochemical:the monoamine neurotransmitters.
• Pharmacological:side effects of medications e.g.steroids.
• Metabolic:DM, Inflammatory/autoimmune.

Psychological factors:

• Thinking distortions.
• Emotional dysregulation.
• Behavioral problems.
• Unconscious conflicts.

Social Factors:

• Family factors:lack of social support, criticism and over protection within the family.
• Life events:Migration, unhappy marriage, problems of work, school, financial issues.

CLINICAL FEATURES:

Specific Phobia:

• Loss of self control
• Fainting
• Avoidance of activities involving feared stimulus
• Anxiety when thinking  about stimulus
• Worry with anticipatory anxiety
• Impaired work function

Social Phobia

• Cold and clammy hands, blushing.
• Anticipatory anxiety.
• Occur in advance (public speaking/social event).
• Embarrassment at end.

Agoraphobia

• Overriding fear of open / public space.
• Avoidance of public places.
• Dry mouth.
• Shortness of breath.
• Rapid speech.
• Inability to speak.
• Shortness of breath.

Fear of high places:

Common remedies	Uncommon remedies:
Arg-n., Arg-m., bell., carbo v., hep., Carc.	Aur-m-n., Tung-met., Abies-c., gal-s., nicc-s.

Fear in narrow place:

Common remedies:	Uncommon remedies:
Acon., Arg-n., Calc. c., Lyc., Puls.	Aur-m-n., Bamb-a., Nitro., Positr., Ferr-n.

Fear of animals:

Common remedies:	Uncommon remedies:
Bell., China, Alumina, Tuberculinum, Stramonium and Calc. carb.	Elaps, hyos., Chinin-s., positr.

Fear of dark:

Common remedies:	Uncommon remedies:
Stram., Acon., Calc., Agar., Bell., Bapt.	Ozone, Rad-br., Xan., Thres-a., Zinc-i.

Fear in a crowd:

Common remedies:	Uncommon remedies:
Acon., Nat-m., Nux-v., Aur., Bell., Lyc.	Elaps, Osm-met., Tung-m., Visc.

 Fear of being left alone:

Common remedies:	Uncommon remedies:
Arg-n., Ars., Lyc., Phos., Puls.	Ars-h., Lyssi., Tritic-vg., Nat-caust., Nat-lac.

Fear of water:

Common remedies:	Uncommon remedies:
Bell., Lach., Phos., Puls., Sep.	Mancinella, Crot-c., Arist-cl., Bism-sn., Ars-s-f.

BARYTA CARBONICA
Barium is a mineral belonging to the group IIA of the Periodic Table. The main feeling of remedies from this group is one of dependence, and Baryta carbonica is the most dependent of them all.

• Phobia where the fear is due to their slow mental grasp and learning disabilities.
• They fear they are ridiculed by others in class room.For their Poor memory.
• They suffer from loss of memory, mental weakness.
• Children cannot remember to learn.
• Child does not want to play, but sits in the corner doing nothing.
• Slow in all developments –slow to walk, talk, read, speak or mature.

CALCAREA CARBONICA

• Calcarea carbonica is a mineral remedy belonging to the psoric miasm. It also has some sycotic traits. The main feeling of Calcarea is the need for stability and security.
• Calcium offers protection not only to humans in the form of bone but also in earlier forms of life in the form of shell, exoskeleton, etc.
• They are forgetful, confused, misplaces words, and expresses himself wrong.
• Fears of being observed.
• Dull lethargic children who do not want to play. They prefer safety to high-risk behaviors. They are cautious.
• They prefer indigestible things like dirt, chalk, coal, pencil etc.
• Craving for eggs is characteristic to Calcarea carb.
• Profuse sweating during sleep, especially head and chest.
• The central theme of the Carbonates is of a vital reaction.
• Thus the main theme of Calcarea carbonica is a need for protection. But in order to get this protection the person does not need to make any effort – all he has to do is show a vital reaction.
• He seeks the protection he needs by expressing a lot of fears. He surrounds himself by a lot of people who protect him.
• The Calcarea carbonica persons are people who don’t go out much, don’t want any adventure in life. Rather they choose for themselves friends and partners who are protective and on whom they can depend.
• Remember: Fear of change and losing control; tiring on exertion; perspiring easily; anxiety on hearing about unpleasant things.

ANACARDIUM ORIENTALE

• Anacardium Orientale is a plant. It is prepared from the fruit of Semecarpus anacardium, the marking nut tree.
• The situation of Anacardium is that of a kind of child abuse.
• Overstrict parents impose all their desires on the child and do not allow him to think or do anything on his own.
• He cannot take his own decisions, to the extent that he is not allowed even to decide what clothes he should wear.
• There are two sides to Anacardium. On the one hand he is good, angelic, obedient from fear of punishment. He is very orderly, fastidious, cannot rest till things are in proper place.
• The other part of him is hard, malicious, violent, devilish, disgusted with himself. He becomes immoral, develops suicidal or homicidal tendencies, is abusive, stubborn and avoids the company of people.
• These two sides of Anacardium are constantly in opposition to each other: should he be an angel or a devil.
• Anacardium could be the wife of a selfish tyrant who rules with an iron fist, and does not allow her to take any decisions.
• She becomes irresolute, lacks in self-confidence, is confused – always has two wills. She becomes dull and very absent-minded (Anacardium has a marked absent-mindedness).
• She may be childish, idiotic and timid out of lack of self-confidence and fear. The fear can paralyse her thinking as can be seen when appearing for an examination.

PULSATILLA

• Pulsatilla is a plant. The remedy belongs to the sycotic miasm. It is like the windflower which must bend to every gust of wind in order to survive.
• Dependence
• Clingy nature
• Fear of loneliness
• Fear of being abandoned
• Helplessness feeling
• Resistence to growing up
• ( The fear of looking up, being associated with growth and independence – vertigo looking up )
• This remedy is very helpful for children who find separation very difficult.
• They will NOT want to let go of their parents and hold onto the hand very tightly or cling to your leg.
• There will be crying which can be soothed with the help of kind words and an adult they can sit with when in class.
• They are mild, timid, emotional and tearful.
• They tend to weep easily.
• Craves sympathy and attention.
• Changeable nature is another leading symptom of Pulsatilla.
• Their digestive system is easily disturbed.

ARGENTUM NITRICUM

• It is a mineral remedy belonging to sycotic miasm.
• It is a compound silver(Ag).
• Argentum’s main theme is performance and Nitrate whose main theme is the feeling of sudden danger.
• The two come together in Argentum nitricum, whose main theme as “Performance in sudden danger or crisis”.
• For anticipatory fears where your child may tremble with nervous energy and experience diarrhea before an event.
• Particularly useful when your child worries a great deal before doing anything new. They will worry a lot – “What if…” questions will come up, and lots of questions about upcoming events.
• There will be lots of early preparation for an event, so the school bag may be packed days in advance and constant checking of bag contents and uniform.
• They will be very fidgety and restless, will be better for company and not want to be alone.
• They will appear worried but not terrified but there will be lots of fears and phobias. Such as fear, fear of being late, and a fear of crowds.
• There is a feeling as if the person will be accepted only if he can perform at the time of crisis.
• There is a feeling of being neglected and despised if he does not perform at the time of crisis.
• They are called as crisis managers.
• It is important for him to keep control in a critical situation and find his way out of the problem.
• This is shown in rubric “Fear of losing self-control”, which is considered one of the leading rubrics of this remedy.
• In whichever situation self-control is needed, he becomes highly nervous, as he lacks it.
• They have anticipation and anxiety which leads to diarrhoea.
• They feel as if they are alone and the exit is blocked.
• The compensation is to see the way out all the time and to never enter a situation where the exit is not seen
• For example going on journey only after booking the return ticket, sitting next to the door in a cinema theatre.

LYCOPODIUM

• Lycopodium is sometimes called “vegetable Sulphur”. It is a plant remedy and belongs to the the psoric miasm.
• Lycopodium becomes a person’s remedy when he/she cannot think of anything else or seems stuck.
• The timidity and cowardice of Lycopodium is best seen in children requiring the remedy.
• They have a fear of facing new situations, meeting new people, and will try and avoid the same.
• As a result of this timidity, and also because of the physical weakness, in Lycopodium children we find an aversion to play.
• Lycopodium thus represents a constant struggle between cowardice and egotism, between lack of confidence and haughtiness, between timidity and a dictatorial attitude.
•   The person is scared of those in authority, but to those for whom he can represent it, he is rude and contemptuous.
• Lycopodium has a tremendous fear of being alone, amidst unfamiliar people. He seeks out known persons,  wants someone with him “even if in the next room”.

MANGANUM ACETICUM

• It is also called as Acetate of Manganese or, Manganous Acetate.
• Formula: Mn(C2H3O2)2.4H2O.
• A solution.
• It is indicated in a child who is shy and with dominating parents.
• The child has a lack of confidence as a result of this domination and becomes anxious, nervous, tense, jittering and frightened.
• So, he develops a feeling of bitterness towards his parents and is discontent with himself and his situation.
• And, finally becomes sad, reserved and brooding.

STRONTIUM CARBONICUM

• It is the carbonate salt of strontium that has the appearance of a white or grey powder.
• It occurs in nature as the mineral strontianite.
• Formula: SrCO3
• It is indicated for the anxiety of a person in the age of adolescence.
• The age of adolescence is the age when one ventures out into the new, with the full knowledge that if one is faced with a problem, one could always come back.
• What a person of this remedy looks for is guidance, that is, an experienced person’s help chart out the unknown, someone to rely on if there is a problem.
• The relationship with his guide is the most important thing.
• There arise a problem if such a guide is missing or guides in excess. It then creates anxiety in him.
• Also, new tasks like learning to drive a car or starting a profession, are anxious moments in his life.
• And, therefore he needs encouragement and support from an experienced person.

ADRENALINUM

• Adrenaline or Epinephrine, the active principle of the medulla of the suprarenal gland, (cortical secretion not as yet isolated), is employed as a chemical messenger in the regulation of the activities of the body.
• “fight-or-flight response,”

Now, you know what it does and how it feels. Which situations could benefit from this remedy?

• a driving test
• exams
• a break up
• an anxious situation
• a fight with a friend
• starting a new job
• a demanding boss
• a medical procedure
• an abusive relationship

Presents with:

• anxiousness
• nervousness
• blood pumping through your body
• hyperventilating
• pounding heart

BRYONIA ALBA

• Bryonia is a plant remedy. The thick root of the Bryonia plant contains a resin-like substance that’s used in holistic remedies.
• The main feeling of Bryonia is the feeling of a loss, which has to be made up very fast.
• So, there is feeling of loss with fear of poverty.
• One of the commonest ways of making up a loss is by business.
• So, he invest what he has and take risks and try to increase his wealth.
• Hence, the Bryonia person is very industrious, busy and determined.
• He becomes dry, insensitive to the emotions and feelings of others.
• One may also compare Bryonia with Veratrum album, but Veratrum is concerned more with the loss of position than with the loss of money.
• So egotism, extravagance and show become the theme in Veratrum, but are not so much seen in Bryonia.

NATRUM MURIATICU
Natrum muriaticum is a sycotic remedy. It is a mineral – a salt – and it has the elements Natrum with belongs to group IA and Chlorine (Halogen group). Deep emotions and a self-protective shyness can make these people seem reserved, aloof, and private. Even when feeling lonely, they tend to stay away from social situations, not knowing what to say or do. (Inhibitions sometimes leave completely if they turn to alcohol, which makes them feel embarrassed afterwards.) Easily hurt and offended, they can brood, bear grudges, dwell on unhappy feelings, and isolate themselves—refusing consolation even when they want it. However, they are often sympathetic listeners to other people’s problems. Claustrophobia, anxiety at night (with fears of robbers or intruders), migraines, and insomnia are often seen when this remedy is needed.

ARSENICUM ALBUM

• The mineral Arsenic lies between Phosphorus and Bismuth in the Periodic Table.
• In this group, which also includes Antimony, there is a feeling of insecurity, of loneliness, of being isolated,and of not belonging.
• Phosphorus tries to make up for this feeling by excessive friendliness and sympathy.
• In Arsenicum, it manifests as fear and insecurity.
• He needs people and is dependent on them because of his weakness, yet feels that they cannot be trusted, that they are interested only in his money.
• Hence, have fear in trusting people.
• The Arsenicum person has a hypochondriacal anxiety.
• He fears that he will lose his health unless he exercises regularly and will avoid many things which he feels are harmful.
• He will not eat out in restaurants, etc., and will impose many restrictions on himself in diet and other matters. His life is full of anxiety.
• He needs people and is dependent on them because of his weakness, yet feels that they cannot be trusted, that they are interested only in his money.
• Hence, have fear in trusting people.
• The Arsenicum person has a hypochondriacal anxiety.
• He fears that he will lose his health unless he exercises regularly and will avoid many things which he feels are harmful.
•  He will not eat out in restaurants, etc., and will impose many restrictions on himself in diet and other matters. His life is full of anxiety.

ACONITUM NAPELLUS

• Aconitum napellus is a plant. The remedy prepared from it belongs to the acute miasm and is, in fact, the most acute of all our remedies.
• The main feeling of Aconitum is of a sudden, intense threat from outside that comes suddenly and goes suddenly. For that moment the person, who is otherwise calm becomes intensely restless.
• Child will look anxious, they will stare glassy eyed. Often as a result of shock or a negative experience.
• Fear and terror can come on suddenly. All anxiety will be worse at night, and may be very distressed and inconsolable – will also help to restore calm after nightmares and night terrors.
•  They will fear they will not survive the anxiety, a feeling of panic. Great for panic attacks when the heart is pounding and feel faint.
• Panicky and nervous.
• This feeling of a sudden threat is seen in the fear of walking across a busy street, fear of accidents, of suffocation, in presentiment of death and in the delusion that he is about to die.
• Mentally this is expressed as a fear of death, anxiety and restlessness.
• While in physical sphere, we find a racing pulse, palpitation and flushing of face alternating with paleness.
• Fears death but believes he will soon die; predicts the day.

BELLADONNA

• Belladonna is a tall bushy herb of the nightshade family (Solanaceae). It is a highly poisonous plant.
• The main feeling of a Belladonna person is of a sudden threat from outside from which he has to escape in order to survive.
• The suddenness is one of the main characteristics of Belladonna. Everything comes in paroxysms with suddenness and goes with equal suddenness. But while it lasts, there seems to be a very intense and life threatening situation.
• He feels he wants to escape. Also, there is a certain degree of violence in his sensations and actions.
• He also has fear of animals.
• Whenevere the attack comes, he becomes crazy with fear, anxiety, and excitement.
• Also, with throbbing of the carotids, palpitation of the heart and a feeling of imminent threat or danger.

LACHESIS

• Lachesis is a snake remedy prepared from the venom of the South American bush master, and in its miasmatic range, the remedy falls between sycosis and syphilis.
• The symptoms of Lachesis are worse on entering sleep. He may have felt nothing of his symptoms when awake, but when sleep comes on, they are aroused.
• The symptoms gradually increase as the sleep is prolonged, so that a very long sleep will aggravate all the state and condition of a Lachesis patient.
• And, when awakening, he looks back at that sleep with sorrow.
• Hence, a Lachesis patient is afraid of going to sleep.
• The sleep has been disturbed by attacks of suffocation and by awful dreams, and now, after having slept a long time, he arouses with dreadful headaches, palpitations and melancholy.
• He also has a dream of snakes, hence this also creates fear in him.

CENCHRIS CONTORTRIX

• It is prepared from the venom of the copperhead snake. Formulated with the snake poison, it has marked action on mind, heart and genital system.
• This remedy is indicated for anxiety where the person fears that she will die suddenly.
• She feels of taking the wrong car without realising where she was going.
• She also feels like when riding in the car rode past the place she intended to get off at.
• There is also a delusion like thinks her husband is going to put her in an insane asylum, yet she knew it was a delusion.
• All this creates anxiety in her.

KALI ARSENICOSUM

• Kali arsenicosum is a remedy of the mineral kingdom. Its chemical name is Potassium arsenite, As2O3K2O.
• In this remedy, conditions include hypochondria, excessive personal hygiene, and even a fear of heart attacks. People who suffer from health-related anxiety may have racing thoughts and difficulty sleeping. They may be terrified of death or dying as well. They are prone to feeling cold and having panic attacks.

THUJA OCCIDENTALIS

Thuja is a genus of coniferous trees or shrub in the Cupressaceae (cypress family). Thuja is a strongly sycotic remedy.

It is an excellent treatment for generalized anxiety disorder and obsessive compulsive neurosis. The patient typically becomes concerned over little matters and is unable to concentrate on his tasks. He has a lot of established thoughts that he can’t seem to get rid of. Social phobia is also frequent in these people, who get uneasy and twitchy when approached by strangers. Overall, a really effective anti-anxiety medication.

SYPHILINUM

It is a Nosode. It is prepared from the Syphilitic virus.   It is the most effective anti-anxiety medication. A significant characteristic of Syphilinum sufferers is that they wash their hands frequently and feel obligated to do so in order to soothe their uneasiness. The patient has a strong phobia of the night and is terrified of it approaching. There is extreme anxiety and a persistent fear that he will go nuts.

KALI PHOSPHORICUM

• Kali phosphoricum belongs to the mineral kingdom. It is a tubercular remedy.
• Kali Phosphoricum, also known as Potassium Phosphate or Kalium Phosphoricum, is a biochemic tissue salt or cell salt.
• Individual having stressful life or feeling overwhelmed at every circumstance. Anxiety arises from having too much to achieve or having unachievable goals. Physical trembling of hands and psychical symptoms arise due to this anxiety.

CONCLUSION:
This article clearly shows the effects that homoeopathy displays in relation to the management of psychiatric disorder namely phobia and how remedial action is based upon the symptoms faced by a psychiatric patient.

Hence, to conclude, homoeopathy indicates well for phobic disorders.

REFERENCES:

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Dr Keerti Rathod
keertir70@gmail.com