It is an abnormal and unrelenting fear of heights encountered by many individuals. Sufferers of this condition are referred to as “acrophobes”. They always feel excessive discomfort and nervousness in high places.
The term acrophobia is derived from the Greek words “acron”, meaning height and “phobos”, referring to fear.
Approximately 2-5% of the general population is affected with the condition. It affects twice as many females as males.
This type of phobia often goes unreported as many patients attempt to avoid situations that give rise to it. Affected individuals tend to fear a varied range of things that are considerably higher than the ground level. The severity of the disorder determines the degree of fear and other related conditions.
Acrophobic patients may begin to panic when being on a high floor of a building, standing near a window on the upper floors of a high-rise building, standing on a chair, or climbing up a ladder. In fact, sufferers may even begin to deliberately search for something to cling to in order to avoid falling. Equilibrioception or sense of balance is lost due to lack of confidence. Such patients feel that they may fall over anytime while walking or standing still. Despite the knowledge that heights do not cause any fatal consequences as long as one is careful, acrophobic patients may experience severe anxiety and nervousness. Immediate response to heights usually results in the following behavioral and emotional symptoms:
- Excessive perspiration
- Nervous shaking
- Dry mouth
- Hot or cold flashes
- Stomach distress
- Inability to speak
- Descending spontaneously
- Lowering the body
- Feeling of choking
- Stomach distress
- Crying or yelling
- Feeling faint
- Temporary feelings of paralysis
- Loss of ability to think rationally or normally
- Display of extreme agitation when asked to get down safely
- Intense desire to leave the high place
The phobia becomes so intense that sufferers begin to avoid situations or activities that involve high places. Some of these include:
- Residing on higher floors of tall buildings
- Home repairs that may require the use of a ladder
- Hang gliding
- Visiting places that have balconies
- Sitting near the window in a plane
The condition belongs to a particular category of phobias called “space and motion discomfort”, which refers to the situational specificity of symptoms occurring in some patients with balance and panic disorders. Such ailments are marked by inadequate visual information for normal orientation of the body. The vestibular system in the body controls the balancing mechanism that requires coordination between the eyes, the inner ear, and the joints and muscles. Each of these organs sends out important signals about position to the brain in order to balance the body. However, there is a sudden loss of vestibular function in acrophobes, resulting in balance dysfunction. The visual cues/signals perceived by the patients gradually reduce with increase in height. This causes difficulty in maintaining proper balance.
At greater heights, an appropriate visual system is needed for a normal view of any object. In this case however, there is an overloading of the visual cortex (a part of the cerebral cortex of the brain responsible for processing visual information). The perception of motion as well as the integration of locomotion gets severely impaired, causing a weak response. Many medical researchers claim that fear of heights can be ascribed to the following factors:
It is an essential aspect of behavioral learning theory that shows relationship between an environmental signal and a naturally occurring stimulus. Fear conditioning is an adaptive mechanism, which protects an individual from serious consequences by associating an unpleasant stimulus with a neutral one. The expression of fear is neutral and experienced by almost everyone. Elevated heights are also an unpleasant stimulus and create a state of fear in every individual, but is more pronounced and persistent in acrophobic patients. The phenomenon basically involves the amygdala, almond-shaped groups of nuclei in the brain, responsible for processing of memory and emotional reactions. When amygdala gets abnormally activated there is an expression of excessive fear.
Prior traumatic events involving heights such as falling from a high place or seeing someone else experience a similar trauma can also be a contributory factor. Such experiences often get stored as images in the brain that trigger a feeling of fear in some individuals when encountered with situations involving heights to prevent the reoccurrence of the past trauma.
The phobia can be diagnosed by an experienced mental healthcare specialist. Patients are normally asked some questions in order to know and evaluate all the symptoms that they are actually experiencing. These questions generally include:
- The reaction of patients in a high place
- The duration of the prevalence of this irrational fear
- The degree of severity of the symptoms
The condition can be confirmed on the basis of the answers provided by patients. The diagnosis is appropriate only when the fear severely interferes with the functioning of patients and gives rise to extreme distress. Based on the information collected, healthcare providers decide upon the kind of medical treatment that should be administered to the affected individual.
Following are some of the remedial methods that are usually implemented by doctors to treat the phobia:
It is a form of psychotherapy that focuses on present thinking, behavior, and communication rather than on past experiences. Its main aim is to eliminate the symptoms of the condition and induce positive thinking. The way acrophobes interpret a situation or an object, involving heights is usually reversed using various cognitive techniques.
In this process, therapists expose patients to the source of fear in a gradual manner in order to eradicate the phobia. A series of exercises are performed to help the sufferers in facing the situation. This particular technique is called systematic desensitization. In other cases, the affected individuals are given the flooding therapy, in which prolonged exposure to the fear-provoking situation helps in observing their reactions. The method is faster and yields effective results. Behavioral assessment is a must for monitoring the progress of patients undergoing the treatment.
Hypnotherapeutic method, in conjunction with fear exposure sessions, helps mental therapists to spot the emotional triggers and eliminate the unreasonable phobia.
Although there are no proven drugs available to treat the condition, use of D-Cycloserine may aid in reducing panic attacks and anxiety.
The subtle shifts in breathing elicit anxiety and other physical symptoms. In this technique, the fast breathing pattern is changed to a slow one for subsequent reduction of the symptoms.
This unusual phobia can severely affect the normal life of an individual. Such patients may restrict their activities to avoid sources that generate their fear. Precautionary measures could be taken to ensure safety, although in case of panic attacks such individuals may end up taking an extreme step to avoid falling.
Acrophobia and Vertigo
Vertigo is an abnormal condition characterized by a sensation of spinning and dizziness. Problems in the inner ear could be one of its underlying causes. A miscommunication results between the visual and vestibular system, leading to this balance disorder. The morbid fear of heights has often been associated with the illness. However, acrophobic patients normally do not experience a feeling of motion when stationary.
Acrophobia needs to be treated in time before it manifests into a more complicated and incurable anxiety disorder. Patients must be taught various methods to overcome the phobia and resume a normal life. It is very important for family members to provide constant support and care to such patients as most of them begin to lead an isolated life and go into depression.