What diseases are you really afraid of?

Psychiatry, Psychosomatics & Psychotherapy

However, an interplay of hereditary, neurobiological and psychological factors determines whether the fear is expressed in an exaggerated form in an individual patient.

Genetic factors

Genetic factors seem to be important for the development of the various anxiety disorders. There is an accumulation of anxiety disorders in the families of patients. Identical twins are more likely to have anxiety disorders at the same time than dizygoti. A single, responsible gene has not been identified, so it is assumed that several genes can cause anxiety disorders.

Neurobiological factors

The biological and chemical processes in our body play a very important role in the origin of anxiety attacks. In anxiety disorders, the balance between messenger substances (neurotransmitters) such as serotonin, noradrenaline or gamma-aminobutyric acid (GABA) and in the brain is probably disturbed. The role of serotonin in the origin of fear is supported in particular by the effectiveness of drugs that inhibit the breakdown of serotonin and thus increase the serotonin level in the brain (serotonin reuptake inhibitors / SSRIs); the same applies to norepinephrine. GABA is an anxiety-inhibiting neurotransmitter in the brain. In anxiety patients, changes were also found in certain areas of the brain that are responsible for controlling human emotions.

Psychological factors

Several psychological factors are involved in the development of anxiety disorders. Traumatic childhood experiences (e.g. physical or emotional violence, sexual abuse), but also long-lasting and stressful stress are considered risk factors for the development of an anxiety disorder.
According to learning theory, negative learning experiences favor the development and maintenance of fears. By avoiding fearful situations, patients take the opportunity to have the positive learning experience that their fear is unfounded.

Psychoanalytic (depth psychological) theories, which still require scientific confirmation, have different explanations for the development of pathological fears. Some hypotheses assume a triggering by repressed sexual and aggressive impulses. Intrapsychic conflicts caused by traumatic experiences in childhood or by certain styles of upbringing are assumed to be the cause.