At the 2017 Neuroscience Education Institute (NEI) Congress, a Friday session focused on the physiology of fear and its impact on wellness.
“Fear is a feeling that is internal and is conscience,” said Mary D. Moller, PhD, DNP, ARNP, PMHCNS-BC, CPRP, FAAN, associate professor, Pacific Lutheran University School of Nursing, and director of Psychiatric Services, Northwest Center for Integrated Health.
It arises when sensory systems in the brain have determined an external stimulus poses a threat. Outputs of threat detection circuits trigger a general increase in brain arousal and can result in altered threat processing: fear and anxiety disorders.
Moller first explained Hans Selye’s 3 predictable stages the body uses to respond to stressors, called the general adaption syndrome:
- Alarm: The first reaction to stress recognizes there’s a danger and prepares to deal with the threat. The hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system are activated. Primary stress hormones cortisol, adrenaline, and nonadrenaline are released
- Resistance: Homeostasis begins restoring balance and a period of recovery for repair and renewal takes place. Stress hormones may return to normal, but there may be reduced defenses and adaptive energy left.
- Exhaustion: At this phase, the stress has continued for some time. The body’s ability to resist is lost because its adaption energy supply is gone. This is often referred to as overload, burnout, adrenal fatigue, maladaptation, or dysfunction.
Alterations to the HPA axis can cause several conditions such as chronic pain, fibromyalgia, and insulin resistance, said Moller.
Moller then outlined the potential consequences of fear on overall, physical, emotional, environmental, and spiritual health. The potential effects of chronic fear on overall health include:
- Immune system dysfunction
- Endocrine system dysfunction
- Autonomic nervous system alterations
- Sleep/wake cycle disruption
- Eating disorders
- Alterations in hypothalamus-pituitary-adrenal axis
The potential effects of chronic fear on physical health include headaches turning into migraines, muscle aches turning into fibromyalgia, body aches turning into chronic pain, and difficulty breathing turning into asthma, said Moller.
The potential effects of chronic fear on emotional health include:
- Dissociation from self
- Unable to have loving feelings
- Learned helplessness
- Phobic anxiety
- Mood swings
- Obsessive-compulsive thoughts
The potential consequences of chronic fear on environmental health include:
- Continued living in fear-generating situations due to uncertainty of moving out and unknown associated dangers
- Not able to find safe housing
- Afraid to leave home because of paranoia
The potential consequences of chronic fear on spiritual health:
- Bitterness/fear toward God or others
- Confusion/disgust with God or religion
- Loss of trust in God and/or clergy
- Waiting for God to fix it
- Despair related to perceived loss of spirituality
Lastly, Moller explained that fear affects the ability to learn.
“The brain’s capacity to retrieve previous learning is dependent on specific chemical states,” said Moller. “Chemical alterations can distort perception of sensory information thus distorting storage.”
When the brain is hyper aroused, storage may be incomplete and new information will be stored in nonverbal memory, said Moller. This distorts the storage of sensory input and the retrieval of information will be affected.