What is Asthenophobia? (An Overview)

In this blog we will discuss the symptoms, causes and treatments of Asthenophobia. 

An intense fear of weakness or fainting is called Asthenophobia. It is a type of specific phobia which comes under the category of anxiety disorders in the DSM-V.

Someone suffering from it experiences extreme anxiety when exposed weakness or a situation where one might faint. 

To one, even the thought of weakness or fainting can be enough to instigate anxiety. In severe conditions, one can undergo full-blown panic attacks

Fainting is a sign of weakness. People are scared of suffering from weakness because of the feelings of fatigue, muscle pain and or fainting it might result in.

Asthenophobia is not wholly irrational due to these reasons, however, the exaggerated sense of anxiety one suffers from is out of the touch of reality. 

Someone suffering from this type of specific phobia is unable to rationalise his feelings and thus, ends up getting more anxious.

To eliminate these distress causing feelings, one avoids his fear stimuli (fainting/weakness). 

Avoidance, though, seems an easy way of getting rid of anxiety, in reality it can lead to bigger problems.

An individual can suffer from OCD because the repetitive acts of avoidance can turn into compulsions. 

According to the DSM-V, anxiety that causes avoidance affects one’s social and occupational functioning.

For example, one will avoid doing strenuous activities in an attempt to avoid weakness or fainting. They might end up eating more food than required in order to stay strong. 

This can lead to them developing eating disorders in the future. 

A sufferer will refrain from going to school or office so he doesn’t overburden himself with work, causing weakness and fainting. 

Asthenophobia is an irrational fear of fainting or weakness.

The name originates from the Greek word ‘a’ meaning no, ‘stehnia’ meaning strength and ‘phobos’ meaning fear.

Symptoms of Asthenophobia  

Like in the case of all other specific phobias, Asthenophobia too has anxiety as its focal symptom.

Individuals suffering from an irrational fear of fainting/weakness suffer from extreme anxiety which, as mentioned earlier, can result in one having panic attacks. 

When one undergoes extreme anxiety, the body experiences other physiological symptoms as well. Such as increased heart rate or palpitations. 

When the sufferer thinks about fainting or weakness, he goes into flight or fight mode because of an adrenaline rush.

In this state, the body’s physiological responses help one make decisions when in fear causing situations.

They either decide to escape the situation (flight)-faint or suffer from panic attacks or stay and combat their fear (fight)-by taking counterproductive actions.

Sufferers of Asthenophobia experience symptoms in different ways. One might have more severe symptoms than the other, based on their past experiences and intensity of the phobia.

Though, as the DSM-5 suggests, one must experience anxiety lasting for at least 6-months.  

Symptoms one experiences in Asthenophobia are: 

  • Excessive anxiety when they think they’re experiencing weakness or are fainting 
  • Excessive anxiety when thinking about weakness or fainting 
  • Inability to manage anxiety 
  • Full-blown panic attacks 
  • Avoiding fainting/weakness 
  • Increased heart beat 
  • Breathlessness 
  • Muscle tension 
  • Nausea 
  • Feeling depressed 
  • Fear of an impending doom 
  • Excessive sweating 
  • Tremors 
  • Hot/cold flashes 
  • Butterflies in the stomach 
  • Drying up of the mouth 
  • Disorientation 
  • Migraine 
  • Insomnia 

For one to be diagnosed with Asthenophobia, a person should experience at least 3-5 of these symptoms (including anxiety). 

Causes of Asthenophobia 

Like every other specific phobia, Asthenophobia is a result of either genetics or a past traumatic experience. 

Someone who has a family history of anxiety disorders or specific phobias has a higher chance of developing Asthenophobia than someone who doesn’t.

This is because they are genetically predisposed to develop it.  

Genes and neurotransmitters also play a significant role in this genetic predisposition. 

This genetic tendency to develop a mental disorder/specific phobia can also be referred to as a Diathesis-stress relationship.

According to this, one with a genetic predisposition will not develop symptoms of Asthenophobia until and unless there is some trigger event, instigating anxiety or fear related to fainting or weakness. 

Fear of fatigue (Kopophobia) and Asthenophobia are very closely related to each other. One might develop a specific phobia as a result of the other.  

Someone who has a fear of hospitals (Nosocomephobia) will also fear getting weak or fainting because it might result in a hospital visit. 

Additionally, a sufferer may have developed Asthenophobia due to the unpleasant feelings of helplessness or body pain they experienced when weak or fainted. 

An individual who got injured because of fainting or heard someone else suffer from it can also develop this irrational fear of fainting or weakness. 

Therefore, Asthenophobia is caused by both a genetic predisposition and or environmental factors.  

Treatment of Asthenophobia 

Asthenophobia, like all other specific phobias, has no exclusive type of treatment that is specifically designed to treat it.

Like all the other specific phobias, Asthenophobia is treated by a number of different therapies including, Cognitive-behavioral Therapy (CBT) and or medications that lower downs the anxiety or other physical symptoms. 

• Cognitive-Behavioral Therapy (CBT) 

It is one of the most frequently used treatments for patients with almost all kinds of mental disorders.

Asthenophobia is defined as the irrational fear of fainting or weakness.

Thus, the therapist helps the patient in replacing these irrational thoughts with more rational ones. 

The patients are helped out in analyzing and justifying the way they feel about their fear stimuli.

Therapists assist them in uncovering the reasons behind their fear and later they provide them with alternate, pleasant thoughts. 

The patient is told to maintain a thought diary (with ABCD column) which provides them a replacement for every irrational thought they have, when thinking about a particular situation.

The ABCD stands for: 

i. A (antecedents) a situation or triggering event.

ii. B (belief) the thought that comes to one’s mind when in that triggering situation.

iii. C (consequences) the symptoms/feelings caused by that event/thought 

iv. D (dispute) alternate, rational thoughts provided by the therapist in an attempt to        dispute/challenge those irrational beliefs.

This last section of the thought diary is what really plays a role in helping the person feel good/less anxious.  

• Mindfulness-Based Stress Reduction (MBSR) 

MBSR is a meditation therapy, used to manage stress or anxiety. It is an 8-week program which includes group sessions.

Mindfulness meditation and Hatha yoga are practiced in these sessions. Lectures and group discussions are also done to talk about mental health and increase interactivity.

In mindfulness meditation the person is told to, for example, focus on the sensations felt while breathing or the rhythm of the chest rising and falling during the process.

This distracts the person’s attention from something stressful to something which is neutral and soothing. 

For quick and effective treatment, patients are also given a set of home works, for example 45 minutes of yoga and meditation sessions for 6 days a week and to record their results/feelings in a book or diary for 15 minutes a day.

• EMDR 

This another form of treatment used with patients suffering from specific phobia or anxiety disorders. 

It is used with patients who know the cause of their phobia. 

First, the therapist collects the patients’ history of different fears. They then identify the real cause of the particular fear/phobia the patient has. 

They then discuss any new/latest event that triggered their anxiety and fear in the past few weeks.

People coming with specific phobias are told to imagine their distress causing stimuli. 

The therapist then works with the individual in order for them to overcome their fear.

In the case of Asthenophobia, the patient will be advised on how to overcome his fear of fainting or weakness. They do this by creating a positive imagery for the patients’ feared stimuli.

• Dialectical Behavior Therapy (DBT) 

This is another effective therapy used to treat Asthenophobia.

It is more commonly used with people suffering from personality disorders, but is also useful with patients suffering from this type of specific phobia.

Coping skills are taught in the DBT group which lasts for about 6-months and can have a number of people (depending on how many join the group). 

            i.Half-smiling is the first module of DBT. It is a technique that is used with patients who are distressed because of their irrational thoughts.

The technique is known as ‘Half-smiling’ because the person is first advised to think about the stimuli that fears or upsets them, and while doing so they are told to lift the corners of their mouths by subtly smiling.

Smiling is not that will help one get rid of these unpleasant thoughts, it is the person’s ability to constrain itself from thinking about those thoughts while half smiling.

          ii.Mindfulness, the second module, is another technique used in DBT groups which helps the individual in getting rid of those negative thoughts.

Individuals are told to focus on the present and be attentive to what is going on around them at the moment.

This helps in breaking the link between their mind and any negative thought that might come to them then. 

For example, a person is told to focus on his breath or on the sound of the wind around them, making use of their auditory sense. 

         iii.The third technique or module of the DBT is distress tolerance skills. This module teaches people to calm themselves down in healthy ways when they are distressed or emotionally overwhelmed.

Individuals are allowed to make wise, rational decisions and take immediate action, rather than being captured by emotionally destructive thoughts that might make the situation worse.

Reality acceptance skills are also learnt under this model so that people fully accept reality and later make plans on how to address the problem.

• Yoga/Meditation 

They are not just one of the many treatment therapies used for Asthenophobia, instead they are one of the most common ways of relaxation used by many people.

Yoga tends to stimulate the meditative state of one’s mind while the person is in a particular yoga posture.

Through yoga/meditation the mind is diverted towards something more productive and calm, allowing the person to escape the negative, distress causing thoughts.

Out of a number of yoga types, one can benefit from any yoga type/pose they like. Hatha yoga is one of the different types of yoga.

The breathing techniques or the imagery one creates while in a yoga posture are the real factors that makes the person feel less anxious and diverts their mind, away from the thoughts about their fear stimuli. 

• Drug Therapy 

Drugs are used to reduce the physical symptoms caused by Asthenophobia.

Drugs are very quick in effectiveness, as they start showing progress in the patients’ health at least 2 weeks after the medicine is taken. 

This type of biological treatment is usually more effective if the cause of the phobia is only genetic.

However, these drugs/medicines are not to be taken without a doctor’s prescription or consultation. 

Two types of drugs are used in the treatment of this phobia:

                      i.  Antidepressant Drugs

These drugs, as the name suggests don’t only treat depression but are also very effective in treating phobias.

Medicines like Paxil reduce the anxious feelings of a person and makes him feel calm. They need to be taken on a daily basis but not without a doctor’s advice.

                       ii.Anti-anxiety Drugs

Medicines like Klonopin are anti-anxiety drugs. They are most commonly used with patients who experience panic attacks and also lowers their anxiety by binding to receptor cells of the brain that cause these unpleasant symptoms.

Whether the cause of Asthenophobia, or any other type of specific phobia is genetics, environmental or both, the best and the most effective way of treating them is by using a combination of both biological treatments (drugs) with cognitive treatment (for example CBT/exposure therapy).

Frequently Asked Questions 

Q1)  Is Asthenophobia curable?

Yes. Therapies like NLP, CBT are effective in treating all specific phobias including Asthenophobia.

Q2) What are the symptoms of Asthenophobia?

One will experience extreme anxiety, panic attacks, nausea and or breathlessness including other physiological symptoms. 

Q3) How is Asthenophobia caused? 

 A genetic predisposition or environmental factors can be the reason for why one develops Asthenophobia.  

Citations 

  • https://fearof.org/asthenophobia/
  • https://psychtimes.com/asthenophobia-fear-of-fainting-or-weakness/
  • https://common-phobias.com/astheno/phobia.htm
  • https://www.rightdiagnosis.com/a/asthenophobia/intro.htm

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