Your question: Why do you get scared when you’re about to fight?
By
OptimistMinds
| Reviewed by
Dr. Mark Mohan Kaggwa
The contents of this article are fact-based except otherwise stated within the article.
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Author bio
The Optimistminds editorial team is made up of psychologists, psychiatrists and mental health professionals. Each article is written by a team member with exposure to and experience in the subject matter. The article then gets reviewed by a more senior editorial member. This is someone with extensive knowledge of the subject matter and highly cited published material.
Reviewer bio
Dr. Mark Mohan Kaggwa is a psychiatrist with experience in both clinical and research work. Major research contributions have been in forensic psychiatry, suicidology, medical education, and addiction psychiatry. He writes and reviews articles on these topics.
Brief bio
I have a wealth of expertise and experience in research and publication in psychiatry. I am a psychiatrist who has led and participated in several research projects and trainings, covering various topics such as addiction, forensic psychiatry, student mental health, and suicidology. I have a strong track record of mentoring and guiding early career researchers, especially students, to achieve academic excellence and recognition.
I have supervised and supported several students to publish their first peer-reviewed articles in high-impact journals such as the Lancet. Five of my mentees have received prestigious awards for their scientific contributions through publications, conference presentations, and travel grants. I derive great satisfaction and motivation from seeing others succeed and grow in their research careers.
Through mentoring activities, I have also enhanced my research and publication skills, resulting in over 70 publications in the past three years. My notable publications include several Lancet Psychiatry papers, widely cited and whose findings are implemented in various settings. I have also won several awards for my writing skills, such as the best journal article from the Royal College of Psychiatry Journals in August 2023.
Many of my articles have been featured on the cover pages of various journals, reflecting their significance and impact. I have also disseminated my research findings through conferences, seminars, and lectures, where I have been invited as a keynote speaker on three occasions.
I am passionate about solving real-world problems and improving the lives of people with mental health issues, especially those who are marginalized and vulnerable, through a team-based approach. I believe in training others to increase the field’s diversity of knowledge and perspectives.
I have extensive experience in data analysis, research methodology, design, and implementation science, which enables me to execute and train others effectively and efficiently. I am also a motivated team leader, an innovative problem solver, and a collaborative partner. My contribution is instrumental to this project’s success and advancing knowledge in this field.
Ongoing research projects:
- Self-harming behaviours among forensic patients in Ontario.
This project which started in December 2022, focuses on identifying the risks associated with physical self-harming behaviors and their related correlates
Role: Principal Investigator
- Suicide, all-cause mortality, and self-harming behaviours among forensic patients in Ontario.
This project is based on administrative databases to determine trends of suicide and all-cause mortality among forensic patients in Ontario. The project has been running since July 2023 to date
Role: Principal Investigator.
- Horticulture therapy’s role in reducing aggressive incidences among forensic patients in Ontario.
In this stepwise pragmatic cluster-randomized, we employ horticulture therapy in rehabilitating forensic patients in Ontario.
Role: Principal Investigator
- A preliminary study exploring the relationship between electroretinography waveforms and suicidal behaviour severity.
This project seeks to identify the waveforms that are related to suicidal behaviours among patients with depression. Recruitment for the study started in October 2023
Role: Principal Investigator
- Positions, Scientific Appointments, and Honors
| 2023 – present | American Psychiatry Association Colloquium fellow 2023, American Psychiatry Association, USA |
| 2022 – present | McMaster Forensic Psychiatry fellowship, McMasters University Department of Psychiatry and Behavioural Neuroscience, Hamilton, Canada |
| 2018 – 2021 | First Mile Fellowship (Masters support program), Massachusetts General Hospital Institute of Health Professions, USA
|
- Contributions to Science
- Suicidology epidemiology
I have been involved in projects investigating the prevalence of suicidal behaviours in various parts of the world. This work has reported the burden and associated factors among the following populations: university students, individuals affected by food insecurity, and those affected by the COVID-19 pandemic.
1) Kaggwa M.M, Akatussasira R, et. al. The global burden of suicidal behaviour among people experiencing food insecurity: A systematic review and meta-analysis. Journal of Affective Disorders. 2023. https://doi.org/10.1016/j.jad.2023.09.012
2) Nahrin R, Al-Mamun F, Kaggwa M.M, et al. Prevalence and factors associated with suicidal ideation among students taking university entrance tests: revisited and a study based on Geographic Information System data. BJPsych Open. https://doi.org/10.1192/bjo.2023.526
3) Abaatyo, J., … Kaggwa, M.Ml. Suicidal behaviour among inpatients with severe mental conditions in a public mental health hospital in Uganda. BMC Psychiatry 23, 346 (2023). https://doi.org/10.1186/s12888-023-04858-x
4) Kaggwa MM, Nuwamanya S, Ashaba S, Rukundo GZ, Harms S. An Adolescent’s Use of Veterinary Medicines: A Case Report Exploring Addiction. Journal of Psychoactive Drugs. 2021/08/08 2021;53(4):339-344. doi:10.1080/02791072.2021.1873466
5) Kaggwa MM, Muwanguzi M, Nduhuura E, et al. Suicide among Ugandan university students: evidence from media reports for 2010–2020. BJPsych International. 2021;18(3):63-67. doi:10.1192/bji.2021.13
6) Mamun MA, Al Mamun F, Hosen I, … Kaggwa MM, et al. Suicidality in Bangladeshi Young Adults During the COVID-19 Pandemic: The Role of Behavioral Factors, COVID-19 Risk and Fear, and Mental Health Problems. Risk Manag Healthc Policy. 2021;14:4051-4061. doi:10.2147/rmhp.S330282
7) Kaggwa MM, Arinaitwe I, Muwanguzi M, et al. Suicidal behaviours among Ugandan university students: a cross-sectional study. BMC Psychiatry. 2022/04/01 2022;22(1):234. doi:10.1186/s12888-022-03858-7
8) Kaggwa MM, Mamun MA, Najjuka SM, et al. Gambling-related suicide in East African Community countries: evidence from press media reports. BMC Public Health. Jan 24 2022;22(1):158. doi:10.1186/s12889-021-12306-2
9) Kaggwa MM, Rukundo GZ, Wakida EK, et al. Suicide, and Suicide Attempts Among Patients Attending Primary Health Care Facilities in Uganda: A Medical Records Review. Risk Manag Healthc Policy. 2022;15:703-711. doi:10.2147/rmhp.S358187
10) Rukundo GZ, Wakida EK, Maling S, Kaggwa MM, et al. Knowledge, attitudes, and experiences in suicide assessment and management: a qualitative study among primary health care workers in southwestern Uganda. BMC Psychiatry. Sep 12 2022;22(1):605. doi:10.1186/s12888-022-04244-z
11) Manouchehri A, Marznaki ZH, Atim LM, Mohammadian Amiri M, Kaggwa MM. The relationship between causes of suicidal attempts in Iran and individual and social variables: a retrospective study. BMC Psychiatry. Dec 12 2022;22(1):780. doi:10.1186/s12888-022-04449-2
12) Kaggwa MM, Najjuka SM, Favina A, Griffiths MD, Mamun MA. Suicidal behaviors and associated factors among medical students in Africa: A systematic review and meta-analysis. Journal of Affective Disorders Reports. 2022/12/09/ 2022:100456. doi:10.1016/j.jadr.2022.100456
13) Al-Mamun, F., Kaggwa, M.M., Hosen, I. et al. Suicide related to the COVID-19 pandemic in India: A systematic review. Discov Psychol 3, 2 (2023). https://doi.org/10.1007/s44202-022-00063-1
- University student’s mental health
Following my experience as a student and seeing many of my colleagues face vast challenges in their pursuit of knowledge. I investigated various aspects of university students’ mental health to find solutions to an ever-growing problem. I have published a few peer-reviewed articles on subjects ranging from depression, burnout, behavioural addictions, and sexual risk behaviours, among others.
1) Kaggwa MM, Devine J, and Harms S. The opioid crisis fuelled by health systems: how will future physicians fare? BJPsych International, 2023, 1-3, https://doi.org/10.1192/bji.2023.12
2) Sserunkuuma, J., Kaggwa, M. M., et al. Problematic use of the internet, smartphones, and social media among medical students and relationship with depression: An exploratory study. Plos One, 18(5), e0286424. https://doi.org/10.6084/m9.figshare.22794644
3) Kajjimu J, Kaggwa MM, Bongomin F. Burnout and associated factors among medical students in a public university in Uganda: A cross-sectional study. Adv Med Educ Pract. 2021;12:63-75. doi:10.2147/amep.S287928
4) Al Mamun F, Hosen I, Misti JM, Kaggwa MM, Mamun MA. Mental Disorders of Bangladeshi Students During the COVID-19 Pandemic: A Systematic Review. Psychology research and behavior management. 2021;14:645-654. doi:10.2147/PRBM.S315961
5) Najjuka SM, Checkwech G, Olum R, Ashaba S, Kaggwa MM. Depression, anxiety, and stress among Ugandan university students during the COVID-19 lockdown: an online survey. Afr Health Sci. Dec 2021;21(4):1533-1543. doi:10.4314/ahs.v21i4.6
6) Kaggwa MM, Kajjimu J, Sserunkuma J, et al. Prevalence of burnout among university students in low- and middle-income countries: A systematic review and meta-analysis. PLoS One. 2021;16(8):e0256402. doi:10.1371/journal.pone.0256402
7) Kaggwa MM, Arinaitwe I, Nduhuura E, et al. Prevalence and Factors Associated With Depression and Suicidal Ideation During the COVID-19 Pandemic Among University Students in Uganda: A Cross-Sectional Study. Front Psychiatry. 2022;13:842466. doi:10.3389/fpsyt.2022.842466
8) Kihumuro RB, Kaggwa MM, Kintu TM, et al. Knowledge, attitude and perceptions of medical students towards mental health in a university in Uganda. BMC Med Educ. Oct 20 2022;22(1):730. doi:10.1186/s12909-022-03774-0
9) Kihumuro RB, Kaggwa MM, Nakandi RM, et al. Perspectives on mental health services for medical students at a Ugandan medical school. BMC Med Educ. Oct 25 2022;22(1):734. doi:10.1186/s12909-022-03815-8
10) Kaggwa MM, Muwanguzi M, Najjuka SM, et al. Risky sexual behaviours among Ugandan university students: A pilot study exploring the role of adverse childhood experiences, substance use history, and family environment. PLoS One. 2022;17(11):e0277129. doi:10.1371/journal.pone.0277129
11) Muwanguzi, M., Kaggwa, MM., et al. Exploring adverse childhood experiences (ACEs) among Ugandan university students: its associations with academic performance, depression, and suicidal ideations. BMC Psychology, 2023/01/13.
- Influence of family caregivers and peer influence on patient’s mental health
From the unique perspective of using caregivers in caring for mental health patients in Mbarara Regional Referral Hospital. I embarked on understanding their roles, burdens, and significance in patients’ recovery. I continued to explore this in different populations, such as those involved in the criminal justice system. In this adventurous journey, I published a few peer-reviewed articles.
1) Kaggwa, M.M, Olagunju, A.T, Prat, S, Harms, S, and Chaimowitz, G. Peer support mental health teams in correctional settings in Uganda. Lancet Psychiatry, January 2023. https://doi.org/10.1016/S2215-0366(22)00431-X.
2) Kaggwa MM, Najjuka MS, Kesande C, et al. Length of stay of hospitalized patients at tertiary psychiatry facilities in Uganda: the role of caregiver’s presence. Discover Mental Health. 022/07/04 2022;2(1):15. doi:10.1007/s44192-022-00018-x
3) Kaggwa, M.M, Najjuka SM, Mamun, MA, Griffiths, MD, Nyemara, N, and Ashaba, S. Involvement and burden of informal caregivers of patients with mental illness: the mediating role of affiliated stigma. BMC Psychiatry. January 2023. http://dx.doi.org/10.1186/s12888-023-04553-x
4) Nuwamanya S, Nkola R, Najjuka SM, et al. Kaggwa MM. Depression in Ugandan caregivers of cancer patients: The role of coping strategies and social support. Psychooncology. Oct 26 2022;doi:10.1002/pon.6057
5) Najjuka SM, Iradukunda A, Kaggwa MM, et. Al., The caring experiences of family caregivers for patients with advanced cancer in Uganda: A qualitative study. Plos One, October 2023.
- Mental healthcare and psychiatry epidemiology in Uganda
I have also contributed to understanding Uganda’s mental healthcare system through written commentaries, perspectives, reviews, and primary research.
1) Kaggwa MM, Harms S, Mamum M, A. Mental health in Uganda. Lancet Psychiatry; 2022. Oct;9(10):766-767. doi: 10.1016/S2215-0366(22)00305-4.
2) Kaggwa MM, Najjuka SM, Bongomin F, Mamun MA, Griffiths MD. Prevalence of depression in Uganda: A systematic review and meta-analysis. PLoS One. 2022;17(10):e0276552. doi:10.1371/journal.pone.0276552
3) Abaatyo J, Kaggwa MM, Favina A, and Olagunju AT. Readmission and associated clinical factors among individuals admitted with bipolar affective disorder at a psychiatry facility in Uganda. BMC Psychiatry, 23, 474 (2023). https://doi.org/10.1186/s12888-023-04960-0
4) Abaatyo, J., Favina, A. & Kaggwa, M.M. Absconding among admitted patients with bipolar affective disorder diagnosis in Uganda. BMC Psychiatry 23, 318 (2023).
5) Anyayo L, Ashaba S, Kaggwa MM, Maling S, Nakimuli-Mpungu E. Health-related quality of life among patients with bipolar disorder in rural southwestern Uganda: a hospital-based cross-sectional study. Health and Quality of Life Outcomes. 2021/03/10 2021;19(1):84. doi:10.1186/s12955-021-01729-5
6) Kaggwa MM, Namatanzi B, Kule M, et al. Depression in Ugandan Rural Women Involved in a Money Saving Group: The Role of Spouse’s Unemployment, Extramarital Relationship, and Substance Use. Int J Womens Health. 2021;13:869-878. doi:10.2147/ijwh.S323636
7) Kaggwa MM, Acai A, Rukundo GZ, Harms S, Ashaba S. Patients’ perspectives on the experience of absconding from a psychiatric hospital: a qualitative study. BMC Psychiatry. 2021/07/26 2021;21(1):371. doi:10.1186/s12888-021-03382-0
8) Kaggwa MM, Najjuka SM, Harms S, Ashaba S. Mortality Among Patients Admitted in a Psychiatric Facility: A Single-Centre Review. Clinical Audit. 2021 2021-06-17 2021;13:21-28. doi:10.2147/CA.S308757
9) Kaggwa MM, Nkola R, Najjuka SM, Bongomin F, Ashaba S, Mamun MA. Extrapyramidal Side Effects in a Patient with Alcohol Withdrawal Symptoms: A Reflection of Quality of the Mental Health Care System. Risk Manag Healthc Policy. 2021;14:2789-2795. doi:10.2147/rmhp.S314451
You can view some of my scholastic work from the following
eRA COMMONS: ORCID ID: https://orcid.org/0000-0002-4733-154X
Scopus Author ID: https://www.scopus.com/authid/detail.uri?authorId=57221518864
Researchgate ID: https://www.researchgate.net/profile/Mark-Kaggwa
Loop profile: https://loop.frontiersin.org/people/926359/overview
Semantic Scholar Link: https://www.semanticscholar.org/author/Mark-Mohan-Kaggwa/2046806840
Google scholar: https://scholar.google.com/citations?user=pPNqr_AAAAAJ&hl=en
My reply:
Hi, I hope this message finds you well. My name is Cesar Guedez, a psychologist trained in cognitive behavioral therapy. Through this article, I will explain why you may experience fear or anxiety in fight situations, either physical or verbal, exploring the origin of fear and the fight or flight response, as well as some strategies to calm this fear.
Discussions are necessary in your daily lives. Whether you want to or not, you are going to have confrontations with people because of your different points of view. The fear of fighting is common, because people naturally fear that your integrity will be violated, physically or emotionally. Therefore, arguments can be frightening and trigger deep fear and anxiety for many people. Fights themselves are stressful because whether physical or not they involve a risk that you must take. Fear of fighting is also related to fear of death and illness, feeling that you will be physically harmed.
Understanding your “Fight or Flight” response
The origin of fear in general is in the amygdala. The amygdala is a complex organ, composed of at least 13 different subnuclei that have different functions, but are generally related to the management of emotions, the fear response and the release of cortisol (known as the stress hormone) (1).
In your brain, when the amygdala detects a stimulus that seems threatening and could cause you physical or moral harm, it sends physical and emotional signals to your body that cause what you know as fear. People act differently to fear, and there is a process called fight or flight that exemplifies your typical reactions to a frightening situation.
The fight or flight response implies that in the presence of a fear or anxiety generating stimulus, you will react in two possible ways. The person can fight, that is to say, confront the frightening stimulus, filling his body with adrenaline to act. Have you heard stories of people who, in the face of a mugging, rush at the attacker or who, in an argument, get up the courage to tell someone everything they have in store? That is the fight response.
In the flight response, the person avoids the intimidating stimulus by passivity, physically fleeing the scene or becoming paralyzed both physically and emotionally. In the case of the assailant or a verbal argument, the flight response causes you to run away or to remain absolutely silent, holding your words.
How can you avoid being afraid of fights?
Understand that there are no “wrong” reactions to fear in general. If you are reading this, it is possible that you feel frustrated and “cowardly” for not facing fights of any kind. I would like you to understand that your fear is normal and common, and does not represent a negative characteristic of you. However, if it causes you significant discomfort, it is necessary to change things to improve your condition. To cope with the intense fear associated with fighting, some strategies are:
Martial arts
If your fear is related to physical fights, a valuable strategy is to enroll in martial arts or karate groups. These spaces, when guided by a professional, work individually and collectively on the fear associated with fighting. The professionals of these fighting spaces know that the mind has a close relationship with the body, so they will provide you with adequate techniques to control your fear of fighting, in addition to allowing socialization in a new space that will reduce your feeling of anxiety, shame and alienation related to the fear of fighting (2).
Relaxation and breathing
Fear in general is an emotion that destabilizes your body, therefore, it is your responsibility to implement strategies that make you feel more relieved when the fear overflows. Relaxation and breathing techniques are very useful when the feeling of fear invades your body. Maybe before a fight of any kind you start to feel your heart racing, your palms sweat and your limbs go numb.
You begin to imagine a myriad of catastrophic scenarios. Whether you are alone or in public, relaxation allows you to relieve these symptoms. You should close your eyes and inhale and exhale in 3-second intervals. In the meantime, repeat in your mind key phrases that generate motivation and pride. “You got this”, “you have prepared for this moment”, “you are capable of doing it”, to mention a few examples.
Reinforce your self-esteem
Much of the fear of fighting is related to the fear of failure and humiliation. You must first reconcile yourself to the idea that you will not win every fight and argument you face. You must accept yourself as a fallible human being, who is not defined by his victories and defeats but by the effort he constantly makes to improve. Also, you must work on your self-confidence, reinforcing yourself on a daily basis with confidence-building phrases, avoiding self-critical and humiliating thoughts, and reminding yourself that at the end of the day, you are doing your best.
In my experience…
Cognitive behavioral therapy is extremely useful for treating fears and anxiety in general. In my experience, working with this therapeutic approach allows people to connect with their emotions, fears and traumas, facing them and taking control of the overwhelming situation they are experiencing. My final recommendation would be to go to a professional who will alleviate any remaining doubts and allow you to find the treatment that is right for you.
Remember that you have the ability to improve your psychological state, even if during moments of anxiety or depression you feel hopeless. We can always make small changes that will pay off in the long run. The fact that you are contacting me to seek professional attention in psychological counseling is already a step, and I recognize and applaud you for that. You are already doing something and wanting to change always leads you in the right direction.
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References
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