top of page
medpulsemag

The Fearful Heights: Understanding Acrophobia



Introduction

Have you ever looked up at a skyscraper and been completely awestruck by its beauty? The sight of a skyscraper can be breathtaking. It is truly a sight to behold, is it not?

However, for some individuals, the mere thought of being up high is enough to send shivers down their spine. Just the idea of standing on top of it could awaken extreme anxiety and fear.


This fear is known as acrophobia, and it can be a debilitating condition that affects countless people all over the world. But fear not, because in this article, we are going to explore everything you need to know about acrophobia. We will define acrophobia and delve into the factors that contribute to its development. We will also examine the various treatment options available for those who suffer from this condition.


So, buckle up and get ready to learn all about acrophobia—we are going to conquer this fear together!


Definition and Symptoms

Did you know that acrophobia affects about 1 in 20 adults? It is a specific type of phobia where people have an irrational fear of heights, even in situations where they are actually safe. The fear may be triggered from stairs, elevators, high apartments, terraces, and even bridges. It is not surprising to find out that people with acrophobia are hindered from going to many places because they tend to avoid these situations at all costs, which can limit their ability to go to certain places and events and choose isolation.


Interestingly, just seeing heights on TV or from a distance does not usually trigger the fear. It is only when they are actually in a high environment that the fear kicks in and they feel the need to escape. Some medical professionals even consider acrophobia to be a type of anxiety disorder. All of these symptoms can be extremely distressing and can interfere with daily activities, work, and social life.


Acrophobia itself can develop in childhood or adulthood and it is thought to be a conditioned behavior although this is supported by weak evidence. This means that the phobic person likely experienced intense fear while in a high position, which then led to the development of the phobia. We will talk about what caused this fear later on in the article.


The severity of acrophobia can vary from mild to extremely severe, depending on the individual and whether or not they seek treatment.


Why do some people experience its effects while others do not?

Acrophobia affects millions of people worldwide. Crazy, right? But here is the thing—not everyone experiences this fear. So, what is the deal? Why do some people have acrophobia while others do not? Well, it turns out that there are a few factors at play here. Genetics, environment, and individual experiences all play a role in the development of acrophobia.


Let us start with genetics.


Studies in the psychiatric research field have shown that certain genes may be linked to the development of phobias, including acrophobia.

Two genes in particular have been studied extensively. These genes have variations that could be associated with an altered function of the neurotransmitters involved in anxiety and fear regulation, leading to an increased risk of developing acrophobia.


The COMT gene is responsible for encoding an enzyme called catechol-O-methyltransferase (COMT). This enzyme is involved in the metabolism of catecholamines, including dopamine, norepinephrine, and epinephrine. On the other hand, the 5-HTTLPR gene encodes for a serotonin transporter protein that regulates the reuptake of serotonin from the synaptic cleft into the presynaptic neuron.


Model of association between 5-HTTLPR, 5-HTT availability and amygdala reactivity. Previous studies indicate that the genotype effect on amygdala reactivity


Along with genetics, it is believed that certain inherited personality traits may also contribute to acrophobia. Yes, you read that correctly!


For instance, studies have shown that individuals who are naturally more anxious or are prone to negative emotions may also be more likely to develop this phobia. This suggests that increased vulnerability to anxiety is a contributing factor that can be inherited and passed down through families.


It is interesting to note that acrophobia is not the only phobia that can be influenced by inherited traits. Other phobias, such as arachnophobia (fear of spiders) and claustrophobia (fear of enclosed spaces), have also been linked to genetics.


So, there you have it. It seems like genetics play a pretty big role in the development of phobias. However, genetics alone cannot explain why some people develop acrophobia while others do not.


How can life experiences and Trauma contribute to Acrophobia?


It is not just about genetics, but also about the environment and experiences that a person has had.


Environmental and developmental factors, such as cognitive biases and learning processes, may also contribute to the development of acrophobia. For example, if someone grows up in an environment or culture that emphasizes the dangers of heights and discourages activities involving heights, they may be more prone to developing a fear of heights. Similarly, if a person has had negative experiences with heights (such as falling or feeling wobbly), they might be more likely to develop a fear of heights as a result.


Even traumatic events from childhood like seeing a loved one fall from a height or going on a very scary roller-coaster ride, can contribute to acrophobia.


When something really scary happens to us, our brains process it differently than normal, and that can lead to us being more sensitive to things that remind us of the trauma similar to the gene factor we discussed—this can lead to heightened arousal and increased emotional responses to stimuli associated with the trauma. All of these factors can create a lasting impression in someone's mind that heights are super dangerous, and that can lead to a fear of heights that is really hard to shake.


Treatment: Is there a cure?


There is no doubt that this phobia can greatly affect a person’s quality of life, so the question remains: can it be cured? The treatment options available for acrophobia can help the person to cope with their fear; however, there is no certain cure for acrophobia. The treatment usually includes both psychotherapy, which is most commonly relied on, and medications, which can sometimes be used.


To start off with psychotherapy, there are various methods applied aiming to treat the person’s excessive fear of heights, and these include:


1. Exposure therapy:

It is not a surprise that people with specific phobias do their best to avoid exposing themselves to the thing they are afraid of. However, in this case, this therapy actually gradually exposes the person to their fear, which can cause anxiety but also encourages the person to learn how to cope in such situations. This therapy is considered the first-line treatment for not only acrophobia, but numerous other specific phobias.


2. Virtual reality exposure therapy (VRET):

This is quite similar to exposure therapy, except that the situation are not actually real. This uses technology, such as a virtual reality (VR) headset, to simulate situations that involve heights. As a result, a person can be exposed to heights in a completely safe way that feels real, but actually is not.


Figure (2) showing how virtual reality therapy can help people overcome their fear of heights.

3. Cognitive-behavioral therapy (CBT):

This method is highly preferred if a person does not feel prepared enough to face their fear of height by the previous two options. CBT mainly focuses on helping the person think about their fear differently, and remove any negative thoughts about height. This is done through talking with a therapist or psychologist who helps the person to gain a different perspective.


Additionally, some medications can be used to help with managing the symptoms of anxiety and panic. These mainly include prescribing beta-blockers, which prevent physical arousal. Benzodiazepines, on the other hand, are sedatives that are only used temporarily due to their addictive nature.


FAQ

Q. Do all acrophobic people present with panic attacks, or clear fear of heights?

No, in fact, acrophobia presents with varying degrees of severity. Meaning that while some may experience intense anxiety, others may just avoid situations involving heights.


Q. Are acrophobic people aroused by watching bridges, birds, or airplanes?

No, in fact, acrophobic people don’t react to just watching scenes on T.V that includes bridges, or birds flying. They experience fear when physically being on a bridge.


Q: What are some common misconceptions about acrophobia?

Several common misconceptions surrounding acrophobia are that it is a matter of personal choice or weakness, that it can be easily overcome through willpower or exposure therapy, and that it is not a legitimate mental health condition. To counteract these misconceptions, it is essential to promote education and awareness.


Q: Could people be stigmatized for having acrophobia?

Yes, individuals with acrophobia may experience stigma or discrimination based on their condition. This can occur due to a lack of understanding or awareness about the nature of phobias, or as a result of negative stereotypes or misconceptions about mental health.


Q: What are some examples of acrophobia-related stigma?

Stigma related to acrophobia can manifest in various ways, including mocking, belittling, or ostracizing individuals with the condition, or treating them as though their fear is irrational or unfounded.


Q: How can I support someone with acrophobia?

To provide support for individuals with acrophobia, it is essential to demonstrate empathy and patience to them as they work through their fear. Listen carefully to their concerns, and refrain from minimizing or dismissing their fears. Acrophobia can be a debilitating condition that can greatly impact a person's life. Encourage them to seek professional assistance and take proactive measures to promote their well-being.


 

References

  1. Loken, E. K., Hettema, J. M., Aggen, S. H., & Kendler, K. S. (2014). The structure of genetic and environmental risk factors for fears and phobias. Psychological medicine, 44(11), 2375–2384. https://doi.org/10.1017/S0033291713003012

  2. Kobiella, A., Reimold, M., Ulshöfer, D. et al. How the serotonin transporter 5-HTTLPR polymorphism influences amygdala function: the roles of in vivo serotonin transporter expression and amygdala structure. Transl Psychiatry1, e37 (2011). https://doi.org/10.1038/tp.2011.29

  3. Kang, E., Choe, A. Y., Kim, B., Lee, J. Y., Choi, T. K., Na, H. R., & Lee, S. H. (2016). Serotonin Transporter and COMT Polymorphisms as Independent Predictors of Health-related Quality of Life in Patients with Panic Disorder. Journal of Korean medical science, 31(5), 757–763. https://doi.org/10.3346/jkms.2016.31.5.757

  4. Eaton, W. W., Bienvenu, O. J., & Miloyan, B. (2018). Specific phobias. The lancet. Psychiatry, 5(8), 678–686. https://doi.org/10.1016/S2215-0366(18)30169-X

  5. https://my.clevelandclinic.org/health/diseases/21956-acrophobia-fear-of-heights

  6. Figure (1) Retrieved May 1st, 2023, from: https://www.nature.com/articles/tp201129

  7. Figure (2) Retrieved May 4th, 2023, from: https://www.indiatvnews.com/lifestyle/health-study-virtual-reality-therapy-helps-people-overcome-fear-of-heights-452379


40 views0 comments

Recent Posts

See All

Comments


bottom of page