Basophobia: symptoms, causes and treatment

What is basophobia? Let's take a look at a summary of the characteristics of fall phobia.

Every day, all of us perform actions that do not require our attention. One of these actions is walking, which despite being subject to a remarkable degree of motor coordination, tends to become automated from a very early age.

When we walk, we shift our weight forward, changing the axis of gravity and positioning both feet so that the body moves in space without colliding with the ground or an obstacle. Everything happens without the need to think in detail about what is happening.

It is for this reason that many people are surprised to discover that it is possible to be afraid of making a mistake in this "simple" process, and suffer as a consequence a serious fall. Such a fear, more common than you might think, is known as basophobia..

In this article we will talk about this specific fear, its causes and treatments, as well as about which is the group with a higher risk of suffering from it.

What is basophobia?

Basophobia is a specific phobia, and therefore it can be considered as an anxiety disorder. The sufferer reports a very disabling fear of staggering and falling while moving from one place to another.. The fact that ambulation is an absolutely common act, necessary to develop the daily life, turns this fear into a problem that limits in a very remarkable way the autonomy and the participation in activities of daily life.

Symptoms

This fear usually has a number of identifiable causes, which we will discuss in detail in the next section, and tends to be maintained through a process of deliberate avoidance.

Many people with basophobia, faced with the experience of this irresistible fear, decide to stop walking permanently. Thus, they remain for a long time in situations of extreme sedentary lifestyle, suffering physically while the fear continues to increase.

It is important to keep in mind that the majority of people living with basophobia (also known in the literature as fear of falling) are older adults with additional physical problems, especially in the locomotor system, so it is a very common fear of falling.This is a problem that can exacerbate the decline of their health or the risk of complications in other organs or systems. This is why early detection and treatment is of paramount importance.

People with basophobia may also report difficult emotions with great frequency, since the resulting inactivity implies a succession of important losses (social, occupational, etc.). Therefore, mood disorders or a painful feeling of loneliness are common.

Causes of basophobia

Below we will present the main causes of basophobia. They will include both physical and psychological aspects, which can often occur at the same time or even interact with each other, enhancing each other.

1. Previous history of falls

Most of the research on basophobia indicates that a history of falls in the past is one of the main reasons why this form of fear may develop.. Thus, the memory of tripping and falling would be stored as an emotional imprint in the narrative of life, which would condition the ability to walk normally. Although it is possible to develop the phobia without having experienced a serious fall in one's own skin, the fact is that most sufferers report having done so.

A two-way relationship is established: people who have fallen are more afraid of falling than those who have never fallen, but it is also the case that those who fear a fall more intensely are at greater risk of falling than those who feel more confident. As a result, a vicious cycle is traced a vicious cycle between the experience and the expectationThe resolution of which requires a personalized therapeutic procedure.

2. Anxiety and posture control

When the fear of falling is established, the sufferer pays excessive attention to the whole process involved in moving from one place to another, causing him/her to lose the normality with which he/she was developing until that moment. Therefore, this automated coordination would be conditioned by a perception of threat or danger, which would imply a harmful need for control and security.

This supervision alters the functioning of gait at many levels. We know that people with basophobia adopt a greater stiffness in the Muscle groups involved in gaitlimiting the range of motion and altering the center of balance by contracting the tibialis anterior, soleus and calf muscles. This variation may increase the risk of a new fall (or the first one in those who have never experienced one before).

Such a deliberate alteration of gait is a behavior that is difficult to control, by which the person tries to anticipate an unexpected situation that increases the risk of falling: an obstacle in the way, a slope in the terrain or a dizziness. This is why it is more common in people who live with anxious symptoms in which there is a constant worry about what might happen in the future.

Even in an upright position, where there is no anticipated need to walk, people with basophobia feel fearful and their confidence in their own balance is undermined, precipitating a hyperactivation of the autonomic nervous system (and more specifically its sympathetic branch). This physiological phenomenon is linked to sensations such as tachycardia, tachypnea, sweating, sensation of unreality and instabilityand in themselves increase the risk of falling.

3. Increased cognitive demand

Elderly people with basophobia have a higher risk of falling, as well as a greater fear of this happening to them, when a simultaneous activity requiring cognitive effort is added to the fact of wandering. This is why they may feel insecure in unfamiliar places, because there they must devote much more attentional resources to assessing the properties of the physical environment (presence of obstacles and support elements, for example).

This circumstance also implies that people with impaired cognitive functions are at a higher risk of falling than those with impaired cognitive functions. are at a higher risk of falling than those whose cognitive functions are preserved, since in the former case it is easier for the resources available for information processing to be exceeded. This is one of the reasons why patients with dementia fall more frequently than individuals who do not suffer from these neurodegenerative problems.

4. Poor physical function or need for ambulation aids.

People who perceive themselves to be physically limited (by accident, surgery or pathology) may be at greater risk of developing this phobia. In such a case, self-efficacy for movement may be severely impaired, leading to loss of confidence and a generalized sense of insecurity. This problem increases when walking assistance, such as crutches or a cane, is required.

Many studies point out that what is really important in explaining the fear of falling is not the objective physical state, but the person's perception of it. Thus, a subject with less mobility may not have this problem as long as he is confident in his own capacity, and considers that his body is in good shape. Institutionalization of the elderly can increase the risk of basophobia, especially if the residential center in which they are placed does not have information on the risk of basophobia.This is especially true if the residential center they are in does not have information about this problem.

5. Use of drugs

Older people eliminate drugs more slowly than younger people. They also report more (and more severe) side effects than younger people, so it is necessary to be cautious in the administration of compounds that could cause dizziness or instability in people suffering from basophobia.

Sometimes, in order to treat the anxiety directly associated with basophobia, it is decided to administer benzodiazepines. This is a subgroup of drugs with myorelaxant, hypnotic and anxiolytic properties. Well, in some cases can cause undesirable drowsiness and muscle laxity in those living with this phobic problem (especially early in the morning). in those living with this phobic problem (especially early in the morning), so their use and effects in these specific cases should be monitored to the extreme.

Treatment of basophobia

Basophobia can be treated through therapeutic programs that include four main components: physical exercises, psychoeducation, exposure and the use of protective or safety measures..

With regard to physical exercises, activities aimed at improving the sense of balance have been proposed. They include sitting and standing movements, stepping in all directions while maintaining a standing position, bending the body to explore the limits of stability, lying down and standing up (since orthostatic hypotension sometimes contributes to fear) and the practice of (adapted) team sports.

As for psychotherapeutic strategies, the use of psychoeducation (providing information on the problem reducing (providing information about the problem to reduce the presence of preconceived and harmful ideas), cognitive restructuring (identification and discussion of irrational ideas) and exposure (both in vivo and in imagination or through the use of new technologies).

Protective measures involve modifying the physical environment in order to increase the feeling of safety in the spaces where the person normally functions, as well as making use of elements that minimize the potential anticipated consequences of a potential fall (protection in the areas of the body that the person perceives as vulnerable or fragile, such as the head or knees).

Among all these strategies those that have been shown to be most effective are those that combine both physical exercise and psychological intervention.The use of one or the other alone is not enough, and multidisciplinary programs that address the reality of the person as a whole are necessary. The separate use of one or the other has also shown positive effects, but they tend to dilute rapidly as time goes by.

Bibliographical references:

• Seonhye, L., Eunmi, O., & Gwi-Ryung, S.H. (2018). Comparison of Factors Associated with Fear of Falling between Older Adults with and without a Fall History. International Journal of Environmental Research and Public Health, 15, 1-12.
• Stojanovic, Z., Kocic, M., Balov, V., Milenkovic, M., Savic, N. e Ivanovic, S. (2016). Fear of Falling. Praxis Medica, 44(3), 61-66.
• Young, W.R. y Williams, M. (2015). How fear of falling can increase fall-risk in older adults: applying psychological theory to practical observations. Gait Posture, 41(1), 7-12.