Fear and Anxiety

Heidegger defines fear as fearing something within the world that threatens us. Fear causes us to await this something’s arrival, which leads to giving up our possibilities and retreating into bewilderment. In contrast, anxiety is anxious about our possibilities and brings us back to ourselves.

We are both fearful and anxious of Parkinson’s. The disease is seen as something threatening our physical control and in bewilderment we await its arrival. But, Parkinson’s is part of our thrownness and as such is a possibility we are anxious of. Therefore, we threaten ourselves with Parkinson’s, causing us to try and retreat from ourselves in fear. But while waiting for the loss of control to arrive we confront the thrown possibility of Parkinson’s as our own in anxiety. We try and tear our problems away in fear but end up gluing them back to ourselves with anxiety. The oscillation between fear and anxiety can be very painful and disorientating.

dr jonny

A very important topic and one which can cause PWP a lot of distress, thank you for raising it here.

My views on the subject are based on personal experience and from the experiences of others I have talked to:

Fear is an unpleasant emotion that is brought about by the way the body reacts to a situation. It is a necessary warning system that protects us by raising our awareness to potential danger around us. The emotion we feel from a situation that we find fearful stimulates the secretion of adrenaline, the fight or flight hormone, which in turn prepares our body for action. If the potential energy created by the adrenaline is not released this manifests as a feeling of uncertainty which we call anxiety.

Anxiety is a very common problem with PWP because Parkinson's Disease has an affect on the way adrenaline works. Apart from the obvious anxieties that may be felt due to an uncertain future etc there are also some less obvious manifestations that occur which can cause real problems.

For instance; a bill arrives in the post. We may have no financial difficulties, we may even be expecting it, however, the slight fear of the unknown sets off the feeling of anxiety. If we don't overcome this there and then we can end up in a vicious cycle of inaction and anxiety, the longer we leave it the worse it gets.

Often we cope with this by doing something more pleasurable to distract us, putting off the inevitable. This leads us to other feelings of emotion guilt frustration etc. The whole situation can get out of control and we become demotivated and even depressed.

The fear has put us in a hole. How do we climb out?

My personal way is to make people I know aware of this problem so they can help when it happens and notice the signs.

Asking for help is really hard sometimes. If you are aware that this is an effect of the PD and you aren't going crazy this can help you to feel deal with the problem. Its one of the most annoying non motor symptoms of PD,being aware of it and making sure those around you can recognise it does help.

Hope this sheds some light on the subject from a different perspective.
Thanks for your input Leyther.

I've thought of a possible solution to fear and anxiety:

How do we cope with fear and anxiety of Parkinson’s? Fear causes a narrowing of perspective and a shortsighted focus on the thing we are fearful of. We can become addicted to our fear of Parkinson’s and the subsequent wish that we were different. However, this misses our thrownness and the multitude of possibilities thrownness gives us; for example, we don’t have to be led by the nose by fear. We have the ability to think a different emotion and replace our fear; states of mind are changeable. We can’t change the fact of Parkinson’s but remaining open to alternatives gives us the opportunity to choose to think, feel and react differently to the disease.

Anxiety is anxious about possibilities and therefore it is anxious about “nothing”. Possibilities need us to act upon them to make them “something” more; they need free will (within the limits of thrownness) to actualise them. Since anxiety concerns only possibilities we are less anxious when we do something. We may become anxious about the consequences of our actions but we are again concerned only with possibilities.

Therefore, remaining open to alternatives (e.g. “I’m scared I might fall but maybe I can go to the shops today”) reduces fear and doing something (e.g. “I went to the shops today”) makes us less anxious.

dr jonny
Hi Leyther.

Thanks for the translation, very helpful when it is written in plain English.

I found telling everyone I have PD lessens my anxiety. I don't have the added worry of trying to hide symptoms.

I am not frightened of the future as none of us know what will happen. May get struck down by a number 9 bus !!! All that worry for nothing.

cannot say a lot as a TIA has affected my vision. For me, beginning to really learn about Mindfulness meditation and practise this form of meditation wherein you focus on your breath and when thoughts get in the way simply bring Self back to you breathing - is proving very helpful. nhs is running courses. Book by Mark Williams & Danny Penman - Mindfulness a practical guide to Finding Peace in a Frantic World.
Read Face the Fear and do it anyway by Susan Jeffers.
hi Dr J
if Heidigger defines fear as fearing something then a) it is a definition that contains the term to be defined and b) is wrong.
It is possible to have pure fear without a subject - fear is the existence of a combinations of neurological chemicals, sometimes these are the result of an external stimulus and sometimes they are not. For example when i was on a particular drug (amantadine) i had a panic attack but it wasn't about anything it was just a chemical event. People with pd have real fears with an object but also have objectless fear caused just by chemical situations.
ps what does 'retreating from ourselves' actually mean? I don't think I could do that if i tried.
Hello Turnip

Based on what you say about PWP having fear based on an object ie the illness itself and also abstract fear caused by chemical imbalance I wonder how ,or if ,cognitive
behavioural therapy can help with the latter. Will see as I am starting a course of it on Monday.


Hi turnip

"Retreating from ourselves" means believing we don't have PD when we do or wishing we were different.

I think I agree with Heidegger that fear always has an object - what you had was a panic attack not a fear attack.

When we experience fear we are in a state of fearing something, I don't think that's a tautology....

Dr jonny
I recognise the idea of "retreating from yourself". I would define it as something like finding unhelpful distractions to take your mind off reality. That isn't a particularly rigourous definition and I think the key word in it is "unhelpful".

With the exception of Turnip's point about chemical imbalance, whether caused by Parkinson's itself or by the medication, I don't think these issues are more likely to affect people with Parkinson's than the others (i.e. the 'People not yet with Parkinson's')

My experience over the last eight years is that people take the physical aspects of Parkinson's much more seriously than the associated psychological issues. That is unfortunate, because the psychological issues can be much more debillitating, at least in the early years.

I have dabbled with cognitive behaviour therapy and mindfulness meditation and yoga in an effort to improve clarity of thought and motivation, mood etc. I have found some value in each technique although they all require consistent practice. Did I mention that I was easily distracted?……

me and heidegger will have to disagree on the definition off fear! To me fear has two components - the chemical state which we experience as 'being afraid' and the relationship between us and a frighting object. It seems to be that the former can exist without the latter. whether that counts as fear is probably just semantics. i had the same discussion with my philosophy lecturer 35 years ago!

Samdog - will be interesting to see how you get on.
The chemical event of fear must have a trigger, fear is not a permanent state. The trigger is fearful object, whether an actual lion or a lion as an object of thought. A PD prognossis nothing but an object of thought, its still induces fear

Dr jonny
don't agree. a large dose uf adrenelin can cause instant objectless fear. epelectic events in the temporal lobes can cause pure fear.
Hi turnip

Good debating with you!

I think we can agree that fear has a cause (e.g. prognosis of PD, epileptic fit). Fear, like all thought, has a chemical basis and can be manipulated by chemical means (called extraordinary instances of fear) but the amazing thing about thought (and its chemical basis) is that it can be influenced by itself (fear of an object of thought) or external object; object fear can be defined as ordinary fear.

Your argument seems to use an extraordinary instance (epilepsy or injecting adrenaline) to explain the ordinary instance of fear; like a heart attack can be caused by injecting a drug, therefore all heart attacks are caused by that drug. The logical end point of your argument is that only epileptics experience fear but that leaves fear in non-epileptics (the majority) unexplained. True, I'm also generalising ordinary fear to explain the extraordinary instances of fear. Maybe we shouldn't generalise. Therefore, fear of the prognosis of PD is an instance of an object of thought causing the chemical basis of fear; if we limit the argument to this instance of fear, then Heidegger's (now partial) definition of fear holds in the argument about fear of PD; similarly, your definition of fear as objectless is also partial. We were talking at cross purposes; we need a proper definition of types of fear

dr jonny
The apparently "meaningless" anxiety I and others get can be quite hard to deal with. Similarly the "depression" that can be caused by PD and the drugs.

Knowing that its a vagary of the illness and that it is transitory or can be balanced by medication can be beneficial to sufferers. Understanding helps calm the situation and stop the anxiety cycle.

Sometimes ocd behaviour is resumed, this act as a distraction and a comfort but of course can be destructive.