Fear-extinction Medication

Scientists have learned that inhibiting a protein called NMDA (N-methyl D-asparate) in the amygdala inhibits fear extinction. They reasoned, then, that stimulating that protein might stimulate fear extinction. Studies show that the antibiotic D-cycloserine (well-known for treating tuberculosis) might be helpful in fear extinction by assisting the action of NMDA [ref]. This type of approach would be beneficial when paired with behavioral therapies that attempt to create fear-extinction memories.

The idea is not to replace exposure therapy, but to speed it up. This hypothesis was played out in a study on rats who'd been conditioned to associate a bright light with a foot shock. When the light was presented repeatedly without the shock, the rats who'd been injected with D-cycloserine unlearned their fear much faster than those who were going the natural route. The antibiotic also achieved results in a study of people with a fear of heights. Following virtual-reality sessions designed to expose individuals to heights in a safe environment, the people who'd been given the antibiotic exposed themselves to heights in the real world twice as often as the subjects who did not receive the drug.

This type of research is very promising for people who are under the control of debilitating phobias and anxiety disorders. But what about those of us who just get butterflies before delivering a presentation or have trouble getting close enough to the thirtieth-floor balcony to check out the view?

Eight Practical Tips

The Prevention magazine article "What are you afraid of?: 8 secrets that make fear disappear" offers these tips for dealing with everyday fears:

  1. It doesn't matter why you're scared. Knowing why you've developed a particular fear doesn't do much to help you overcome it, and it delays your progress in areas that will actually help you become less afraid. Stop trying to figure it out.
  2. Learn about the thing you fear. Uncertainty is a huge component of fear: Developing an understanding of what you're afraid of goes a long way toward erasing that fear.
  3. Train. If there's something you're afraid to try because it seems scary or difficult, start small and work in steps. Slowly building familiarity with a scary subject makes it more manageable.
  4. Find someone who is not afraid. If there's something you're afraid of, find someone who is not afraid of that thing and spend time with that person. Take her along when you try to conquer your fear -- it'll be much easier.
  5. Talk about it. Sharing your fear out loud can make it seem much less daunting.
  6. Play mind games with yourself. If you're afraid of speaking in front of groups, it's probably because you think the audience is going to judge you. Try imagining the audience members naked -- being the only clothed person in the room puts you in the position of judgment.
  7. Stop looking at the grand scheme. Think only about each successive step. If you're afraid of heights, don't think about being on the fortieth floor of a building. Just think about getting your foot in the lobby.
  8. Seek help. Fear is not a simple emotion. If you're having trouble overcoming your fear on your own, find a professional to help you. There are lots of treatments for fear out there, and no good reason not to try them under the guidance of someone with training and experience.

For more information on fear and related topics, check out the links on the next page.