Any fear should be rational and justified, so that the response it triggers in the body leads to survival in the most optimal way possible. In other words, fear should accurately measure the level of danger causing discomfort, effectively assigning it a precise numerical value with an appropriately calibrated response.
The fear of heights (even when not panicky) is natural to any terrestrial biological being incapable of flight or gliding, as falling from a great height is fatal. However, a small jump from low ground is generally perceived as normal and may provoke slight caution rather than fear. This is where the boundary between fear and phobia lies.
Any person standing at the edge of a precipice without mountaineering safety gear feels a natural fear of falling. That fear calls one to step back from the edge.
If the elevation is negligible (e.g., standing on a stool) or there is no real risk of falling (such as looking out of a 10th-floor window while being securely indoors), we are dealing with a phobia.
Natural fear gives the body a chance to survive, while phobia weakens and makes one more vulnerable.
Moreover, in a state of panic and hesitation to descend from a height, individuals often get injured or die from falling or jumping down.
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What is Acrophobia?
The fear of heights, when it evolves into a phobia, is called acrophobia. It is one of the most widespread fears, affecting almost 10% of the population (4% women and approximately 5% men). One in ten – that’s significant.
This phobia must be addressed, as it tends to intensify over time. For seniors, the fear of falling often combines with a seemingly rational fear of fractures. Over time, a “fear of fear” may develop, leading to avoiding the situations that trigger fear. Gradually, life can become unbearable, relationships with loved ones may deteriorate, and simple activities like working, leaving home, or descending a staircase may become impossible. Sometimes, panic strikes even when an acrophobic person is firmly on the ground but observes someone else at a height (a neighbor on a balcony, a cat on a roof, etc.). In such instances, the person imagines themselves in that position and fears falling. This fear can make life utterly unbearable, turning it into a state of constant self-imposed restrictions and lack of freedom.
Symptoms
Acrophobia manifests through symptoms such as dizziness, nausea, panic, stiffness or numbness in the hands, trembling, and unstable legs. It can also cause attacks of breathlessness, sweating or shortness of breath, tachycardia, increased salivation, or conversely, dry mouth – all clear signs of the physical manifestations of fear. This is an uncontrollable hormonal panic combined with a “hypnotized” focus on the height.
There is a compulsive need to cling to something or someone, with the inability to think clearly, speak coherently, or react appropriately to surroundings. Sometimes, there is an overwhelming urge to jump or fall down, which, notably, is unrelated to suicidal intent. On the contrary, it stems from a fear of death. Some fear losing self-control and jumping from a height, while others fear losing balance and falling – a valid concern when legs are not cooperating. Standing often exacerbates the fear of heights compared to sitting or lying down. Moving one’s head intensifies the fear, prompting many sufferers to “freeze” in place and stare at a single point of focus.
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Causes of Acrophobia
Previously, it was believed that the causes of such fear were either a weak vestibular apparatus or an early trauma related to falling or the fear of heights. It is now proven that this is almost exclusively a genetically determined and innate quality, which may not be related to the vestibular system at all. The body’s sense of balance is ensured by the coordinated and precise work of the vestibular apparatus, eyes, neural pathways, midbrain, and cerebellum. Any discrepancies, delays, or desynchronization in the signals of “seeing” and “feeling” send contradictory information to the brain, leading to system failures. If, on top of this, the muscles respond with an incorrect delay, the balance system becomes completely disrupted.
Treating Acrophobia
If the fear of heights is mild, it is possible to overcome it independently by gradually exposing oneself to heights, increasing them step by step, and discarding safety measures. It is important to consciously fight fear, convincing yourself that the height of, say, a stool is not life-threatening. Breathing exercises and yoga practices, which teach control over the autonomic nervous system and help suppress panic quickly, can be helpful. A person can “anchor” their gaze on a certain object, focusing on it directly while perceiving other events with peripheral vision—this can help reduce anxiety and discomfort, aiding in calming oneself. This “anchor” should ideally be located no more than 25 meters away and preferably at the same height.
Interestingly, video games such as “walkers-shooters,” in which the player identifies with a character who runs, jumps, and falls from heights without any harm, can have a positive effect.
Similarly, watching horror movies can gradually strengthen one’s nerves. Watching films that feature staged high jumps, stunts at great altitudes (for example, those with martial arts themes), or scenes involving parachute jumps might also help overcome the fear of heights. By logically breaking down the fear of heights into its components, it becomes possible to tackle it step by step.
Treating more severe forms will require the help of a highly qualified psychologist. Psychologists train patients in relaxation techniques, control over their psychophysical state, and methods for blocking fear. Non-medication-based cognitive-behavioral therapy techniques are available. Once a patient learns to control or at least suppress fear at the hormonal level, they can begin height exposure training. When fear is triggered, it is suppressed by an effort of will to a zero-stress level. Treatment continues until the fear is completely gone. Essentially, this approach is the same, just with professional support. Sometimes it can take several months, but success is always achievable, and the phobia eventually recedes.
However, treating acrophobia with medication is practically impossible. Drugs can only support the psychological state, slightly reduce anxiety, and improve the coordination of brain function.
