Bookmark and Share

The Fear Factor

When fear is more dangerous than the original threat

By Nadine Kaslow

Story Photo

Historic public health signs from the National Library of Medicine's collection and other sources

What is it about plague-like pandemics that scare us so?

When the odds of dying from a car accident, a lightning strike, even second-hand smoke, are greater (at least in the US) why do rare, infectious diseases loom large in the public's collective nightmare?

The truth is, odds don't factor into what frightens us. Our rational mind isn't the one calling the shots at that point.

Anxiety can sometimes be a constructive response, as it inspires caution and careful analysis of a situation before jumping in feet first, but as anyone who has experienced overwhelming anxiety knows, it is not necessarily a response based on logic, facts and figures, or even reality.

And so it is with the reactions to fatal or potentially fatal epidemics: the plague, Ebola, HIV/AIDS, West Nile virus, severe acute respiratory syndrome (SARS), the list goes on and on. Oftentimes people respond with panic and fear and suspicion … even superstition, paranoia, or a moral absolutism that is alarming in its own right.

Psychological and sociological epidemics often occur parallel to the medical one. The victims are stigmatized, discriminated against, even demonized. Those around the victims may follow not only guidelines recommended by the authorities, but go far beyond that: my children can't be in class with your children, we don't want a health clinic in our village, you aren't allowed entry back into the country under any circumstances. Misconceptions emerge out of fear and anxiety—the less people know, the more they panic. We saw this around victims of AIDS, SARS, and recently, Ebola.

Disease outbreaks are, indeed, terrifying, and often involve mass casualties. And there's no denying that some diseases, like hemorrhagic fevers, have the potential to kill in horrific ways.

There is something supremely unsettling about the invisibility of these germs, and the way they proliferate, that invokes our deepest, most primal survival instincts: The world is unsafe. If you get too close to things that are risky, something terrible could happen.

Infectious diseases, in their relentless march from host to host and exponential eagerness, seem to underscore what we have known all along, but, whistling past the graveyard, try to ignore. We are vulnerable, we are mortal, we will all die.

When our emotions and fears take over, we have difficulty making rational decisions. We become anxious or angry and unable to process information.

Experts might be trying to get out the facts in a clear and concise manner, but if you're already in an emotionally labile place, you're not hearing them. So—and public health communicators have realized this—you have to combine feelings and facts, to acknowledge people's fears, to recognize that it's understandable to feel anxious.

Facts do win out, in the end. When was the last time anyone except for the most alarmist among us worried that the person sitting next to us on the subway or serving our salad had AIDS? And yet, there was a time when outraged townspeople burned down a family's home over this fear.

We are all a part of a world that has frightening aspects. There are and will continue to be wars, beheadings, pandemics, terrorist attacks, car accidents, plane crashes, unexpected loss, unexplained illness.

In the face of such amorphous threats, try to listen calmly—with open mind and open heart—to your rational side. I can assure you, more people have died from misguided decisions based on fear than from the original stimulus itself.

Email the editor