What really happens when people get spooked easily has a lot to do with the makeup of the brain, according to researchers.
As Americans revel in all things scary on Halloween, scientists say they now know better what's going on inside our brains when a spook jumps out and scares us. Knowing how fear rules the brain should lead to treatments for a major medical problem: When irrational fears go haywire.
"We're making a lot of progress," said University of Michigan psychology professor Stephen Maren. "We're taking all of what we learned from the basic studies of animals and bringing that into the clinical practices that help people. Things are starting to come together in a very important way."
About 40 million Americans suffer from anxiety disorders, according to the National Institute of Mental Health. A Harvard Medical School study estimated the annual cost to the U.S. economy in 1999 at roughly $42 billion.
Fear is a basic primal emotion that is key to evolutionary survival. It's one we share with animals. Genetics plays a big role in the development of overwhelming - and needless - fear, psychologists say. But so do traumatic events.
"Fear is a funny thing," said Ted Abel, a fear researcher at the University of Pennsylvania. "One needs enough of it, but not too much of it."
Armi Rowe, a Connecticut freelance writer and mother, said she used to be "one of those rational types who are usually calm under pressure." She was someone who would downhill ski the treacherous black diamond trails of snowy mountains. Then one day, in the midst of coping with a couple of serious illnesses in her family, she felt fear closing in on her while driving alone. The crushing pain on her chest felt like a heart attack. She called 911.
"I was literally frozen with fear," she said. It was an anxiety attack. The first of many.
The first sign she would get would be sweaty palms and then a numbness in the pit of the stomach and queasiness. Eventually it escalated until she felt as if she was being attacked by a wild animal.
"There's a trick to panic attack," said David Carbonell, a Chicago psychologist specializing in treating anxiety disorders. "You're experiencing this powerful discomfort but you're getting tricked into treating it like danger."
These days, thanks to counseling, self-study, calming exercises and introspection, Rowe knows how to stop or at least minimize those attacks early on.
Scientists figure they can improve that fear-dampening process by learning how fear runs through the brain and body.
The fear hot spot is the amygdala, an almond-shaped part of the deep brain.
The amygdala isn't responsible for all of people's fear response, but it's like the burglar alarm that connects to everything else, said New York University psychology and neural science professor Elizabeth Phelps.
Emory University psychiatry and psychology professor Michael Davis found that a certain chemical reaction in the amygdala is crucial in the way mice and people learn to overcome fear. When that reaction is deactivated in mice, they never learn to counter their fears.
Scientists found D-cycloserine, a drug already used to fight hard-to-treat tuberculosis, strengthens that good chemical reaction in mice. Working in combination with therapy, it seems to do the same in people. It was first shown effective with people who have a fear of heights. It also worked in tests with other types of fear, and it's now being studied in survivors of the World Trade Center attacks and the Iraq war.
The work is promising, but Michigan's Maren cautions that therapy will still be needed: "You're not going to be able to take a pill and make these things go away."
When it comes to ruling the brain, fear often is king, scientists say.
"Fear is the most powerful emotion," said University of California Los Angeles psychology professor Michael Fanselow.
People recognize fear in other humans faster than other emotions, according to a new study being published next month. Research appearing in the journal Emotion involved volunteers who were bombarded with pictures of faces showing fear, happiness and no expression. They quickly recognized and reacted to the faces of fear - even when it was turned upside down.
"We think we have some built-in shortcuts of the brain that serve the role that helps us detect anything that could be threatening," said study author Vanderbilt University psychology professor David Zald.
Other studies have shown that just by being very afraid, other bodily functions change. One study found that very frightened people can withstand more pain than those not experiencing fear. Another found that experiencing fear or merely perceiving it in others improved people's attention and brain skills.
To help overcome overwhelming fear, psychologist Carbonell, author of the "Panic Attacks Workbook," has his patients distinguish between a real threat and merely a perceived one. They practice fear attacks and their response to them. He even has them fill out questionnaires in the middle of a fear attack, which changes their thinking and causes reduces their anxiety.
That's important because the normal response for dealing with a real threat is either flee or fight, Carbonell said. But if the threat is not real, the best way to deal with fear is just the opposite: "Wait it out and chill."