Understanding the Difference - Fear of Heights vs Fear of Falling
A guide to two distinct phobias and how you can help
Do you know someone who is afraid of heights?
Or perhaps someone who is afraid of falling?
Or are you the one struggling with these fears yourself?
These two conditions are often misunderstood as being the same, but the fear of heights and the fear of falling are actually two distinct, yet related phobias that can cause significant anxiety.
What’s the difference?
Fear of Heights (Acrophobia)
Acrophobia, the fear of heights, is an intense anxiety or panic triggered when someone is in or anticipates being in a high place. It is officially classified as a specific phobia in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Fear of Falling (Basophobia)
On the other hand, Basophobia is the fear of falling, often linked to concerns about losing balance, injury, or developing a disability. While it overlaps with acrophobia, it can exist on its own, independent of height.
Both phobias share similar symptoms, which often leads to confusion. However, they do have distinctive features, even though they might not be obvious at first glance.
Fear of Heights (Acrophobia) Symptoms:
Dizziness or feeling lightheaded
Sweating and shaking
Rapid heartbeat
Shortness of breath or hyperventilation
Nausea or gastrointestinal distress
Panic attacks when near heights
Avoidance behavior (e.g., avoiding tall buildings, bridges, or mountains)
Fear of Falling (Basophobia) Symptoms:
Intense fear or anxiety when standing, walking, or even anticipating movement
Dizziness or a feeling of losing balance
Avoidance of situations where falling could occur (e.g., uneven surfaces, stairs)
Shakiness or unsteadiness when standing
Over-reliance on physical support (e.g., handrails, canes)
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In simple terms, someone with acrophobia (fear of heights) tends to panic when they are in high places, especially if safety measures are lacking. For example, they may feel uncomfortable in tall buildings with sky views, even though they are enclosed, as their awareness of being at a high level triggers a fear of falling.
On the other hand, people with basophobia (fear of falling) may experience fear at any height, usually triggered by the fear of losing balance, rather than the height itself. Essentially, their primary fear is their perceived inability to maintain balance.
For a long time, I believed I belonged to the smaller percentage of people who suffer from basophobia. I had always felt fine in tall buildings, even with clear, sky-high views, provided they were enclosed. I thought my fear was about falling, not the height itself, as I always felt safe as long as there were protective measures in place. How wrong I was.
After diving deeper into clinical studies, I discovered that I actually have acrophobia (fear of heights). Interestingly, many people with acrophobia also experience elements of basophobia, which likely explains why I was so convinced I feared falling more than heights. For instance, I’m perfectly comfortable standing on a high floor in a tall building, even pressing my face to a window without fear. I’m also fine walking across a covered bridge in a high place.
However, place me near an open area on a tall building with half railings or on a shaky open bridge, and my fear takes over. I still remember the first time I rode in a fully transparent cable car; my heart raced as I peered down. The fear washed over me, and I realised I wasn't just afraid of the height; it was the very real possibility of falling that made my palms sweat.
What could be the cause of these phobias?
There are various factors that may lead people to develop a fear of heights or a fear of falling.
For fear of heights (Acrophobia), it is often a response to a traumatic experience involving heights, such as:
Falling from a high place
Witnessing someone fall from a high place
Experiencing a panic attack or other negative incident while in a high place
For fear of falling (Basophobia), it is commonly developed due to experiences related to balance or physical stability, including:
Trauma from previous falls or injuries
Medical conditions affecting balance (e.g. vertigo)
Fear of aging and becoming frail
Anxiety about being in situations where help may not be available if a fall occurs
Supporting Friends with Fear of Heights and Fear of Falling
While we are not medical experts, offering simple, non-medical support to friends with acrophobia (fear of heights) or basophobia (fear of falling) can make a difference. Though professional advice from a doctor is essential, here are some practical ways to offer support.
Offer Reassurance, Not Pressure
Gently reassure them when they feel anxious, but don’t push them to confront their fears unless they’re ready. Simply being a calm, grounding presence can make them feel more in control. Pressuring them may heighten their fear.
Accommodate Their Needs
Be aware of their triggers. If you’re planning to visit a high place (a bridge, tall building, etc.), ask how they feel about it and offer alternatives if necessary. Respecting their boundaries shows empathy and avoids putting them in uncomfortable situations
Use Distraction Techniques
If they panic, engage them in conversation, guide them to focus on their breathing, or point out non-threatening things around (e.g. a funny sign, a beautiful view). Distraction helps shift their attention away from their fear.
Be Their Safety Net
Offer physical support by walking close or holding their hand if they feel unsteady. Your presence can make them feel safer, especially in open or unstable areas. Knowing you’re there provides a sense of security.
Encourage Grounding Techniques
If they’re comfortable, suggest techniques like deep breathing, mindfulness, or counting objects around them to bring their mind back to the present. These techniques help them regain control when panic sets in.
Be Patient
Understand that overcoming phobias takes time. There may be setbacks, so if they have a panic episode or need to withdraw from a situation, be supportive and non-judgmental. Your patience reassures them that it’s okay to take time and try again later, reducing feelings of shame or embarrassment.
Respect Their Limits
Always listen when they express discomfort. Even if they are making progress, respect their boundaries. Every person’s journey with fear is different, and respecting their limits builds trust.
Provide Encouragement
Celebrate small victories. Whether it’s overcoming a height or walking through a previously feared area, let them know you’re proud of them. Positive reinforcement builds confidence for future challenges.
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By offering patience, understanding, and gentle encouragement, you can play an important role in helping them manage their fears.
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