Phobias

We all have things that frighten us, that we, in turn, may try to avoid. For some people, it’s an intense fear of heights or a reticence to fly. Others may feel anxiety in the presence of snakes and spiders. Usually, these aversions don’t interfere with our lives. But when they do, they are referred to as phobias. According to some estimates, nineteen million people in the US suffer from this mental illness.

What Is a Phobia?

A phobia is a type of anxiety disorder that causes intense, irrational, fear of a person, animal, situation, place, or object. Someone with this disorder will try to avoid their trigger at all costs. If they do come into contact with the object or situation they fear, they will endure it with extreme stress and/or anxiety.

This disorder can severely impair an individual’s ability to effectively work, attend school, or relax in social situations. It can also interfere with developing and maintaining relationships.

Kinds of Phobias

Phobias are quite common and surprisingly diverse. The list of phobias is long, but common types include:

Acrophobia:

fear of heights

Agoraphobia:

fear of being in public or open spaces

Arachnophobia:

fear of spiders

Claustrophobia:

fear of enclosed spaces

Entomophobia:

fear of insects

Mysophobia:

fear of dirt

Nyctophobia:

fear of the dark

Ophidiophobia:

fear of snakes

Social phobia:

social anxiety disorder

Theophobia:

fear of God

Trypanophobia:

fear of needles (when used for injections or to draw blood)

Zoophobia:

fear of animals

Phobias are so common that they exist for almost any situation. However, fear of heights and fear of animals may be the most widespread. The disorder often begins in childhood but may peak later in life. In fact, almost one in ten children have a phobia.

Some common phobias, such as a fear of spiders or dogs, can be easily avoided. For more severe types, though, people may need to drastically alter their lives. In extreme cases, the illness may dictate a person’s employment, job location, driving route, recreational and social activities, or home environment. When this illness takes over someone’s life, psychological treatment is necessary.

Causes of Phobias

Oftentimes, this condition is caused by exposure to a traumatic situation during childhood. Most children will eventually outgrow their fears, but this is not the case for everyone; sometimes intense fears will persist into adulthood. Twin studies have demonstrated that life experiences, as well as genetic inheritance, can contribute to the development of the condition.

Many mental illnesses run in families. If a child has a close relative with an anxiety disorder, they are more at risk of developing the condition. Additionally, this disorder is more common in females than in males, with a 12.2% prevalence rate in women and a 5.8% prevalence rate in men. Damage to the brain can also put someone at risk — phobias are common after traumatic brain injuries.

Symptoms of Phobias

When someone with a phobia comes into contact with their trigger, they may experience a range of symptoms. These symptoms include:

Excessive, unreasonable, fear and anxiety caused by contact with or worry about the trigger
Feelings of fear and anxiety out of proportion to the danger posed by the trigger
Avoidance of the trigger, even if it poses no significant risk
Mental health issues, such as depression or other anxiety disorders
Substance or prescription drug abuse

Sometimes, people may experience additional physical symptoms, such as:

Feeling hot or sweating
Palpitations or forceful heartbeat
Shortness of breath
Dry mouth
Feeling dizzy or faint
Shaking or trembling
Nausea
Fast heartbeat
A choking feeling
Chest pain or tightness
Numbness or tingling

Diagnosis of Phobias

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), helps mental health professionals make diagnoses for mental health disorders. It can help mental health workers distinguish between phobias.

The American Psychiatric Association recognizes three types of phobias.

Specific phobias: fear and anxiety caused by specific objects or specific situations.
Social phobias (social anxiety disorder): anxiety and fear of humiliation or being singled out in social situations
Agoraphobia: fear of situations from which it would be difficult to escape, such as being in an elevator or being outside in open spaces. It is commonly misunderstood as a fear of open spaces. People with agoraphobia are at risk of developing panic attacks.

While specific phobias are easily identifiable, social phobia and agoraphobia (a.k.a complex phobias) can be harder to diagnose. Complex phobias are more likely to affect someone’s well-being than simple phobias and are more difficult to treat.

When making a diagnosis, doctors will take into account the level of fear and anxiety, physical symptoms, and methods of trigger avoidance. Pinpointing the event that triggered the phobia can also help. For example, a dog or cat bite can lead to a simple phobia of dogs or cats. Alternatively, a scary movie can trigger a phobia of the dark.

Phobias tend to run in families, so a doctor may ask for a family history. They may also ask questions like:

Does the phobia affect your personal life, job, family, or social relationships?
Do you stay inside for fear of being out in public?
Do you avoid getting necessary medical treatment because of your fear of doctors, dentists, or needles?

If someone replies, “yes”, it may indicate that their condition is more than just a normal fear, and they may require treatment.

Treating Phobias

Treating a phobia as early as possible can be extremely helpful. This can help improve productivity and quality of life.

In order to treat the disorder, medications, psychological therapy, or a combination of both are used.

Therapy

Mental health professionals, including psychiatrists or psychologists, can help treat this condition. Both have specialized training in mental health, but only psychiatrists can prescribe medications.

The most common type of therapy to treat this condition is cognitive behavioral therapy (CBT). CBT focuses on identifying and changing negative thoughts, irrational beliefs, and overreactions to triggers. Oftentimes, it will include desensitization (exposure therapy) where the individual gradually exposes themselves to their phobia in a controlled way. This helps to lessen their fear surrounding the trigger.

During exposure, a mental health professional will guide their patient with relaxation techniques to reduce anxiety and related physical symptoms, such as breathing control and meditation. For example, the movie “Spiderman” has been credited with reducing fear of spiders in the general population.

Another interesting technique that has been used for desensitization is virtual reality. Virtual reality can mimic a person’s trigger without having to actually have it present. It can introduce triggers like dogs, cats, spiders, snakes, flying airplanes, and social situations in a more controlled way.

Other forms of therapy, such as group therapy and family therapy, can also help.

Medications

Medications are also useful in treating phobias. Beta-blockers can reduce palpitations, sweating, and shaking that may occur. Anti-anxiety medications, such as Xanax, are helpful for phobias that only happen occasionally, like the fear of flying.

Anti-depressants, including Selective Serotonin Reuptake Inhibitors (SSRI) medications, can help for more serious and ongoing phobias like agoraphobia. Finding the best medication can require some trial and error. For example, if one anti-depressant is not effective, the doctor may order a different one.

Prognosis for Phobias

For the best results, make an appointment to see a mental health professional as soon as possible. This is especially true if your fears or anxieties are disturbing your peace of mind, interfering with your relationships, or preventing you from functioning normally at home, school, or work. Get help early, because the longer this condition persists, the harder it is to cure.

Phobias in children are usually short-term and disappear within a few months. In adults, about 80% of phobias become long-term problems that do not go away without proper treatment.

However, the outlook for successful treatment is very good. 75% – 80% of people treated with CBT, medications, or a combination of the two eventually overcome their fears.