Phobias are a large group of specific fears. A phobia is defined as the unrelenting fear of a situation, activity, or thing that causes one to want to avoid it. The three kinds of phobias are
- social phobia (fear of public speaking, meeting new people or other social situations),
- agoraphobia (fear of being outside), and
- specific phobias (fear of particular items or situations).
Phobias are largely underreported, probably because many phobia sufferers find ways to avoid the situations to which they are phobic. Therefore, statistics that estimate how many people suffer from phobias vary widely, but at minimum, phobias afflict more than 6 million people in the United States.
Other facts about phobias include that these illnesses have been thought to affect up to 28 out of every 100 people, and in all western countries, phobias strike 7%-13% of the population. Women tend to be twice as likely to suffer from a phobia compared to men.
Some of the most common kinds of phobias include fears of public speaking or other social situations (social phobia or social anxiety disorder), open spaces (agoraphobia), closed-in spaces (claustrophobia), clowns (coulrophobia), flying (aerophobia), blood, animals (zoophobia), commitment (commitment phobia), driving, spiders (arachnophobia), needles (aichmophobia), snakes (ophidiophobia), math, heights (acrophobia or altophobia), germs (mysophobia), and having dental work done (dentophobia). Fears of midgets, haunted houses, helmets, pickles, and feet are just a few of the less common phobias and may be considered strange by some but can be just as debilitating as those phobias that are more common. Agoraphobia often coexists with panic disorder.
What are the effects of phobias?
If left untreated, a phobia may worsen to the point in which the person's life is seriously affected, both by the phobia itself and/or by attempts to avoid or conceal it. In fact, some people have had problems with friends and family, failed in school, and/or lost jobs while struggling to cope with a severe phobia. There may be periods of spontaneous improvement, but a phobia does not usually go away unless the person receives treatments designed specifically to help phobia sufferers. Alcoholics can be up to 10 times more likely to suffer from a phobia than those who are not alcoholics, and phobic individuals can be twice as likely to be addicted to alcohol than those who have never been phobic.
What are the causes and risk factors for phobias?
While there is no one specific known cause for phobias, it is thought that phobias run in families, are influenced by culture, and can be triggered by life events. Immediate family members of people with phobias are about three times more likely to also suffer from a phobia than those who do not have such a family history. Phobia sufferers have been found to be more likely to manage stress by avoiding the stressful situation and by having difficulty minimizing the intensity of the fearful situation.
What are the signs and symptoms of phobias?
Symptoms of phobias often involve having a panic attack -- in that they include feelings of panic, dread, or terror, despite recognition that those feelings are excessive in relationship to any real danger -- as well as physical symptoms like shaking, rapid heart beat, trouble breathing, and an overwhelming desire to escape the situation that is causing the phobic reaction. Also, extreme measures are sometimes taken to escape the situation.
How are phobias assessed?
Many providers of health care may help diagnose phobias, including licensed mental-health therapists, family physicians, or other primary-care medical providers, specialists whom you see for a medical condition, psychiatrists, psychologists, and social workers. If one of these professionals suspects that you may be suffering from a phobia, you will likely be asked a number of questions to understand all the symptoms you may be experiencing and you may need to submit to a medical interview and physical examination. A phobia may be associated with a number of other mental-health conditions, especially other anxiety disorders. As anxiety disorders in general may be associated with a number of medical conditions or can be a side effect of various medications, routine laboratory tests are often performed during the initial evaluation to rule out other possible causes of the symptoms.
How are phobias treated?
Helping those who suffer from phobias by supportively and gradually exposing them to circumstances that are increasingly close to the one they are phobic about (desensitization) is one way phobias are treated. Cognitive behavioral therapy (CBT) has been found to significantly decrease phobic symptoms by helping the phobia sufferer change his or her way of thinking.
CBT uses three techniques to accomplish this goal:
- Didactic component: This phase helps to set up positive expectations for therapy and promote the phobia sufferer's cooperation.
- Cognitive component: It helps to identify the thoughts and assumptions that influence the person's behavior, particularly those that may predispose him or her to being phobic.
- Behavioral component: This employs behavior-modifying techniques to teach the individual with a phobia more effective strategies for dealing with problems.
Selective serotonin reuptake inhibitor (SSRI) medications are often used to treat phobias, particularly when desensitization and CBT are inadequately effective. These medications affect levels of serotonin in the brain. Examples of these medications include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa), and escitalopram (lexapro). The possible side effects of these medications can vary greatly from person to person and depend on which medication is being used. Common side effects of this group of medications include dry mouth, sexual dysfunction, nausea, tremors, trouble sleeping, blurred vision, constipation or soft stools, and dizziness. In very rare cases, some people have been thought to become more acutely more anxious or depressed once on the medication, even trying to or completing suicide or homicide. Children and teens are thought to be particularly vulnerable to this rare possibility.
Phobias are also sometimes treated using beta-blocker medications, which block the effects that adrenaline has on the body. An example of a beta blocker is propranolol. These disorders are less commonly treated with drugs in a medication class known as benzodiazepines. This class of medications causes relaxation but is used much less often these days to treat anxiety due to the possibility of addiction and the risk of overdose, especially if taken when alcohol is also being consumed. Examples of medications from that group include diazepam (Valium), alprazolam (Xanax), lorazepam (Ativan), and clonazepam (Klonopin).
How can people cope with phobias?
Ways that phobia sufferers can work to overcome their fears include talking about their fears, refraining from avoiding situations they find stressful, imagining themselves facing their fears (visualization), and making positive self-statements like, "I will be OK."
- American Academy of Child and Adolescent Psychiatry https://www.aacap.org
- American Counseling Association http://www.counseling.org
- American Psychiatric Association https://www.psychiatry.org/
- American Psychological Association http://helping.apa.org
- Anxiety Disorders Association of America http://www.adaa.org/
- Freedom From Fear http://www.freedomfromfear.org
- National Anxiety Foundation 3135 Custer Dr. Lexington, KY 40517-4001 (606) 272-7166
- National Association of Social Workers http://www.naswdc.org
- National Mental Health Association http://www.nmha.org
- Phobics Anonymous (619) 322-COPE
The future How well phobias respond to various treatments over the course of years as well as how age-related changes in thinking ability (cognition) may interact with anxiety are areas being focused on for future research studies.
Phobias At A Glance
- The definition of a phobia is the unrelenting fear of a situation, activity, or thing that causes one to want to avoid it.
- The three classes of phobias are social phobia (fear of public speaking, meeting new people or other social situations), agoraphobia (fear of being outside), and specific phobias (fear of other items or situations).
- Although phobias are largely underreported, the number of people who suffer from phobias is estimated at more than 6 million people in the United States.
- Women tend to be twice as likely to suffer from a phobia compared to men.
- While there are nearly as many phobias as there are situations, the most common kinds of phobias include social phobia, agoraphobia, claustrophobia, coulrophobia, aerophobia, zoophobia, arachnophobia, dentophobia, aichmophobia, ophidiophobia, acrophobia, mysophobia, and a fear of fear of blood.
- Agoraphobia often coexists with panic disorder.
- If left untreated, a phobia may worsen to the point where the person's life is seriously affected by the phobia and by attempts to avoid or conceal it, leading to problems with friends and family, failures in school, and/or lost jobs while struggling to cope.
- Phobias tend to run in families, are influenced by culture, and can be triggered by life events.
- Phobia sufferers have been found to be more likely to manage stress by avoiding the stressful situation and by having difficulty minimizing the intensity of the fearful situation.
- Symptoms of phobias often involve panic attacks.
- Assessment of phobias often includes questions by a trained professional that explore the symptoms being experienced, a medical interview, and a physical examination.
- Phobias are often treated using desensitization, cognitive behavioral therapy, and/or medications.
- The groups of medications doctors tend to choose from when treating a phobia include selective serotonin reuptake inhibitors, beta blockers, and occasionally, benzodiazepines.
- Phobia sufferers sometimes cope with their fears by talking about it, refraining from avoiding situations they find stressful, visualization, and making positive self-statements.