Phobia

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9 Minutes

Edited & medically reviewed by THE BALANCE Team

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CONTENTS

It is common for a person to have one or two irrational fears. Some people are afraid of spiders, for example, while others feel scared to go for their annual dental checkup. Most such people have these fears well under control as they are minor and do not disrupt their lives. However, for some, these fears may become so severe that they induce tremendous levels of anxiety and start interfering with their normal life.

Medically known as a phobia, such fears are so intense that they can cripple a person, even if they know that these fears possess little to no actual danger. Fears and phobias can be categorized based on their nature and can range from mild to very severe. Regardless of the nature and severity of a phobia, it is possible to treat it with the right integration of medicinal, therapeutic, and alternative treatment elements.

The American Psychiatric Association defines phobia as an irrational and excessive fear of a situation or object. In the majority of cases, a phobia involves a fear of harm or a sense of endangerment. For instance, people with agoraphobia may feel scared of trapping themselves in an inescapable situation or place.

Most people with phobias experience feelings of intense anxiety and fear triggered by particular places, situations, objects, or animals that may be disproportionate to the actual danger or threat a situation poses. Such cases may not necessarily provoke anxiety in all people but may prove detrimental to the individual with a phobia of it. The symptoms of this psychiatric condition may last for at least six months and can be accompanied by panic attacks.

The specific symptoms of phobias may vary depending on the type; however, some of these symptoms may overlap. These overlapping symptoms include:

Uncontrollable feelings of anxiety

When faced with a situation that induces phobia, an individual may experience anxiety-related physical symptoms, such as sweating, nausea, heart palpitations, blushing, and shakiness. Some other symptoms may include shortness of breath, elevated heart rate, chest discomfort or pain, a choking feeling, a feeling of losing control, hot flashes, numbness, chills, and dizziness.

Intentional avoidance

Individuals with phobias may attempt to avoid any situation or circumstance that causes them to experience intense anxiety and fear. Depending on the type of phobia they suffer, this may include avoiding meeting new people, flying on a plane, going into the elevators, or getting out of the house.

Inability to regain control

Many people with phobias realize that their reaction is exaggerated; however, they are still unable to remedy it without taking help from others. Untreated phobias are often life-limiting, leading to significant interference in interpersonal relationships and everyday activities.

According to the American Psychiatric Association, phobias refer to anxiety disorders that can be categorized as:

Agoraphobia

This type of phobia describes a fear of being trapped in a situation or place where escaping is difficult or impossible. As a result, the phobic person may start avoiding such situations altogether. Sometimes, the underlying dear may become so overwhelming and pervasive that the patient stops leaving their home to avoid feeling trapped anywhere.

Specific phobias

These involve fear of a specific object, such as moths, butterflies, or insects. Specific phobias may further fall into one of the four subcategories:

Situational: Fear of leaving home, driving, or bridges
Environmental: Fear of water, tornadoes, hurricanes, or lightning
Medical: Fear of visiting a doctor
Animal: Fear of rodents, cats, birds, or snakes

Different factors that may increase the chances of developing a phobia include:

Genetics

Research has indicated that some types of phobias way run in families. For example, if a pair of twins are raised separately in different homes and environments, they may develop the same phobias due to their shared genetic makeup. However, a lot of people who develop phobias do not have any close members suffering from similar conditions.

Cultural Factors

Many types of phobias tend to occur in specific cultural groups. Tajin kyofusho is a classic example of a phobia deeply rooted in cultural elements. This type of phobia is exclusively seen in the Japanese and involves a fear of harming or offending others in a social setting. Tajin kyofusho differs from the traditional social anxiety disorder in which a sufferer feels scared of being personally humiliated or embarrassed.

Behavioral and Environmental Factors

A lot of phobias that people suffer from are based on real-life events that they may or may not consciously remember. For example, a phobia of dogs may stem from being attacked by one during childhood. Similarly, many people develop social anxiety disorder due to the teenage awkwardness they faced earlier in life. Combining all these factors may make the prevalence of a phobia very likely. However, experts need more research exploring these factors before drawing a definitive conclusion.

Fortunately, phobias are highly treatable, as most people are aware of their triggers. A good treatment plan for fears and phobias involves a combination of psychotherapy, medication, graded exposure, and alternative treatment.

Graded Exposure

Graded exposure is a common treatment modality many experts rely on for the primary management of different phobias. The technique involves helping clients learn how to tackle their fear of a particular situation by acknowledging how it can be approached. Experts may encourage the clients to use imagination before approaching the problem and handling it in reality. Interoceptive exposure is an element of graded exposure therapy that helps expose bodily sensations and understand how dangerous they are. Other aims of this type of therapy include assisting patients to:

Elicit their feared bodily sensations
Maintain the feared bodily sensations without any avoidance or distraction
Activate any unhelpful beliefs related to the physical sensations
Learn new things about the bodily senses to take place

At all stages of graded exposure, a therapist will keep working with clients to make it more beneficial and effective. All in all, this therapy helps patients with phobias systemically and carefully learn to face their fears in a controlled and gradual way. As a result, such people tend to reduce their avoidant behaviors and learn to embrace phobia-triggering situations with confidence. Graded exposure also explores, identifies, and challenges any safety behaviors that a person may have enacted to avoid their feared situations.

Psychotherapy

A good treatment plan for phobia management almost always involves a psychotherapy element with different types of therapy, such as:

Cognitive behavioral therapy: This type of therapy helps clients identify and challenge any negative thoughts associated with a phobia and replace them with healthier ones
Phobia clinics and group therapy: Phobia clinics support people in successfully dealing with common phobias, for example, a fear of flying
Social skills training: This element of treatment is recommended for individuals with social phobia and takes place in a group setting where people with similar fears help each other out. A therapist also includes modeling and role-playing to help clients become more comfortable and relate to others in social situations.
Support groups: Sharing experiences and information with others with similar issues and experiences can help people alleviate the anxiety and stress arising from phobias. Support groups may not act as a substitute for psychotherapy but can be a helpful addition alongside it. Currently, multiple support groups offer help to people fighting phobias and fears across the United States.

Medication

Medications are typically prescribed in combination with a psychotherapeutic modality. Some common medicines that work well for phobia management include:

Beta-blockers: Experts may prescribe the use of a beta-blocker, such as propranolol, to reduce the physical effects of anxiety before being exposed to potential triggers, such as public speaking.
SSRI antidepressants: SSRI antidepressants include multiple drugs, such as mirtazapine, imipramine, venlafaxine, and clomipramine, which can work to manage the symptoms related to agoraphobia.
Anti-anxiety medications: These medications include benzodiazepines, such as lorazepam, diazepam, and clonazepam which can manage the symptoms of agoraphobia and social anxiety. Experts warn against combining these medications with alcohol as it may lead to unwanted side effects.

Alternative Treatments

An increasing number of patients and mental health professionals are turning towards the use of alternative treatment to increase the efficacy of conventional treatment modalities for phobias. Remember that these alternative approaches are not the first-line treatment and may cause some side effects. Some examples include:

Homeopathy
Hypnotherapy
Herbal remedies.

Even those alternative phobia treatments have not yet undergone any controlled rigorous testing necessary to be endorsed by the mainstream medical community; it has brought symptomatic relief to many. It is, however, essential to undertake these therapies after seeking guidance from a mental health professional.

FAQs

How are phobias different from common fears?

As soon as the human brain perceives a threatening or dangerous situation, it triggers the body to activate the fight-or-flight response. This response helps process the stress hormones, making the body react quickly and escape dangerous situations. Once the threat passes, the system turns off on its own, and the body returns to normal functioning. By contrast, a phobia includes unreasonable fear and agitation over things that do not pose a risk of an actual threat. These phobias may occur every time a person experiences the same stimulus and can affect an individual such much that they may start structuring their daily routine differently just to avoid the triggers.

How many people have a phobia?

Studies estimate that up to 19 million Americans suffer from one or more phobias, ranging from mild to moderate in intensity. Phobias may begin happening during early childhood but often go unnoticed until a child reaches the ages of 15 to 20 years. Both men and women tend to be affected by phobias in equal proportions.

Are there any risk factors that make an individual more vulnerable to developing fears and phobias?

Some people tend to have a genetic predisposition to anxiety and are consequently at a higher risk of developing a phobia. Socioeconomic status, gender, and age are important risk factors determining if a person will acquire certain phobias. For instance, women are much more likely to develop animal phobias. Similarly, people with a low socioeconomic background typically develop social phobias more commonly than others. Men, on the other hand, make up the majority of those with doctor and dentist phobias.

HOW THE BALANCE CAN HELP

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