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Phobias

Phobias

Phobias

A person who has a phobia  typically experiences a strong, persistent fear that is unreasonable or out of proportion to the object or situation.  Then the person avoids the object or situation or endures it with severe anxiety or distress.  It is estimated that over 6 million adult Americans suffer from phobias and data show phobias to be twice as common in women as in men.

Understanding a Phobia

A phobia is a fear which is caused by a specific object or situation. The fear may be caused by the actual presence of the feared object or situation, or it may be caused by the anticipation of the presence of that object or situation. Anxiety, triggered by the fear, may approach the intensity of panic.

There are phobias for so many things that there are whole websites listing all the phobias. Some of the more common phobias focus on being in places or situations from which escape might be difficult or embarrassing (called Agoraphobia), being in general or specific social situations (called Social Phobia), fear of small enclosed places, heights, escalators, tunnels, highway driving, water, flying, dogs, and injuries involving blood.  Phobias are more than just extreme fear - they are an irrational fear of a particular thing or situation.

Agoraphobia and Social Phobia

Two of the most common phobias are Agoraphobia and Social Phobia.

In Agoraphobia the person experiences intense anxiety about being in places or situations from which escape might be difficult or embarrassing.  These situations are avoided or else are endured with marked distress combined with anxiety about having a panic attack or panic-like symptoms.  Agoraphobic fears typically involve situations that include being outside the home alone, being in a crowd or standing in a line, being on a bridge, and traveling in a bus, train, or automobile.  Many agoraphobics develop the disorder after first suffering a series of panic attacks usually in public places.  The attacks seem to occur randomly and without warning, making it impossible for a person to predict what situation will trigger such a reaction. The unpredictability of panic attacks leads the victim to anticipate future panic attacks and, therefore, to fear any situation in which an attack may occur. As a result, they avoid going out in public. Agoraphobia victims also are likely to develop depression, fatigue, tension, spontaneous panic and obsessive disorders.

Social phobia involves overwhelming anxiety and excessive self-consciousness in everyday social situations. People with social phobia have very strong and persistent fear of being watched and judged by others and being embarrassed or humiliated by their own actions.  Social phobia can be a generalized fear where the person experiences symptoms almost anytime they are around other people or it can be limited to only one type of situation, such as a fear of speaking in public or eating in front of others.  Social phobia can severely disrupt normal life, interfering with school, work, or social relationships.  Social phobia can be treated successfully with psychotherapy and/or medications.

The causes of specific phobias are still not well understood. There is some evidence that genetic factors are associated with phobias. Personal trauma and stress can sometimes trigger a phobia in children and adults. As an example, a person who was once trapped in a small room might later become frightened of closed spaces.  

Many people who have phobias have relatives with similar phobias or symptoms such as fears and/or a tendency to avoid certain situations. If it is easy to avoid the object of the fear, then people with specific phobias may not seek treatment. In other cases, they may make important career or personal decisions just to avoid a phobic situation. People with a phobia may self-medicate with drugs or alcohol in an attempt to relax and reduce or avoid their anxiety and fear.  Specific phobias are highly treatable with carefully targeted psychotherapy

Treatment

The treatment of phobias usually involves a behavior therapy focus. In the safety of the therapeutic situation, a person with a phobia is gradually introduced into the very situation that normally causes them anxiety. They learn that they can control their anxiety while gaining greater and greater exposure to their phobic situation. This type of therapy, called desensitization, is based upon having the person relax, and then imagine the components of the phobia, working from the least fearful to the most fearful.

Graded real-life exposure has also been used with success to help people overcome their fears. Cognitive or behavior therapy may also be extremely effective when used in conjunction with relaxation training. Therapy is often combined with anti-anxiety and/or anti-depressive medications.

Additional Resources

For more information about fear, phobias, and other mental health problems, please click on the linked websites listed below.

For a list of the many phobias please visit the page List of Phobias.

 Kids health: phobias
 Phobialist: Treatment for Phobias
 Psychnet on phobias and agoraphobia disorder
 About mental health: anxiety, panic, and phobias
 National Institutes of Health Medlineplus: phobias

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