PHOBIAS

The term “phobia” refers to a group of anxiety symptoms brought on by certain objects or situations.  It is a an unrelenting fear of a situation, activity, or thing that causes one to want to avoid it.  Unlike the brief fear, a person experience when they give a speech or test, phobia is long-lasting, causes intense physical and psychological reactions, and can affect your ability to function normally.

Much is still unknown about the actual cause of phobias. However, there does appear to be a link between your own phobias and the phobias of your parents. This could be due to genetics or learned behavior.

These factors may increase your risk of phobias:

  • Your age. Social phobia typically develops early in life, usually by age 13. Specific phobias first appear in childhood, usually by age 10. Agoraphobia occurs most frequently in the late teens and early adulthood, usually before the age of 35.
  • Your relatives. If someone in your family has a specific phobia, such as a fear of spiders or snakes, you’re more likely to develop it, too.
  • Your temperament. Your risk may increase if you’re more sensitive, more inhibited or more negative than the norm.
  • A traumatic event. Experiencing a traumatic event, such as being trapped in an elevator or attacked by an animal, may trigger the development of a phobia.

Phobias are divided into three main categories:

Specific phobias. A specific phobia involves an irrational, persistent fear of a specific object or situation that’s out of proportion to the actual risk.

There are different types of specific phobias, based on the object or situation feared, including:

  • 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).

Social phobia. More than just shyness, social phobia involves a combination of excessive self-consciousness and a fear of public scrutiny or humiliation in common social situations. In social situations, the person fears being rejected or negatively evaluated or fears offending others.

Fear of open spaces (agoraphobia). This is a fear of an actual or anticipated situation, such as using public transportation, being in open or enclosed spaces, standing in line or being in a crowd, or being outside the home alone. The anxiety is caused by fearing no easy means of escape or help if intense anxiety develops. Most people who have agoraphobia develop it after having one or more panic attacks, causing them to fear another attack and avoid the place where it occurred. For some people, agoraphobia may be so severe that they’re unable to leave home.

No matter what type of phobia you have, it’s likely to produce the following reactions:

  • A feeling of uncontrollable panic, terror or dread when you’re exposed to the source of your fear
  • The feeling that you must do everything possible to avoid what you fear
  • The inability to function normally because of your anxiety
  • Physical as well as psychological reactions, including sweating, rapid heartbeat, difficulty breathing, a feeling of panic and intense anxiety
  • Often, the knowledge that your fears are unreasonable or exaggerated but feeling powerless to control them
  • In some cases, anxiety just thinking about what you fear
  • In children, possibly tantrums, clinging or crying

DIAGNOSIS

If symptoms of a specific phobia are present, the doctor will begin an evaluation by performing a medical and psychiatric history and may perform a brief physical exam. The doctor uses the criteria in the Diagnostic and Statistical Manual of Mental Disorders.

The doctor bases his or her diagnosis of specific phobias on reported symptoms, including any problems with functioning caused by the symptoms.

 

RECOMMENDED MEDICATIONS

The goal of phobia treatment is to reduce your anxiety and fear and to help you better manage your reactions to the object or situation that causes them.

Medications

Medications can help control the anxiety and panic from thinking about or being exposed to the object or situation you fear.

  • Beta blockers. These medications work by blocking the stimulating effects of adrenaline on your body, such as increased heart rate, elevated blood pressure, pounding heart, and shaking voice and limbs that are caused by anxiety.
  • Antidepressants. These medications act on the chemical serotonin, a neurotransmitter in your brain that’s believed to influence mood.
  • Sedatives. Medications called benzodiazepines help you relax by reducing the amount of anxiety you feel.

Psychotherapy

Talking with a trained mental health professional can help you deal with your phobias. Several types of psychotherapy, also called talk therapy, may be effective.

  • Desensitization or exposure therapy focuses on changing your response to the object or situation that you fear and may be helpful for phobias. Gradual, repeated exposure to the cause of your phobia may help you learn to conquer your anxiety.
  • Cognitive behavioral therapy involves exposure combined with other techniques to learn ways to view and cope with the feared object or situation differently.

Treatment choices

Treatment depends on the type of phobia you have:

  • Specific phobias usually are treated with exposure therapy.
  • Social phobias may be treated with exposure therapy or with antidepressants or beta blockers.
  • Agoraphobia, especially when it’s accompanied by a panic disorder, is usually treated with exposure therapy or with SSRIs.

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