Phobia - simple/specific

Causes

Specific phobias are a type of anxiety disorder in which a person may feel extremely anxious or has a pannic attack when exposed to the object of fear. Specific phobias are one of the most common psychiatric disorders, affecting up to 10% of people.

Common phobias include the fear of:

• Blood, injections, and other medical procedures
• Certain animals (for instance, dogs or snakes)
• Enclosed spaces
• Flying
• High places
• Insects or spiders
• Lightning

Symptoms

Being exposed to the feared object, or even thinking about being exposed to it causes an anxiety reaction.

• This fear or anxiety is much stronger than the real threat.
• You may sweat excessively, have problems controlling your muscles or actions, or have a fast heart rate.

You will avoid situations in which you may come into contact with the feared object or animal -- for example, avoiding driving through tunnels, if tunnels are the subject of your phobia. This type of avoidance can interfere with your job and social life.

You may feel weak or cowardly and lose self-esteem when avoiding the object of the phobia.

Exams and Tests

The health care provider will ask about your history of phobia, and will get a description of the behavior from you, your family, and friends.

Signs include:

• Elevated blood pressure
• Rapid heart rate

Treatment

The goal of treatment is to help you function effectively. The success of the treatment usually depends on the severity of the phobia.

Systematic desensitization is a technique used to treat phobias. You are asked to relax, then imagine the parts of the phobia, working from the least fearful to the most fearful. Gradual exposure to the real-life situation has also been used with success to help people overcome their fears.

Anti-anxiety and antidepressant medications are sometimes used to help relieve the symptoms of phobias. See: Panic disorder for more information about medications.

Behavioral therapies should be used together with drug therapy. These include:

• Cognitive-behavioral therapy, including learning to recognize and replace panic-causing thoughts
• Exposure
• Pleasant mental imagery
• Relaxation techniques

Behavioral treatment appears to have long-lasting benefits.

Other treatments that can reduce the number of attacks include:

• Getting regular exercise
• Getting enough sleep
• Reducing or avoiding the use of caffeine, some over-the-counter cold medications, and other stimulants
• Scheduling regular meals

Phobia clinics and group therapy are available in some areas to help people deal with common phobias, such as a fear of flying.

Outlook (Prognosis)

Phobias tend to be chronic, but they can respond to treatment.

Possible Complications

Some phobias may have consequences that affect job performance or social functioning. Some anti-anxiety medications used to treat phobias, such as benzodiazepines, may cause physical dependence.

When to Contact a Medical Professional

Call for an appointment with your health care provider or a mental health professional if a simple phobia is interfering with life activities.

References

Taylor CT, Pollack MH, LeBeau RT, Simon NM. Anxiety disorders: Panic, social anxiety, and generalized anxiety. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 32.

Update Date: 3/7/2012

Updated by: Fred K. Berger, MD, Addiction and Forensic Psychiatrist, Scripps Memorial Hospital, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.