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Phobia - simple/specific

Definition

A phobia is a persistent and irrational fear of a particular type of object, animal, activity, or situation that poses little to no actual danger.

Causes, incidence, and risk factors

Specific phobias are a type of anxiety disorder in which exposure to the feared stimulus may provoke extreme anxiety or a panic attack. Specific phobias are among the most common of all psychiatric disorders, affecting up to 10% of the population.

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 out of proportion to (much stronger than) the real threat.
• The person may have excessive sweating, problems controlling the muscles or actions, or rapid heart rate.

The person avoids situations in which contact with the feared object or animal may occur -- for example, avoiding driving through tunnels, if tunnels are the subject of the phobia. This type of avoidance can interfere with job and social functioning.

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

Signs 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 components 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.

Regular exercise, adequate sleep, and regularly scheduled meals may help reduce the frequency of the attacks. Reduce or avoid the use of caffeine, some over-the-counter cold medications, and other stimulants.

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

Support Groups

Expectations (prognosis)

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

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.

Calling your health care provider

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

Prevention

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.