Phobias

What Are Phobias?

Phobias are a group of disorders that share a persistent, recurring, irrational, and severe anxiety surrounding specific objects, activities, or situations. Phobias also involve specific avoidance of the particular phobic stimulus.

 

Phobias are fairly common, and a diagnosis is usually made only when fear or avoidance behavior is a significant source of distress to the individual, or when it interferes with social or occupational functioning.

 

Different Types of Phobias

The common types of phobias include:

 

Social phobia, also called social anxiety disorder, is characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. People with social phobia have a persistent, intense, and chronic fear of being watched and judged by others and of being embarrassed or humiliated by their own actions. Their fear may be so severe that it interferes with work, school, and other ordinary activities.

 

While many people with social phobia recognize that their fear of being around people may be excessive or unreasonable, they are unable to overcome it. They often worry for days or weeks in advance of a dreaded situation.

 

A specific phobia is an intense fear of something that poses little or no actual danger. Some of the more common specific phobias are centered around:

 

Agoraphobia is the fear of being alone or in public places. This type of phobia rarely occurs in the absence of panic disorder.

 

Possible Causes

Ongoing research is being done to define the exact causes of phobias. Some researchers believe a small structure in the brain called the amygdala is responsible for the symptoms of phobias. The amygdala is believed to be a central site in the brain that controls fear responses.

 

Animal studies are adding to the evidence that suggests phobias can be inherited.

 

Another area of research is investigating a biochemical basis for phobias. Scientists are exploring the idea that heightened sensitivity to disapproval may be physiologically or hormonally based.

 

Other researchers are investigating the role of environment on the development of phobias. People with phobias may acquire their fear from observing the behavior and consequences of others, a process called observational learning or social modeling.

 

Common Symptoms

People with symptoms of phobias experience extreme anxiety when exposed to the feared object or situation. These people recognize that their fear is excessive or unreasonable, and find that normal routines, social activities, or relationships are significantly impaired as a result.

 

Other common symptoms of phobias can include:

 

Treatment Options for Phobias

Depending on the type of phobia diagnosed, there are two effective forms of treatment available:

 

Medications include antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs), as well as drugs known as high-potency benzodiazepenes.

 

Some people with phobias called performance phobia have been helped by beta-blockers, which are more commonly used to control high blood pressure.

 

Cognitive behavioral therapy is also useful in treating phobias. The central component of this treatment is exposure therapy, which involves helping patients gradually become more comfortable with situations that frighten them. The exposure process often involves three stages. The first involves introducing people to the feared situation. The second is to increase the risk for disapproval in that situation so that people build confidence that they can handle rejection or criticism. The third stage involves teaching people techniques to cope with disapproval. In this stage, people imagine their worst fear and are encouraged to develop constructive responses to their fear and perceived disapproval.

 

Cognitive behavioral therapy for phobias also includes anxiety management training -- for example, teaching people techniques such as deep breathing to control their levels of anxiety. Another important aspect of treatment is called cognitive restructuring, which involves helping individuals identify their misjudgments and develop more realistic expectations of the likelihood of danger in social situations.

 

Supportive therapy, such as group therapy or couples or family therapy to educate significant others about the disorder, is also helpful. Sometimes, people with social anxiety disorder also benefit from social skills training.

 

Other Conditions

Phobias can cause lowered self-esteem and depression. In an attempt to reduce their anxiety and alleviate depression, people with phobias may use alcohol or other drugs, which can lead to addiction.

 

Some people with phobias may also have other anxiety disorders, such as panic disorder and obsessive-compulsive disorder (OCD).

 

Statistics on Phobias

Approximately 5.3 million American adults ages 18 to 54 (about 3.7 percent of people in this age group) have social phobia in a given year. It typically begins in childhood or adolescence.

 

Approximately 3.2 million American adults ages 18 to 54 (about 2.2 percent of people in this age group) have agoraphobia in a given year.

 

Approximately 6.3 million American adults ages 18 to 54 (about 4.4 percent of people in this age group) have some type of specific phobia in a given year.