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Fears and Phobias

What Are Phobias? How Do Phobias Differ From Normal Fears?

"Fear" is the normal response to a genuine danger. With phobias, the fear is either irrational or excessive. A phobia is an abnormally fearful response to a danger that is imagined or is irrationally exaggerated. People can develop phobic reactions to animals (e.g., spiders), activities (e.g., flying), or social situations (e.g., eating in public or simply being in a public environment). Although these conditions can be very frightening and disabling, they are also very treatable. It is important to recognize the symptoms and seek help. Specifically, phobias afflict as many as 12 percent of all Americans. They are the most common psychiatric illness in women and the second most common in men over age 25.

What Are The Symptoms of a Phobia?

Phobias are emotional and physical reactions to feared objects or situations. Symptoms of a phobia include the following:
Feelings of panic, dread, horror, or terror
Recognition that the fear goes beyond normal boundaries and the actual threat of danger
Reactions that are automatic and uncontrollable, practically taking over the person's thoughts
Rapid heartbeat, shortness of breath, trembling, and an overwhelming desire to flee the situation
Physical reactions associated with extreme fear
Extreme measures are taken to avoid the feared object or situation

Are All Phobias The Same?

Phobias are not all the same. There are three main groups which include:
Specific (simple) phobias: the most common and the focus is on specific objects
Social phobia: causes extreme anxiety in social or public situations
Agoraphobia: the fear of being alone in public places from which there is no easy escape
Specific or Simple Phobias produce intense fear of a particular object or situation that is, in fact, relatively harmless. People who suffer from specific phobias are aware that their fear is irrational, but the thought of facing the object or situation often brings on a panic attack or severe anxiety. Specific phobias strike more than 1 in 10 people. No one knows what causes them, though they seem to run in families and are slightly more prevalent in women. Specific phobias usually begin in adolescence or adulthood. They start suddenly and tend to be more persistent than childhood phobias; only about 20 percent of adult phobias vanish on their own. When children have specific phobias--for example, a fear of animals--those fears usually disappear over time, though they may continue into adulthood. No one knows why they persist in some people and disappear in others.

Examples of specific phobias include persistent fear of dogs, insects, or snakes; driving a car; heights; tunnels or bridges; thunderstorms; and/or flying.

Social Phobia is the fear of being humiliated or embarrassed in front of other people. This problem may also be related to feelings of inferiority and low self-esteem, and can drive a person to drop out of school, avoid making friends, and remain unemployed. Although this disorder is sometimes thought to be shyness, it is not the same thing. Shy people do not experience extreme anxiety in social situations, nor do they necessarily avoid them. In contrast, people with social phobia can be at ease with people most of the time, except in particular situations. Social phobia is often accompanied by depression or substance abuse.

People suffering from social phobia may:
View small mistakes as more exaggerated than they really are
Find blushing as painfully embarrassing
Feel that all eyes are on them
Fear speaking in public, dating, or talking with persons in authority
Fear using public restrooms or eating out
Fear talking on the phone or writing in front of others
Agoraphobia is characterized by anxiety about being in places or situations from which it might be difficult or embarrassing to escape--such as being in a room full of people or in an elevator. In extreme cases, a person with agoraphobia may be afraid to leave their house. Agoraphobia often accompanies panic disorders. In some cases, panic attacks become so debilitating that the person may develop agoraphobia because they fear another panic attack.

Can Phobias Be Treated?

Phobias can be overcome with proper treatment. No one should have to endure the terror of phobias or the unrelenting anticipatory anxiety that often accompanies them. A person suffering from a phobia is suffering from a diagnosable illness, and mental health professionals take this illness very seriously. A complete psychological evaluation should be conducted by psychologist to obtain an accurate diagnosis. Consultation with a physician can be helpful in ensuring that the symptoms are not being caused by medical condition.

Lastly, it is crucial to comply with treatment, and to work closely with the therapist in order to achieve success. Behavioral therapy and cognitive-behavioral therapy can be very effective in treating these disorders.

Behavioral therapy focuses on changing specific actions or behaviors and uses different techniques to do that. For example, breathing often becomes shallow during a phobic or fear episode. One technique to change this behavior involves teaching the patient diaphragmatic breathing which is a form of deep-breathing. Another technique called exposure therapy gradually exposes the patient to the frightening object or situation and gives the patient time to develop ways of dealing with the anxiety as it increases.

Cognitive-behavioral therapy teaches the patient skills in order to react differently to the situations which trigger the anxiety or panic attacks. Patients also learn to understand how their thinking patterns contribute to their symptoms and how to change their thinking to reduce or stop these symptoms.

Are Medications Used To Treat Phobias?

Medications are used to control the panic experienced during a phobic situation, as well as the anxiety caused by anticipation of that situation and are often used to treat social phobia and agoraphobia.

What Can You Do Now?

1. Make an appointment with one of our clinicians for a comprehensive professional assessment and to develop a treatment plan for relieving the phobia.
2. Make an appointment with your physician to rule out any physical cause of anxiety.

Sources: Mental Health Association, American Psychiatric Association.

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