A phobia is an extreme fear of an object or situation, which is irrational and out of proportion to the danger posed by the phobic stimulus. Phobias can lead to a panic attack, which is sudden and intense and lasts for several minutes. People with phobias don’t just fear the stimulus in its presence but may experience anxiety even while anticipating it. Exposure to the phobic object or situation may lead to intense bouts of anxiety known as panic attacks. Phobias include fear of being in crowded places, blood, injections, animals, enclosed spaces, lightning, and insects.
Phobias are often seen in individuals between 15-20 years of age. It can also happen in early childhood. Phobia affects women more than men due to hormonal fluctuations. Men are more likely to take treatment.
Phobias are broadly categorized into three main types:
Social phobia: People suffering from this type of phobia fears of speaking in public, being watched or humiliated in social situations and avoid socializing with people. Individuals with social phobia may feel anxious, uncomfortable, and have unpleasant feelings before an event. It not only involves shyness and excessive self-consciousness but also builds a fear of public scrutiny. Social phobias usually develop in children in their growing years (after puberty) and if left untreated, it lasts lifelong.
Specific phobias: Although the exact cause of special phobias is still unknown, this type of phobia occurs due to a prior traumatic experience or reaction to a specific situation. It includes fear nature, animals, insects, situations, heights, closed places, tunnels, injection, injury or loud noise. It is normal to experience phobias about more than one situation (airplanes) or object. Specific phobia is often seen more in women.
Agoraphobia: It occurs when a person fears of an anticipated situation or going to a place (where he/she suffered panic attacks). People suffering from this type of phobia develop fear and anxiety in closed or open spaces, in a crowd, when alone (outside their home), travelling in a vehicle, or being in an elevator or on a bridge. Such individuals usually stay away from crowded places. People with this type of phobia may also have depression, stress, substance abuse, and fatigue.
Symptoms
The common signs and symptoms that most people with phobias experience are:
A type of anxiety disorder, social and specific phobias can be caused by various reasons and are heredity. While, in some cases, people are known to suffer from anxiety issues right from birth thereby making them susceptible to various phobias. Apart from this, they can be caused due to pressure or following a stressful event in their life. The reason can be as small as delivering a speech in the class or feeling afraid of abstract things/ situations. Whatever may be the cause of phobia that cause severe physiological and physical reactions in the person affected.
How is the condition different from usual fears that people have?
One of the key differentiators of usual fear and phobias is that a fear becomes a phobia only if it affects one’s social, academic or occupational functioning. For instance, if the person is just not able to leave the house due a fear of dogs or crowded spaces, if a student fails a test for not being able to make oral presentations or losing a job for not being able to travel due to a fear of flying.
Causes of phobias include:
Shyness
Negative or traumatic events
Mental health issues
Health conditions like thyroid problems or arrhythmias
Certain medications
Risk Factors
The causes of most of the phobias are not clearly known but it is believed that some of them run in families. Hence, if your ancestor or parents have suffered from any kind of phobias, you are more likely to get it. Apart from this, experiencing a traumatic event like been struck in an elevator increase your risk of phobias. Too much stress can cause an imbalance in the chemicals that affect your mood, resulting in phobias.
PREVENTION
Early detection of phobias can help in reducing the severity of symptoms and improve quality of life. Apart from this, here are few things for parents to help your child cope with this condition:
Talk to your child openly about fears they experience.
Instil a positive attitude in your child to overcome their fear.
Don’t ever reinforce the feeling of fear in your kid.
As parents you need to set an example (children learn most things by watching their parents).
If you still feel that your child suffers from this psychological problem, visit a good mental health specialist to get treated.
Diagnosis
The diagnosis is usually based on the symptoms that a person experiences and also depends on the type of the phobia experienced by them. The doctor might ask questions about things, places or events that make a person anxious, the severity and frequency of the symptoms experienced. Depending upon the condition, the doctor will decide the type of treatment best for dealing with the type of phobia a person suffers from.
Treatment
The doctor will decide the type of treatment based on the following factors:
Symptoms
Age and history
Type of phobia
Individual’s tolerance for specific medicines.
The main goal of the treatment is to reduce the anxiety levels in the person and aid in the proper management of the reactions to a particular object or situation that triggers the reaction. A phobia is an anxiety disorder that needs to be treated. A person should seek help for this condition when it starts to interfere and adversely affect their day to day lives. While medications can also help, cognitive behaviour therapy is extremely effective in the treatment of phobias. In some cases, a combination of both these treatment options provides effective results.
Medications: The medicines that are commonly prescribed to control the panic attacks or fear include beta blockers, antidepressants, anti-anxiety medications, and sedatives.
Beta blockers: These medications block the action of adrenaline hormone on the body and thus relieve the symptoms that are commonly associated with anxiety.
Antidepressants: SSRIs (selective serotonin reuptake inhibitors) are the most common type of antidepressants that are used to treat phobias. They influence the mood by acting on serotonin, a neurotransmitter.
Anti-anxiety medications: Benzodiazepines can decrease anxiety and worry, but an individual may quickly develop tolerance. This medication is only prescribed as a short-term treatment or may be given along with antidepressants.
Sedatives: They also aid in the treatment of this condition by reducing the anxiety levels in the body. However, these medications can be addictive and should be never taken if you drink alcohol or have history of drug dependence.
Cognitive behaviour therapy (CBT): It is a form of treatment that focuses on relationships between thoughts, feelings and behaviours. It helps people challenge irrational fears and overcome their avoidance of social situations. Read more about cognitive behavioural therapy (CBT) in the treatment social anxiety disorder.
Exposure-base treatment: In this type of treatment, an individual is exposed to various parts of phobia ranging from situations that are least fearful to the most frightening. Patients may also be slowly exposed to relaxation exercises to help overcome their phobias.
Family members and school staff may help to overcome phobias in children.
Lifestyle/management
You can use the following strategies to make the treatment more effective:
Stress management by doing meditation.
Join support groups that encourage people to share their experiences and cope with their phobias.
Learn more about your condition; also help your friends and family understand your state so that they can support you.
Limit caffeine intake as it can worsen your symptoms.
Exercise regularly and eat a balanced diet.
Talk to a healthcare professional before taking any over-the-counter medications or herbal therapy.
If your treatment isn’t working, contact your doctor.
Prognosis And Complications
Prognosis
Phobias can often stay untreated. However, a combination of medications and counselling can help an individual to improve their quality of life, productivity, relationships, and support overall well-being. Talking to a doctor can help in reducing the problems phobias can cause.
Complications
It is very devastating for people who have phobias as the feeling of fear and anxiety interferes with the normal routine. The numerous complications that might result are:
Depression: If phobia is left untreated or ignored, it may lead to depression and other anxiety disorders thereby further worsening your health.
Substance abuse: Most people with phobias may fall prey to substance abuse to deal with the stress and pressure of living with this condition.
Social isolation: People with social phobias avoid public places or gatherings and thus, do not develop good communication skills. This in turn causes professional, academic and relationship problems.
References
Phobias. University of Rochester Medical Center. Available at: https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=85&ContentID=P00739. Accessed on Apr 1, 2021.
Phobia - simple/specific. MedlinePlus. Available at: https://medlineplus.gov/ency/article/000956.htm. Accessed on Apr 1, 2021.
Anxiety disorders. Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/diseases/9536-anxiety-disorders. Accessed on Apr 1, 2021.
Phobias in children and adolescents. Children’s Hospital of Philadelphia. Available at: https://www.chop.edu/conditions-diseases/phobias-children-and-adolescents#. Accessed on Apr 1, 2021.
Phobias in children. Cedars Sinai. Available at: https://www.cedars-sinai.org/health-library/diseases-and-conditions---pediatrics/p/phobias-in-children.html. Accessed on Apr 1, 2021.
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