Phobias

Let’s face it, nearly all of us are scared of something. Examples of common fears are spiders, snakes, heights, dentists and flying. Indeed, the list is endless. However, a fear of a threatening animal or situation is not necessarily a phobia.

In addition, it is normal to experience feelings of anxiety when confronted with a situation that is potentially dangerous. However, these feelings are usually temporary and mild. Furthermore, normally a person will be fine once the dangerous or scary situation is removed.

So, what is the difference between a normal fear and a phobia? Well, a normal fear is a feeling of unease or discomfort. However, a phobia is an exaggeration or irrational fear. Often feelings of intense anxiety and overwhelming physical sensations accompany a phobia. Indeed, such sensations may even lead to a full blown panic attack.

Remember, the only thing you have to fear is fear itself.

Yes, …and spiders … Don’t forget spiders.

Symptoms of Phobias

Phobia symptoms stem from the natural fight-or-flight response. The fight-or-flight response is a reaction to a threatening situation that prepares the body to either run (flight) or fight.

Indeed, the symptoms of a phobic attack are very similar to that of a panic attack. However, the difference is that these sensations only happen when a person is exposed to the feared stimuli.

Palpitations and a racing heart
Dry mouth
Breathing changes such as shortness of breath or rapid breathing
Tummy ache, nausea or diarrhea
Shaking, trembling and sweating
Sensations of tightness or pain in the chest
Feeling faint, dizzy or lightheaded
An overwhelming sense of doom or dread
Feelings of dissociation (detachment from the body or situation)

The symptoms above sound like my typical hangover.

I prefer to call it wine flu.

Types of Phobias

i) Specific Phobias

According to the Anxiety and Depression Association of America (ADAA), phobias are the most common anxiety disorder. Indeed, a whopping 6 million people suffer from a specific phobia; that is, around 8.7% of the population

A simple phobia revolves around a single, specific object, animal, insect or situation that triggers the intense fear.

I have a phobia of German sausage. Yes, I fear the Wurst.

Although, there are many bizarre and unusual phobias, in general, phobias fall into the following categories:-

Animals and Insects Phobia: The most feared creepy-crawlie and number one phobia, is arachnophobia. Other common phobias include snakes, dogs and mice.
Natural Environment Phobia: The natural world can be a scary place. Examples of common environmental fears are heights, water, such as the sea or rivers, germs and thunderstorms.
Blood-injection-injury phobia Typical examples include fear of needles, injury, illnesses and pain.
Situational Phobia: Fear of flying, dentists and elevators are all common examples.
Sexual Phobia: Common sexual phobias include fear of sex, intimacy or contracting a sexually transmitted disease.

How do you know if you have a normal fear or a phobia?

You can take this fun ‘fear level test‘ here.

ii) Social Anxiety Disorder

About 15 million adults suffer from Social Anxiety Disorder in the US alone.

Unfortunately, many people confuse social anxiety disorder with shyness. However, Social anxiety is classified under the heading of phobias, but is often treated as a stand alone condition.

The intense anxiety and fear in social phobia centres around all sorts of social interactions. Symptoms are the same as those listed above and panic attacks are common.

Examples of some social situations that cause severe anxiety include:-

Talking with authority figures
Speaking in group meetings
Meeting strangers
Shopping
Ordering food at a restaurant
Dating
Talking on the telephone
Parties
Dating
Public Speeches

Obviously, day-to-day life is acutely affected for those with social anxiety disorder. Furthermore, phobia sufferers may fear more than one of the social situations listed above.

I joined an online social anxiety forum a year ago.

Oh, that’s great Moose. Has it helped?

Not really. Nobody has posted anything yet.

iii) Agoraphobia

Agoraphobia and social anxiety disorder are known as complex phobias.

A common misconception about agoraphobia is that it is a fear of open spaces or public places. However, this is not the full picture at all.

Agoraphobic sufferers may well fear leaving the home or even leaving a room in the home. In addition, fear of a visit to a public place or travel on public transport are also common.

In addition, the symptoms of agoraphobia can vary between mild to extremely severe.

So, people with agoraphobia usually start to avoid the situation that they fear, thus making both the symptoms and the anxiety much worse. Avoidance behaviour is common to most anxiety disorders.

Living with agoraphobia is NO walk in the park, you know.

Treatment of Phobia

Cognitive-Behavioral Therapy

The good news is that phobias respond very well, and very quickly, to treatment. Furthermore, the most effective treatment is exposure therapy, also known as gradual desensitisation.

Cognitive behavioral therapy (cbt) works on the premise that it is our interpretation of the situation that leads to the feelings and behaviors that cause distress. Such thoughts, or interpretations, become distorted in phobias.

Cognitive-behavioral-therapy aims to change the negative thoughts surrounding the object of phobia. As a consequence the associated feeling and symptom of anxiety will also change.

Once a person feels better when faced with the phobia, the avoidance behaviour and symptom of anxiety will lessen.

My therapist told me that one thing that would help is to finish things that I’ve started.

Yes, that sounds good. What did you finish?

… so far two bottles of wine and a donut.

Exposure Therapy

Exposure therapy is a type of cbt treatment that gradually exposes the sufferer to the feared stimuli.

Indeed, a lot of phobia sufferers go to great length to avoid the feared situation, object or stimuli. So the avoidance, in turn leads to an increase of the unreasonable fear that goes with it.

Furthermore, exposure to the feared object helps to retrain the brain to stay calm and re-learn that there is no real danger.

In exposure therapy the patient is gradually introduced to the feared object, (systematic desensitization) often with the use of photos or mental imagery.

In addition, the sufferer will be taught relaxation techniques and visual imagery.

If you are interested in trying any exposure therapy or behavioral therapy always choose a qualified mental health professional who specializes in this field.

So, let me get this right. If I have phobia fear of snake, I have to go and see one … maybe even touch it? Really?

Yes, but it is all done in a very gradual and safe environment.

There are so many unusual phobias. Here is a full phobia list

Medications for Phobia

There has been very little research on specific phobias and medication. However, it appears that drug therapy is not recommended in the treatment of phobias. This is because therapy itself is very effective.

In severe phobic reaction, anti-anxiety medication may be prescribed to treat the panic disorder that often comes alongside exposure to the feared stimuli.

Examples of medications that may help with anxiety symptoms are antidepressants such as Selective Serotonin Reuptake Inhibitors (SSRI). In addition, tranquilizers and beta-blockers may be prescribed.

Guess what phobia 50% of British people have?

Fear of rain?

No! Nomobphobia which is being out of mobile phone contact or having no mobile.

Questions and Answers

I do not want to visit a therapist at the moment. Is there a self-help program for phobia treatment?

There are so many self-help groups and on line forums for treatment of phobias. Certainly, exposure therapy can be done at home, although results are better with a trained specialist.

In addition, certain life style changes may help. For example, taking a healthy diet is crucial. So is getting enough exercise and sleep and avoiding stimulants such as caffeine and alcohol.

Furthermore, relaxation techniques such as meditation, hypnosis, mindfulness, yoga and neuro-linguistic programming (NLP).

So … Oikophobia? Any ideas?

Is it the fear of pigs?

No, it is the fear of household appliances. Imagine being scared of your fridge and toaster?

What causes Phobias?

It is not entirely clear why some people develop phobias. However, specific phobias often develop in childhood around age 7 and may be associated with a traumatic event.

In addition, experts think that phobias may be learnt from a parent. So, if a young child sees a parent screaming at the sight of a spider, they may form deep-seated thought patterns that can develop into a phobia.

Finally a phobia is more likely if a parent has any anxiety disorder.

Here is the best – Phobophobia. It is the fear of developing a phobia.

Imagine, having a phobia about having a phobia!

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Anxiety Disorders: A brief overview of the 5 main anxiety disorders.
Generalized Anxiety Disorder: Do you feel anxious, tense and on edge all of the time? Do you have intrusive worrying thoughts and worst-case scenario thinking?
Bipolar Disorder: A common mental health condition that is so often misunderstood.

References

Hamm AO. (2009) Specific phobias. Psychiatr Clin North Am. 2009 Sep;32(3):577-91 (Retrieved November 30^th 2016) https://www.ncbi.nlm.nih.gov/pubmed/19716991
North MM, North SM, Coble JR. (1998) Virtual reality therapy: an effective treatment for phobias. Stud Health Technol Inform. 1998;58:112-9. (Retrieved December 1^st 2016) https://www.ncbi.nlm.nih.gov/pubmed/10350911

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