Phobias are persistent, extreme, irrational fears of certain objects or situations. The 5%-12% of Americans who have phobias have physical and emotional reactions to the objects or situations that they fear. These reactions and the anxiety associated with them can be so overwhelming that people will do all they can to avoid the feared objects or situations. As a result, phobias can interfere with normal life—working, socializing, and functioning from day to day. Luckily, treatment is available; a phobia that interferes with daily life should be treated.

Phobias are the most common psychiatric illness among women of all ages, and the second most common illness among men older than 25.

The general symptoms of phobias include the following:

  • Feelings of panic, dread, horror, or terror
  • Recognition that the fear goes beyond what is considered normal and is out of proportion to the actual threat of danger
  • Reactions that are automatic and uncontrollable, and seem to take over the person’s thoughts
  • Rapid heartbeat, shortness of breath, trembling, and an overwhelming desire to escape the situation
  • Extreme measures taken to avoid the feared object or situation

Types of Phobias

Phobias are classified into three main types:

Agoraphobia

Agoraphobia is the fear of being in any place or situation where it would be difficult to get help or to escape, if necessary. For example, busy streets or crowded stores, theaters, or churches are often avoided by people with agoraphobia. In extreme cases, a person may be afraid to leave his or her home, or will only do so only under specific circumstances.

Agoraphobia often accompanies panic disorder . People with panic disorders often have panic attacks, which are feelings of intense, overwhelming terror accompanied by symptoms such as sweating, shortness of breath, and faintness. Panic attacks seem to occur randomly and with no warning. Therefore, people often worry about when the next attack will occur. They may avoid places where attacks have occurred, or in extreme cases, avoid leaving their homes at all.

Two-thirds of the people with agoraphobia are women. The symptoms may occur between ages 18 and 35; they may come on suddenly or over a period of time.

Social Phobia

Social phobia , also called social anxiety disorder, is the fear of being watched or humiliated in a social setting, such as when meeting new people, giving a speech, or eating in a restaurant. Most people experience these fears—especially around public speaking—with mild to moderate intensity, and the fear passes. For people with social phobia, however, the fear is extremely intrusive and can disrupt normal life, interfering with work or social relationships in varying degrees of severity.

Social phobias usually occur after puberty and peak after the age of 30.

Specific Phobias

Claustrophobia, acrophobia, arachnophobia—these are common specific phobias. Specific phobias involve a fear of an object or situation, such as closed-in spaces (claustrophobia), heights (acrophobia), or spiders (arachnophobia). This type of phobia causes a person to take drastic measures to avoid the feared thing or situation.

Most simple specific phobias occur during childhood and eventually disappear. However, those that last into adulthood and involve fear of a common thing or situation rarely go away without treatment. It is unclear why phobias disappear in some people, but persist in others.

What Causes Phobias?

Traumatic events often trigger the development of specific phobias, which are slightly more prevalent in women than men.

Research shows that social phobia may have a hereditary component and occurs in women and men in equal proportions. However, men may seek treatment for social phobia more often than women.

How Are Phobias Treated?

Only about 20% of adult phobias go away on their own. When phobias interfere with a person’s quality of life and life decisions, treatment is essential. And treatment is very successful—most people who seek treatment completely overcome their phobias.

Successful treatment involves behavioral therapy, medication, or a combination of both.

Behavioral Therapy

A type of cognitive-behavioral therapy called desensitization or exposure therapy is used to treat phobias. In this therapy, a person is carefully and gradually exposed to what frightens him or her and trained how to control the physical reactions to fear. The therapist begins by having the person imagine the feared object, then look at pictures, and eventually experience the object or situation. The person learns to confront the feared object or situation and slowly decreases his or her fear. Most people—75%—benefit significantly from this type of treatment.

Relaxation and breathing exercises are also helpful for relieving anxiety symptoms associated with phobias.

Medications

The role of medications in phobia treatment is to control the panic and anxiety that occur both during a phobic situation and in anticipation of a phobic situation.

For example, for social phobias, the following drugs may be prescribed:

  • Monoamine oxidase inhibitors (MAOIs)
  • Selective serotonin reuptake inhibitors (SSRIs)
  • High potency benzodiazepines
  • Beta blockers – often used for people with performance phobia (a form of social phobia)

There is no proven drug treatment for specific phobias, but certain medications may help reduce symptoms of anxiety before one faces a phobic situation.

If phobias are interfering with life, it is essential to seek treatment, as treatment is usually very successful.