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Phobias

What is a phobia?

According to the American Psychiatric Association, a phobia is an uncontrollable, irrational, and persistent fear of a specific object, situation, or activity. The fear experienced by people with phobias can be so great that some individuals go to extreme lengths to avoid the source of their fear. One extreme response to the source of a phobia can be a panic attack.

Who is affected by phobias?

Every year, approximately 19 million Americans experience one or more phobias that range from mild to severe. Phobias can occur in early childhood, but usually are first evident between the ages of 15 and 20 years. They affect both genders equally, although men are more likely to seek treatment for phobias.

What causes phobias?

Research suggests that both genetic and environmental factors contribute to the onset of phobias. Specific phobias have been associated with a fearful first encounter with the phobic object or situation. The question still exists, however, whether this conditioning exposure is necessary or if phobias can develop in genetically predisposed individuals.

What are the three primary types of phobias?

Specific phobia

What is specific phobia?

Specific phobia is characterized by extreme fear of an object or situation that is not harmful under general conditions.

Examples may include a fear of the following:

  • Flying (fearing the plane will crash)

  • Dogs (fearing the dog will bite/attack)

  • Closed-in places (fear of being trapped)

  • Tunnels (fearing a collapse)

  • Heights (fear of falling)

What are the characteristics of specific phobia?

People with specific phobias know that their fear is excessive, but are unable to overcome their emotion. The disorder is diagnosed only when the specific fear interferes with daily activities of school, work, or home life.



Approximately 5% to 16% of American adults of all ages in a given year, have some type of specific phobia. There is no known cause, although they seem to run in families and are slightly more prevalent in women. If the object of the fear is easy to avoid, people with phobias may not feel the need to seek treatment. Sometimes, however, they may make important career or personal decisions to avoid a situation that includes the source of the phobia.



Treatment for specific phobia

There is currently no proven drug treatment for specific phobias, however, in some cases, certain medications may be prescribed to help reduce anxiety symptoms before someone faces a phobic situation.



When phobias interfere with a person's life, treatment can help, and usually involves a kind of cognitive-behavioral therapy called desensitization or exposure therapy. In this, patients are gradually exposed to what frightens them until the fear begins to fade. Relaxation and breathing exercises also help to reduce anxiety symptoms.

Social phobia

What is social phobia?

Social phobia is an anxiety disorder in which a person has significant anxiety and discomfort related to a fear of being embarrassed, humiliated, or scorned by others in social or performance situations. Even when they manage to confront this fear, persons with social phobia usually:

  • Feel very anxious before the event/outing

  • Feel intensely uncomfortable throughout the event/outing

  • Have lingering unpleasant feelings after the event/outing

Social phobia frequently occurs with the following:

  • Public speaking

  • Meeting people

  • Dealing with authority figures

  • Eating in public

  • Using public restrooms

What are the characteristics of social phobia?

Although this disorder is often thought of as shyness, the two are not the same. Shy people can be very uneasy around others, but they do not experience the extreme anxiety in anticipating a social situation, and, they do not necessarily avoid circumstances that make them feel self-conscious. In contrast, people with social phobia are not necessarily shy at all, but can be completely at ease with some people most of the time.

Most people experiencing social phobia will try to avoid situations that provoke dread or otherwise cause them much distress.

Diagnosing social phobia

Social phobia is diagnosed when the fear or avoidance significantly interferes with normal, expected routines, or is excessively upsetting.

Social phobia disrupts normal life, interfering with career or social relationships. It often runs in families and may be accompanied by depression or alcoholism. Social phobia often begins around early adolescence or even younger. Approximately 7% of American adults ages 18 to 54 experience social phobia in a given year.



Treatment for social phobia

People who suffer from social phobia often find relief from their symptoms when treated with cognitive-behavioral therapy, or medications, or a combination of the two.

Agoraphobia

What is agoraphobia?

Agoraphobia is a Greek word that literally means "fear of the marketplace." This anxiety disorder involves the fear of experiencing a panic attack in a place or situation from which escape may be difficult or embarrassing.

The anxiety associated with agoraphobia is so severe that panic attacks are not unusual, and individuals with agoraphobia typically try to avoid the location or cause of their fear. Agoraphobia involves fear of situations such as, but is not limited to, the following:

  • Being alone outside his or her home

  • Being at home alone

  • Being in a crowd

  • Traveling in a vehicle

  • Being in an elevator or on a bridge

People with agoraphobia typically avoid crowded places like streets, crowded stores, churches, and theaters.

What are the characteristics of agoraphobia?

Most people with agoraphobia develop the disorder after first suffering a series of one or more panic attacks. The attacks occur randomly and without warning, and make it impossible for a person to predict what situations will trigger the reaction. This unpredictability of the panic causes the person to anticipate future panic attacks and, eventually, fear any situation in which an attack may occur. As a result, they avoid going into any place or situation where previous panic attacks have occurred.

People with the disorder often become so disabled that they literally feel they cannot leave their homes. Others who have agoraphobia, do go into potentially "phobic" situations, but only with great distress, or when accompanied by a trusted friend or family member.

Persons with agoraphobia may also develop depression, fatigue, tension, alcohol or drug abuse problems, and obsessive disorders, making seeking treatment crucial. Approximately 1.7% of American adults experience agoraphobia in a given year.