1. What is phobia?
A phobia is an intense form of nervousness or anxiety that is triggered by an object (such as a snake, spider, or being on a plane) or is specific situation (such as being in confined or in open spaces). It is not uncommon that people have certain fears for specific situations or objects that are associated with danger. However, people who suffer from a phobia tend to experience an intense irrational fear and terror from the presence of a specific object or a specific situation without being in any actual danger. When imagining or thinking about these objects/situations, their reaction is to exaggerate the perceived danger, with this resulting in anxiety and often panic attacks. There are numerous specific phobias, but the most common and known ones are two: claustrophobia (fear of closed spaces) and acrophobia (fear of heights). A common characteristic of people who have a specific phobia is that they are aware of their phobia, but they believe that their anxious reaction is uncontrollable.
2. Causes, signs and symptoms
Genetically, phobias are not heritable, but it has been discovered that the tendency to be more anxious can be inherited. However, this genetic predisposition just sets the stage and other factors play an important role for phobias to occur. These include factors such as; long-term stress, which interferes with the ability to cope with particular situations; learned responses, which are commonly adopted from the environment where someone is raised; and traumas, which are associated with particular situations (e.g. getting stuck in a lift could cause someone to become claustrophobic).
The most common symptom of a specific phobia is intense and persistent fear of the specific object/situation. This fear is followed by anxiety that ranges from nervousness or mild anxiety to severe anxiety and panic attacks. The physical symptoms in these situations include difficulty breathing, feeling dizzy, lightheaded or faint, trembling, shaking, sweating, palpitations, hot or cold flushes, nausea, vomiting, or diarrhoea, numbness or pins and needles, chest pain or tightness in the chest, and feeling like you are choking. Other symptoms include overwhelming anxiety, a need to escape, feelings of going crazy, losing control, fear of fainting, or feeling out of touch with reality. People who have a specific phobia commonly tend to avoid even the smallest contact with the specific stimuli.
There are specific diagnostic criteria in order for someone to be diagnosed with a specific phobia. These criteria include that the person should have a marked fear triggered constantly by phobia stimuli and these stimuli are either avoided or managed under extreme anxiety. Furthermore, the above symptoms should be persistent for at least 6 months, and the specific phobia will regularly intervene with the individual’s daily routine (e.g. studying, working, going out, etc).
4. Phobia Treatment
Specific phobias are generally treated with psychotherapy, medication or both. The choice of treatment depends on the severity of the phobia. According to the National Institute for Health Care Excellence (NICE) the recommended psychotherapy is Cognitive Behavioural Therapy (CBT). This type of therapy focuses on the connection between thoughts, emotions, and behaviours; and teaches the person new ways of thinking and behaving that may help to reduce anxiety and fear when they are in contact with the stimuli. Over time, irrational thoughts of exaggerating the danger are changed and behavior is altered as a consequence.
Another treatment used is Exposure Therapy, where the person is exposed to the feared objects/situations, and the therapist teaches the person that the danger is exaggerated. Phobias can also be treated through the use of medication and your GP will be able to provide you with guidance on what medication to take. At present, anti-anxiety medications are the most common ones used to help people cope with the anxiety followed after the exposure to the phobic stimuli. Common to all medication is that it may cause side effects and some medication should not be taken for prolonged periods of time.