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Phobias

A phobia is an irrational sense of anxiety or fear. It happens when you’re exposed to a specific object or situation that you’re afraid of. If you have a phobia you will tend to avoid whatever is causing your fear, which can affect your daily life.

Fear is a type of anxiety caused by something in your surroundings. If the situation is a real threat – for example, you're being attacked – fear is a completely sensible and appropriate reaction for you to have.

With phobias, the fear is irrational because you have an exaggerated or unrealistic idea about the situation. If you have a phobia, you may realise that your fear is out of proportion to the true danger, but you can't control or explain it.

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Details

  • Types of phobias Types of phobias

    You can develop a phobia about any object or situation that you’re afraid of. Phobias are often put in to two groups – specific (or simple) and complex phobias.

    Specific (or simple) phobias

    These are restricted to very specific situations and usually begin during your childhood or adolescence. Most people grow out of these types of phobias. Some of the most common types of specific phobias are described below.

    • Animal phobia. This is usually a fear of snakes, mice, insects, spiders or dogs.
    • Environmental phobia. This can be a fear of the dark, heights or water.
    • Situational phobia. This can be a fear of flying, visiting the dentist or being in small spaces (claustrophobia).
    • Body-related phobia. This can be a fear of injections, blood or vomit.

    Complex phobias

    These can significantly interfere with your day-to-day life and may stop you doing certain things. Often, these types of phobias develop after adolescence. The two most common types of complex phobias are listed below.

    • Agoraphobia. This is a fear of open spaces or being in places or situations where you feel you can’t escape. For example, you may have a fear of leaving home, being in a crowd, or travelling in a car, train or bus.
    • Social phobia. This is a fear of being watched and judged in social situations. For example, you might worry that you will do something embarrassing, or that people are going to be critical of you.

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  • Symptoms Symptoms of phobias

    If you have a phobia, you won't usually have any symptoms until you're faced with your feared situation or object. You may then develop symptoms of severe anxiety, which include:

    • the sensation of feeling your heart racing (palpitations)
    • sweating
    • feeling dizzy
    • breathing very quickly (hyperventilation), leading to numbness and pins and needles
  • Diagnosis Diagnosis of phobias

    If you think you have a phobia, and it’s affecting how you live your life, see your GP.

    Your GP will ask about your symptoms. For example, they may ask you about how long you’ve had your symptoms and whether you’ve had any phobias in the past. They may also ask you about your medical history.

    He or she may refer you to another healthcare professional, who specialises in treating mental health problems.

  • Treatment Treatment of phobias

    Self-help

    The best way to get over a phobia is to gradually expose yourself to your feared object or situation. This may seem like a scary thing to do, but it will help to reduce your fear and tolerate the anxiety until it starts to decrease. And you don’t have to do it without support and some tools to help.

    If you can, try and talk about your fear with someone you trust. They may have felt something similar to you and understand what you’re going through. Or you might find a support group helpful – you might be able to find out how others have coped with the same phobia as you. Self-help books or computer programmes can also be useful to work through.

    You can also help yourself by trying relaxation techniques to feel more in control of your anxiety. Different things work for different people so have a think about what might work for you. There are lots of methods out there, such as meditation, deep breathing or stretching. The important thing is to practise relaxation regularly.

    See our resources for more information about where you can find support.

    Talking therapies

    Your GP may suggest a talking therapy called cognitive behavioural therapy (CBT). This is a type of psychological treatment that challenges negative thoughts, feelings and behaviours. Your GP can usually refer you to a suitable therapist.

    CBT involves one-to-one sessions with a therapist trained in treating phobias. Your therapist will help you to identify links between your thoughts, feelings and behaviour and advise you how to develop coping skills. He or she may also teach you relaxation techniques and then gradually expose you to the object or situation that you fear. In this way you’ll learn to tolerate the anxiety.

    Medicines

    Medicines aren’t often used to treat phobias because talking therapies can be very successful. If you have severe anxiety or your symptoms are interfering with something important, for example medical or dental treatment, your GP may prescribe you medicines.

    Your GP may offer you medicines called beta-blockers to help ease your symptoms, such as palpitations. In some situations, your GP may prescribe you another type of medicines called benzodiazepines. These can help relieve very severe anxiety. They can make you drowsy and are only prescribed as a short-term treatment because they can be addictive.

    If your anxiety lasts more than four weeks, your GP may recommend that you take an antidepressant called selective serotonin-reuptake inhibitors (SSRIs). Your GP may offer you these medicines if talking treatments haven’t helped and your anxiety is affecting your day-to-day life.

    Always ask your GP for advice and read the patient information leaflet that comes with your medicine.

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  • Causes Causes of phobias

    There are different theories about what causes phobias to develop.

    Phobias may run in families, but it’s not clear how much this is to do with if you inherit them or if you learn them.

    Sometimes the start of a phobia may be triggered by a frightening situation or place, which caused you to feel anxious at the time.

  • Complications Complications of phobias

    If you have a phobia, you will try to avoid the object or situation you fear and this can affect your mental health. For example, you may feel lonely and isolated if you become unable to leave your home, go shopping or meet with friends. As a result, you may become depressed.

    If you use alcohol or drugs to cope with your feelings, then you can increase your risk of developing alcohol and drug-related health problems.

  • FAQs FAQs

    If I have one phobia, am I more likely to have another?

    Answer

    Yes, it’s possible that if you have one type of phobia, you could develop another.

    Explanation

    Phobias are a type of anxiety disorder. If you have one type, you may experience other types of phobias. For example, agoraphobia is a fear of open spaces or being in places or situations where you feel you can’t escape. If you have agoraphobia, you may also develop monophobia (a fear of being alone) or claustrophobia (a fear of being in a small space).

    What can I do to help my friend if they have a phobia?

    Answer

    Letting your friend know you’re accepting of their phobia and offering your support to get help may be beneficial.

    Explanation

    If your friend has a phobia, it may be helpful to acknowledge how hard it can be for them to deal with it. Just being with them when they are exposed to the activity causing their anxiety can help. Alternatively, encourage them to get help from another source. Your friend’s GP can give them more information about phobias and the treatments available. If your friend is getting treatment, either by following a self-help programme or talking to a therapist, ask how it's going from time to time. Be supportive and ask if there’s any way you can help. For example, offer to travel with your friend to or from treatment sessions.

    How common are phobias, and what’s the most common type?

    Answer

    Phobias are common − around one in 10 people will have a phobia at some point during their lifetime. Social phobia is one of the most common; it’s also known as social anxiety disorder. Specific phobias (fears attached to certain things) are also common phobias.

    Explanation

    A social phobia is when you have a fear of being watched and judged in social situations. About five in 100 people have some degree of social phobia and it’s more common in women than men. If you have a social phobia, you may worry that you’ll do or say something humiliating or embarrassing. This type of phobia can disrupt your normal life. Some of the social situations that you might worry about will be everyday things such as:

    • speaking on the telephone
    • starting conversations or meeting new people
    • eating or drinking in front of people
    • working or going shopping

    Phobias of specific things − such as objects, the environment or body-related − are also common. They might include a fear of heights, particular animals like spiders, flying, enclosed spaces, or the sight of blood for example.

  • Resources Resources

    Further information

    Mental Health Foundation The Mental Health Foundation is a charity that carries out research and offers information about many areas of mental health. This article signposts to its podcasts which aim to introduce you to skills to help you relax and improve your mental wellbeing.
    Mind The charity Mind has information to support people with a mental health condition and those who care for them. As with many of their articles, this includes quotes from people with the condition – in this case phobias – and ways that family and friends can help.

    Sources

    • Phobias. BMJ Best Practice. www.bestpractice.bmj.com, published 9 September 2013
    • Anxiety, panic and phobias: key facts. Royal College of Psychiatrists. www.rcpsych.ac.uk, published February 2014
    • Phobias. Mind. www.mind.org.uk, accessed 22 May 2014
    • Phobias. Mental Health Foundation. www.mentalhealth.org.uk, accessed 22 May 2014
    • Phobic disorders. Medscape. www.emedicine.medscape.com, published 26 December 2013
    • Shyness and social phobia. Royal College of Psychiatrists. www.rcpsych.ac.uk, published May 2008
    • Anxiety and stress related disorders. Oxford handbook of psychiatry (online). Oxford Medicine Online. www.oxfordmedicine.com, published March 2013
    • Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. www.medicinescomplete.com, accessed 13 June 2014
    • Friends and relatives. Anxiety and Depression Association of America. www.adaa.org, accessed 13 June 2014
    • Social anxiety disorder: recognition, assessment and treatment. National Institute for Health and Care Excellence (NICE), 2013. www.nice.org.uk
    • Map of Medicine. Anxiety. International View. London: Map of Medicine; 2013 (Issue 4)
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