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Phobias

Expert reviewers, Dr Sammad Hashmi, Consultant Psychiatrist
Next review due, June 2024

A phobia is an extreme form of anxiety or fear of a specific object or situation. The anxiety or fear is out of proportion to the actual threat or danger the situation poses. If you have a phobia, it can affect the way you live your life and cause a lot of distress. The good news is that phobias are often treatable.

An image of a child at the dentist

What is a phobia?

It’s natural to avoid things that might harm you, and to worry about situations like an exam or public speaking. This is part of the way our minds work, but these fears do not normally interfere with our day-to-day routine. But if you have a phobia, you’ll have an exaggerated or unrealistic idea about a situation or object. You may realise that your fear is out of proportion to the true danger, but you can't control it.

You may find yourself organising your life so that you avoid the thing that you fear. And if you can’t avoid it, you may become very anxious. An untreated phobia can affect your ability to work, travel and socialise. If you have a phobia that’s affecting your life, it’s important to seek help from your GP.

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Types of phobia

You can develop a phobia about many different objects or situations. Some are much more common than others. These are the three main types of phobia.

  • Simple (or specific) phobias. These phobias are the most common cause of anxiety symptoms. Specific phobias include animals (dogs, snakes), situations (flying, enclosed spaces), natural environment (storms, heights) and phobias about blood and medical procedures (visiting the dentist, injections). Of course, some of these triggers are easier to avoid than others.
  • Agoraphobia. This is a fear of being somewhere you feel you can’t escape or where help might not be available if you become anxious. You may have a fear of leaving home alone, of being in a crowd or of travelling in a car, train or bus. You may panic in these situations and deliberately avoid them.
  • Social phobia (social anxiety disorder). This is a fear of being watched and judged in social or performance situations. This may happen during activities like making phone calls, meeting new people, working or even shopping. You may worry that you’ll do something embarrassing or that people are going to criticise you. You may try to avoid all such situations or feel very anxious and panic if you have to endure them.

Symptoms of phobias

If you have a phobia, you’ll probably feel fine until you approach or are faced with the thing you fear. But sometimes, even just thinking about it may trigger symptoms. Phobias can cause severe anxiety or a panic attack. Your physical symptoms may include:

  • feeling your heart racing (palpitations)
  • sweating
  • feeling dizzy or faint
  • a feeling of choking
  • feeling sick
  • trembling or shaking
  • pain or discomfort in your chest
  • struggling to breathe
  • numbness and ‘pins and needles’

You may avoid certain objects or situations, or feel very anxious and panicky if you can’t. You may fear that you’ll faint or that you’re losing control or dying. These feelings can be very distressing. They can severely affect your day-to-day life.

If you think you have symptoms of a phobia that are affecting your everyday life, contact your GP. You may also be able to get help with anxiety by referring yourself directly to a psychological therapist without seeing your GP. Look online for IAPT services (IAPT stands for ‘Improving access to psychological therapies’). It’s a free NHS service.

Diagnosis of phobias

If you contact your GP or a therapist, they’ll ask about your symptoms. They may ask you about how long you’ve had them and when they occur. They may ask whether you’re avoiding certain objects or situations because of your fear. And they’ll ask you how much this affects your life. They may also want to know if anyone in your close family has phobias.

If you have physical symptoms, your GP may want to make sure these don’t have some other medical cause. This might involve a physical examination and perhaps some tests. These tests check for medical conditions that can cause similar symptoms to anxiety. These include low blood sugar and problems with your heart or thyroid. If you need any tests, your GP will explain these to you, and you’ll have the chance to ask questions about them.

If you have a phobia, your GP may refer you to another healthcare professional. This will be someone who specialises in treating mental health problems.

Treatment of phobias

Talking therapies are the main treatment for phobias. Your GP may refer you, or you may be able to refer yourself directly. See our section on symptoms for more information about this. Medicines may sometimes be needed if your symptoms of anxiety are severe.

How easy it is to treat a phobia depends on the type of phobia. A specific phobia is usually easier to overcome than agoraphobia or social phobia. How well your treatment works will also depend on how severe your phobia is. Getting support from your family and friends is important too. And there’s a lot you can do to help yourself. Most people find that their symptoms get better over time.

Self-help for phobias

You might find some of the following tips helpful.

  • Talk about your fear to someone you trust. They may have felt something similar and understand what you’re going through.
  • Find a support group to talk to other people who’ve had similar experiences. It can help to hear how others have coped with their phobias.
  • Learn ways of coping with panic and anxiety. You may find that relaxation techniques can help you control your anxiety. Focussing on your breathing may help during a panic attack.
  • You may find it helps to reduce how much caffeine you drink. Caffeine can make anxiety symptoms worse. Caffeine is found in coffee, caffeinated teas and some fizzy drinks.
  • Try self-help resources such as books or online programmes. These are often based on cognitive behavioural therapy (CBT). For more information about CBT, see the next section on talking therapies. If possible, choose a book recommended by a professional organisation, such as the Royal College of Psychiatrists.
  • Take a course to help overcome a specific phobia. For instance, some airlines run ‘fear of flying’ courses.

You can get more tips and hints on self-help for phobias from the organisations listed in our section ‘Other helpful websites’. Some can also help you find support services.

Talking therapies for phobias

Your GP may suggest you try a talking therapy called cognitive behavioural therapy (CBT). CBT can help you change how you think, feel and behave when you’re exposed to the object or situation that you’re afraid of.

CBT involves one-to-one sessions with a therapist trained in treating phobias. During these sessions, your therapist will help you develop coping skills. These help you face your phobia. They may also teach you relaxation techniques.

Exposure therapy for phobias

Your CBT therapist may gradually expose you to the object or situation that you fear. This helps you learn to cope with your anxiety. This is called exposure therapy (or desensitisation). Your therapist will only start this process if you give your permission.

As a first step, your therapist might ask you to imagine yourself in the scary situation. They may then ask you to approach the object or situation you fear. Once you can do this comfortably, your therapist may ask you to touch the object. Your therapist will keep increasing your exposure to the object or situation. You build in confidence until you are interacting normally with it. Your therapist will go at your pace, with as many, or as few, sessions as you need.

Exposure therapy helps nine in every 10 people who try it. It’s often the only treatment needed for specific phobias.

Medicines for phobias

If your anxiety is so bad that it’s affecting your daily life, your GP may recommend some medicine. There are three main types of medicine which your GP may offer.

  • Antidepressants. These may be an option if you have agoraphobia or social phobia. Your GP may offer them if CBT doesn’t work, or you choose not to have it. They’ll probably offer you antidepressants called selective serotonin-reuptake inhibitors (SSRIs).
  • Beta-blockers. These may help to ease specific physical symptoms, such as palpitations (feeling your heart is racing) and trembling hands.
  • Benzodiazepines (a type of tranquiliser). These can help to relieve very severe anxiety. They can be addictive, so they’re used only for a very short amount of time.

Beta-blockers and benzodiazepines can be helpful for a short time when you can’t avoid facing the situation you fear. An example is having chemotherapy when you have a fear of needles.

Always carefully read the patient information leaflet that comes with your medicine. If you have any questions about taking your medicines, ask a pharmacist for advice.

How can I help someone who has a phobia?

If someone you care about has a phobia, here are some suggestions for how you can help.

  • Learn more about phobias and how they’re treated.
  • Be patient and listen to your friend. Ask what help they would like from you.
  • Don’t pressure them into facing their fears.
  • Gently encourage your friend to see their GP, get help from a therapist or try self-help remedies. See our section ‘Treatment of phobias’ for more information.
  • Offer practical help, such as arranging or going to appointments with your friend.
  • Offer to be with your friend when they’re facing situations they fear.
  • Let them know you understand that their fear is very real to them.

Causes of phobias

It’s not clear why some people develop phobias and others don’t. It may be due to many factors acting together. Sometimes, the start of your phobia may be related to a frightening situation or place. But many people can’t remember any specific event or situation that led to their phobia.

You can develop a phobia at any age, but most specific phobias begin in children aged between seven and 10 years. Sometimes phobias are learnt because the child sees people around them acting fearfully. For instance, they may see someone being scared of a spider. Social phobia may begin during the teenage years. It may follow experiences of being embarrassed or humiliated. Agoraphobia can sometimes start after a panic attack. You may worry about having another one in a similar situation.

Phobias in adults, especially specific phobias, are often a continuation of childhood phobias. Some types of phobia, especially a fear of blood or injury, and social phobia may run in families.

Complications of phobias

If you have a phobia, you’ll try to avoid whatever’s causing your fear and this may cause problems for you.

  • Social phobia can affect your work and relationships, because you may find it difficult to be with other people. You may become very isolated.
  • If you have severe agoraphobia, you may be unable to leave the house. This may stop you seeking help when you need it.
  • A fear of needles can stop you having vaccinations or taking necessary medicines. This might include insulin for diabetes, or chemotherapy for cancer.

You may find that your anxiety causes you to turn to alcohol or tranquilisers. If you’ve been trying to cope with your phobia (especially social phobia) with alcohol or tranquilisers, you’re not alone. You might feel more relaxed at first, but taking alcohol or tranquillisers is very risky because it might become a habit. You may end up having to deal with both your anxiety, and the effects of the alcohol or medicine.

If you have a phobia that affects your daily life, this can affect your mood and lead to depression. You may then be more reluctant to try talking therapies, such as CBT. If you think you may be becoming depressed, contact your GP.

Frequently asked questions

Expand all

  • Can I have more than one phobia at a time?

    Many people have several specific (simple) phobias, fearing more than one object or situation. And more than half of people who have agoraphobia also have social phobia. If you have a phobia, you’re at greater risk of developing other mental health problems. These include panic disorder (a fear of having further panic attacks) and depression.

  • What are some common phobias?

    Some of the more common specific phobias include:

    • animals, especially dogs, snakes and insects
    • situations, such as flying, being in an enclosed space or going to the dentist
    • the natural environment, including thunderstorms, heights, and darkness
    • medical procedures, such as injections or taking blood


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Related information

Antidepressants

Antidepressants are a type of drug that can be used to treat depression and other disorders.

Read more

Anxiety

It’s normal to feel anxious sometimes. But if your anxiety is severe, it can interfere with your everyday life.

Read more

Depression

Read our guide for information about the symptoms, treatment and causes of depression.
Read more

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) is a type of talking therapy. It helps you change how you think, feel and behave.

Read more

Coping with social anxiety

If you suffer from social anxiety, being in certain situations can be a real source of stress.

Read more

Expand all

  • Other helpful websites


    Discover other helpful health information websites.

  • Sources

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    • Social anxiety disorder. BMJ Best practice. bestpractice.bmj.com, last reviewed April 2021
    • Phobic disorders. Medscape. www.emedicine.medscape.com, updated August 2018
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    • Panic disorder. PatientPlus. patient.info/doctor, last edited December 2016
    • Social anxiety disorder. PatientPlus. patient.info/doctor, last edited August 2016
    • Cognitive and behavioural therapies. PatientPlus. patient.info/doctor, last edited April 2014
    • Specific phobic disorders. The MSD Manuals. www.msdmanuals.com, last full review/revision April 2020
    • Agoraphobia. The MSD Manuals. www.msdmanuals.com, last full review/revision April 2020
    • Beta-adrenoceptor blocking drugs. NICE British National Formulary. Bnf.nice.org.uk, accessed May 2021
    • Anxiety and stress-related disorders. Oxford Handbook of Psychiatry (online). Oxford Medicine Online. www.oxfordmedicine.com, published June 2019
    • Mental health. Oxford Handbook of General Practice (online). Oxford Medicine Online. www.oxfordmedicine.com, published June 2020
    • Anxiety, panic and phobias. Royal College of Psychiatrists. www.rcpsych.ac.uk, accessed May 2021
    • Phobias. Mind. www.mind.org.uk, published February 2021
    • How to access mental health services. NHS. www.nhs.uk, last reviewed April 2019
    • Personal communication, Dr Sammad Hashmi, Consultant Psychiatrist, June 2021

  • Author information

    Reviewed by Dr Kristina Routh, Freelance Health Editor, June 2021
    Expert reviewers, Dr Sammad Hashmi, Consultant Psychiatrist
    Next review due June 2024

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