Phobias

What are phobias?

Phobias are intense, irrational fears provoked by a situation or object. The fear response may include all the symptoms of extreme anxiety, including panic (a pounding heartbeat, sweating, shortness of breath, and a sense of impending doom). Fear may be experienced just by the anticipation of coming in contact with the feared matter. The person will make every effort to avoid the feared situation or object due to the discomfort associated with it.

Phobias may be characterized as simple or complex. A simple phobia is triggered by a specific stimulus; common simple phobias include fear of dirt, feces, snakes, spiders, heights, and blood. A complex phobia involves fear of a general situation. For example, agoraphobia is a fear of being in public places and open spaces, and results in a fear of leaving home. With social phobia, a person can become overwhelmingly fearful of situations in which they can be observed; it may be generalized to any social situation, such as a party, or it can be limited to a specific situation such as public speaking or urinating in a public bathroom.

Phobias, especially to animals, may result from a childhood event and actual injury. There can also be a genetic predisposition to phobias, as the fear of needles or blood can run in families.

How is it diagnosed?

History is of fear triggered by a situation or object. The fear appears immediately on contact with the dreaded circumstance, and can occur even with imagined contact. Phobias result in the person making great efforts to avoid the phobic situation. There can be subtle or obvious impairment in the personal, social, academic, or occupational life of the individual.

Physical exam might document changes in respiratory and heart rates when the feared situation is imagined.

Tests do not contribute to these diagnoses.

How are phobias treated?

Phobias are usually treated with behavioral therapy, gradually exposing the individual to the feared situation. Antianxiety medication, beta-blockers, and serotonin-specific reuptake inhibitors, antidepressants are frequently prescribed.

Medications

Information

Brand

Generic

Label

Zoloft

Sertraline

Lexapro

Escitalopram

Paxil

Paroxetine

Celexa (Citalopram), Prozac (Fluoxetine), Xanax (Alprazolam)

What might complicate it?

Limitation and impairment in personal, social, academic, or occupational functioning can result. Major depressive disorder can be a complication.

Predicted outcome

This will vary with the specific kind of phobia.

Alternatives

Other possibilities are acute stress disorder, posttraumatic stress disorder, generalized anxiety disorder, avoidant personality disorder, obsessive-compulsive disorder, hypochondriasis, schizophrenia, or other psychotic disorder. With certain medical disorders (such as diarrhea with Crohn's disease, or convulsions with epilepsy), there could be realistic fears about being in public.

Appropriate specialists

Psychiatrist or psychologist.

Last updated 6 April 2018