Phobia comes from the Greek word ‘Phobos’ that means fear or horror. It has the power to alter the life of a person, making them live in false threat forever. In the US itself, nearly 19 million people grapple with phobias. 

A person with it will always feel anxious and distressed whenever being exposed to their trigger for phobias. It can even restrict their routine functioning and lead to (sometimes) panic attacks. 

What Is A Phobia?

Phobia is an excessive and unreasonable fear from some specific trigger(s). It’s diagnosable as a mental disorder and causes anxiety issues due to extreme fear about a situation, living creature, place, or object.

Types Of Phobias

There are mainly three types of phobia recognized by the American Psychiatric Association (APA).

• Agoraphobia

Agoraphobia is a fear of any place where escape may be ticky like, any crowded area of travel or open spaces.  They can even have difficulty getting on a bridge or in an elevator. Congested markets, enclosed spaces such as shops and cinemas, traveling in a car, bus, or airplane, or even being outside from home alone can trigger a panic attack. 

Those having Agoraphobia can also have an increased risk of panic disorder. The distress can typically last for six months, and in severe cases, it can make a person entirely unable to leave home. Its initial onset is late adolescence or early adulthood, but in some cases, it has occurred in childhood too.  In terms of gender, women are twice as likely as men to have Agoraphobia. 

An Agoraphobia person can restrict themselves to a zone of safety like their home or their immediate neighborhood. In such an event, leaving the safety zone can cause anxiety and panic in them. They may become dependent on other family members or any trusted person completely, to do their shopping and other household errands. It can also make them unable to work. 

• Social Phobia or Social Anxiety Disorder

Social phobia or social anxiety disorder is an excessive self-consciousness or unreasonable fear of being around people.  Such a social anxiety disorder can cause acute and persistent fear about being seen and judged by others. 

The fear can make them uncomfortable in any social situation like a large social gathering and festive get-togethers. They constantly get anxious about being singled out and feel embarrassed or humiliated by their actions. The severity of fear can also interfere with their work, school, or other activities. 

In most cases, social phobia or social anxiety disorder runs in the families.  It may even be accompanied by depression or other anxiety ailments, like panic disorder or obsessive-compulsive disorder. It mostly develops in childhood or early adolescence, but it can rarely affect a person above 25. Even though most men seek help for their condition, women are twice more susceptible than men to social phobias. 

• Specific Phobias 

It’s a fear related to some specific trigger. People having specific phobia know there is no real reason to be afraid, and their behavior is not logical. Yet, they get stunned when faced with their fear, leading to extreme anxiety. 

The Diagnostic and Statistical Manual of Mental Disorders (DSM) categorizes the specific phobia into five broad segments

• Animals – Like fear of spiders, dogs, birds, snakes, or bugs
• Natural environment – Like a fear of heights, darkness, moon, sun, or thunderstorms
• Blood, injury, and injection (BII) – Like fear of needles, accidents, or medical procedures
• Situational – Like fear of flying, riding a car, cooking, or riding in elevators
• Others – Like a fear of vomiting, sleep, or choking

A person can have a specific phobia at any age, but customarily it starts in childhood or adolescence. The symptoms of a specific phobia can be lifelong. Like other types of phobias, specific phobia also affects women twice as likely as men. 

Further, if a phobia affects the overall well-being of a person, it becomes a complex phobia. Say a person has Agoraphobia. He can also have other specific phobias with it, like Claustrophobia – fear of closed spaces or Xenophobia – fear of strangers or foreigners. Together, it can make everything challenging for a person, even to leave home.

Common Symptoms of Phobias

• A sense of uncontrollable anxiety while being exposed to the source of fear
• An active desire to avoid the source of fear at all costs
• Inability to function appropriately when exposed to the trigger
• Having the realization  of the irrationality, unreasonableness, and exaggeration behavior towards the fear and yet remain unable to control the feelings

Other Physical Effects of Phobia

• sweating
• abnormal breathing
• accelerated heartbeat
• trembling
• hot flashes or chills
• a choking sensation
• chest pains or tightness
• butterflies in the stomach
• pins and needles
• dry mouth
• confusion and disorientation
• nausea
• dizziness
• headache

 Symptoms of Agoraphobia

• Fear or anxiety about:
  • Being or going outside the home alone
  • Using public transport
  • Being in enclosed places like retail stores, movie theaters, etc.
  • Standing in a line 
  • Being in a crowd place
  • Being in open spaces like malls, markets, parking lots, etc.
  • Being in areas with a lack of escape routes

• Active avoidance of all sources of their fear 
• Being housebound or remain confined at home for prolonged periods
• The detached or estranged feeling from others
• Feelings of helplessness
• Dependence upon others
• Signs of acute/severe anxiety or panic attack 

 Symptoms of Social Phobia

• Feeling fear of being observed in social situations like 
  • Meeting strangers
  • Eating or drinking in public space
  • Giving a speech or performance
• Having fears of causing embarrassment or being negatively evaluated
• Always having intense anxiety when exposed to social situations 
• Avoidance behavior to escape a social situation
• Feeling out of proportion fear or anxiety in a social situation and considering it as an actual threat
• Persistent fear or anxiety that typically lasts for six months or longer
• The avoidance behavior, anxious anticipation, or distress feelings, affecting the social, academic, or occupational functioning of an individual significantly.

• Other Physical Symptoms of Social Phobia
  • Blushing/ sweating/ trembling experience with a rapid heart rate, or feeling the mental numbness
  • Nausea 
  • Having a rigid body posture, 
  • Poor eye contact or speaking too quietly

Symptoms of Specific Phobia

• Intense fear or anxiety connected to a specific object or situation, resulting in
  • Crying
  • Stiffening
  • Clinging to another person
  • Avoiding or escaping the situation
• The concerned object or the specific situation always provokes immediate fear or anxiety response.
• Avoidance behavior towards the object or situation of fear
• Dis-proportional fear towards the object or situation which otherwise may not dangerous
• Fear or anxiety affecting the routine lifestyle of an individual gravely
• Full panic attack (in some cases) when exposed to the feared object or situation
• Children, specifically reacting to such phobias with crying, tantrums, freezing, or clinging.

Most Common Types of Specific Phobias

The most common specific type of phobias found in the U.S. are listed here

• Claustrophobia: Fear of being in cramped, confined spaces
• Aerophobia: Fear of flying
• Arachnophobia: Fear of spiders
• Driving phobia: Fear of driving a car
• Emetophobia: Fear of vomiting
• Erythrophobia: Fear of blushing
• Hypochondria: Fear of becoming ill
• Zoophobia: Fear of animals
• Aquaphobia: Fear of water
• Acrophobia: Fear of heights
• Blood, injury, and injection (BII) phobia: Fear of injuries involving blood
  • Escalaphobia: Fear of escalators
  • Tunnel phobia: Fear of tunnels

  Causes of Phobias

  Phobias mostly don’t start at the age of 30 all of sudden. It takes roots in early childhood, the teenage years, or early adulthood. Any stressful experience, or a frightening event, can cause a phobia. If a parent or any family member has a phobia, it can also cause a child to ‘learn.’

  • Agoraphobia

  Most phobias develop in the combination of life experiences, psychological traits, and genetic factors. In 61 percent of cases, heritability is the cause of Agoraphobia in people linking it to a genetic predisposition to phobias.

  The other external factors causing Agoraphobia have been known to be associated with experiencing stressful life events like the death of a parent, being physically attacked, or mugged. Additionally, a child raised in a household with little warmth and high levels of overprotection can develop it. 

  • Social Phobia or Social Anxiety Disorder

  Research is still going on to ascertain the specific causes of social phobia. However, as per studies conducted by the National Institute of Mental Health (NIMH), first-degree relatives have a two to six times greater chance of developing a social anxiety disorder than others. 

  Currently, studies are also going on to investigate the environmental influences on it. But, maltreatment of children and adverse behavior towards them can cause social anxiety disorder in later years.

  • Specific Phobias 

  The exact cause might be unknown, but certain specific factors or personality traits like neuroticism can be more at risk of developing a specific phobia than others. A person with neurotic personality traits has low emotional stability. Their frequent worries and negative thoughts can trigger specific phobias. 

  Similarly, specific factors that influence life experiences can cause a specific phobia. These factors can be 

  • having overprotective parents, 
  • losing a parent, 
  • sexual or physical abuse,
  • trauma 

  In terms of a genetic cause, those with a first-degree relative with a specific phobia can be more susceptive to it than others. 

  What happens inside the brain in phobia?

  Investigations by researchers implicate a small structure in the brain called the amygdala (a central site in the brain, behind the pituitary gland) that controls fear responses linked to phobias. It stores and recalls unsafe or potentially deadly events of life. 

  When a person faces a similar situation, the brain retrieves the stressful memory, causing the body to experience the same reaction. In a phobia, the amygdala keeps recovering the frightening event inappropriately, leading to a panic attack or anxiety.

  Treatment of Phobias

  First of all, phobias are treatable!

  Most people are aware of their phobias, and it helps in their diagnosis and treatment. Speaking to a psychologist or psychiatrist can be useful before initiating any treatment.

  People who do not suffer from severe effects of phobias often learn to manage their fears. They try to avoid its source if it helps them to stay in control. However, avoidance behavior does not work in the case of complex phobias. For such cases, speaking to a mental health professional can become the first step to recovery. 

  There is no blanket treatment for phobias for every person. But a doctor, psychiatrist, or psychologist can tailor it to the individual for it to work. The most common recommendations include medications and therapy or a combination of both. It benefits people to control their symptoms of anxiety or panic. It helps them manage their reactions to the object of their phobia.

  Medications

  Medications help people suffering from Agoraphobia and social phobias (Social Anxiety Disorder) to prevent panic attacks or reduce their frequency and severity. 

  • Antidepressants

  The most common medications used to treat Agoraphobia and social phobias include Serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOI). The treatment gets tailored as per the individual requirement. The doctor adjusts the dose and combinations of medication based on the recovery rate of a person. But remember, it can take a while to recover fully.

  Also, there are side effects to SSRIs and MAOI, which a person must consider before taking medications. 

  SSRIs may cause nausea, sleeping problems, and headaches.  

  MAOI may cause side effects like dizziness, an upset stomach, restlessness, headaches, and insomnia.

  • Beta-Blockers

  It helps to treat the physical symptoms of social phobias, like anxiety and lowers the heart rate. However, it also has side effects like upset stomach, fatigue, insomnia, and cold fingers.

  • Tranquilizers

  Benzodiazepines for tranquilizers may help reduce anxiety symptoms. But the Food and Drug Administration (FDA) has warned of its usage currently. It can lead to physical dependence and withdrawal symptoms in people. 

  It is essential to follow the instructions of a licensed medical professional whenever using these drugs.

  Behavioral Therapy

  Cognitive Behavioural Therapy is highly successful in the treatment of phobias. 

  • Desensitization / Exposure Therapy

  Systematic desensitization or exposure therapy can help the agoraphobic person function effectively. It teaches a person techniques of relaxation and then gradually exposes them to the feared situation. It helps them to understand their fears in a controlled environment. It has been used with success to help people overcome their fears. It has effectively improved the morale and quality of life of agoraphobic people in 75 percent of cases.

  • Cognitive Behaviour Therapy (CBT)

  CBT is a psychotherapy that has helped treat  social phobias, specific phobia disorder, and Agoraphobia. It mostly takes at least 8 to 12 weeks to change the behavior of an agoraphobic person with CBT.

  While treating social anxiety disorders, CBT helps a person in three stages: 

  • It introduces the person with a feared situation
  • It helps a person build their confidence to handle rejection or criticism by increasing the risk for disapproval in that situation.
  • It teaches a person coping mechanisms to handle the disapprovals.

  For treating specific phobias, psychotherapists combine CBT with exposure therapy. The therapist gradually guides a patient through real or virtual exposure of the feared object and, at times, combines it with relaxation exercises. Currently, virtual reality has become a promising medium for delivering exposure therapy to patients with specific phobias. 

  Takeaway

  Phobias can cause genuine and continuous distress for a person. However, phobias are treatable and sometimes avoidable too. Moreover, always follow the treatment instructions given by medical professionals for medications and therapy. Lastly, if you have a phobia, never be afraid to seek help about it.