Phobias are generally underreported
Fear is an important basic human emotion that alerts us to a perceived danger. In normal situations, we regain self-control after a while once the fear is triggered, but when fears start to control us as that seen in patients suffering from phobias, anxieties or panic attacks, our lives may be under constant stress. Akin to all other emotions, fear can be mild, moderate, or intense, depending on the individual and the circumstances in which the emotion is brought out.
A phobia is an unreasonable, intense and persistent fear of particular situations, activities, people, things, or animals, which actually has little or no real danger. Phobias are generally underreported, as many sufferers may not usually seek medical help or manage to find ways to avoid the situations or things to which they are afraid. Although statistics estimating prevalence of phobias vary widely, this illness has been reported to affect up to 7 to 13% of the population in western countries. Phobias can limit work efficiency, reduce self-esteem, disrupt daily routines, and place a strain on relationships because people will do whatever they can to avoid the often-terrifying feelings of phobic anxiety.
Usually people suffering from phobias try to avoid what they are afraid of. When this is not possible, they may experience the following symptoms:
• Rapid heartbeat
• Shortness of breath
• Nausea or stomach discomfort
• An overwhelming urge to escape the situation
• Fear of fainting or losing control
Phobias Causes and Risk Factors
There is no one specific known cause for phobias. However, it is thought to run in families, may be influenced by culture, and can be triggered by life events which had occurred in the past. Immediate family members of phobic individuals are more likely to suffer from phobias than those without similar family history. Although some phobias develop in childhood, most seem to happen during adolescence or early adulthood.
Phobias may affect people of all the ages, income levels and walks of the life. Nevertheless, women seem to be twice as likely to be diagnosed with a phobia compared to men. Alcoholics are up to ten times more likely to suffer from phobias than those who are not alcoholics, and people suffering from phobias can be twice more likely to be addicted to alcohol than those who have never been phobic.
The following are common risk factors for phobias:
• Female gender
• Having experienced traumatic life events such as childhood sexual or physical abuse
• Having a tendency to be anxious
• Alcohol or substance abuse disorder
• Having panic disorder
Types of Phobias
According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), there are 3 kinds of phobias:
• Social phobia - fears involving other individuals or social situations such as fear of public speaking, meeting new people, performance anxiety or fears of being scrutinized by others. Social phobia may be further categorized into the following:
o Generalized social phobia – this is also known as social anxiety disorder
o Specific social phobia – this type of anxiety is triggered only in specific situations.
• Agoraphobia - Generalized fear of leaving home or a familiar area. Commonly feared places and situations are bridges, elevators, public transportation, shopping malls and driving.
• Specific phobias - fear of single items or specific situations such as lizards, spiders, snakes, heights, flying, contagious illness, etc.
Some of the commonly experienced phobias are:
• Nyctophobia – fear of dark
• Glossophobia – fear of public speaking
• Aviophobia – fear of flying
• Acrophobia – fear of heights
• Hydrophobia – fear of water
• Atychiphobia – fear of failure
• Claustrophobia – fear of closed spaces
• Monophobia – fear of being alone
• Ophidiophobia – fear of snakes
• Dhanatophobia – fear of death
Management of Phobias with cognitive behavioral therapy, medications and alternative therapies
An effective and most frequently used treatment for phobias is a type of cognitive-behavioral therapy (CBT) called systematic desensitization or exposure therapy. This method helps phobic individuals by supportively and gradually exposing them, first in the imagination and then in reality, to circumstances that are similar to the one they are phobic about. With each exposure, there’s an increasing sense of control over the phobia.
Cognitive Behavior Therapy
Cognitive behavioral therapy has been found to significantly decrease phobic symptoms by helping the individual with phobia understand the cycle of negative thought patterns, and ways to change his or her way of thinking. This is accomplished through three techniques:
• Didactic component - helps to set up positive reinforcement for therapy.
• Cognitive component - helps to identify the thoughts that influence the person's behavior and predisposes him or her to being phobic.
• Behavioral component - uses behavior-modifying techniques to teach the phobic person effective strategies for dealing with problems.
Sometimes antidepressant medications are used to treat phobias, particularly when CBT and desensitization are inadequate. Medications are prescribed to balance the chemicals in the brain and these include prescription of selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil); and benzodiazepines such as diazepam (Valium), and alprazolam (Xanax). Many phobias are best treated with a combination of medications and CBT.
Hypnotherapy along with neuro-linguistic programming can also be used to help remove the triggers of a phobic reaction. Hypnotherapy is based in the principle that phobias exist in the subconscious mind and when the phobic individual is put into a hypnotic state, the subconscious mind can be accessed directly and made open to suggestions, without the interference of the conscious mind.
In addition, relaxation techniques such as deep breathing, meditation, yoga, visualization techniques and progressive muscle relaxation are other effective measures to overcome mild anxiety, panic and fear, when practiced regularly.