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Phobias

The term ‘Phobia’ comes from the Greek word for fear. Phobias are a class of Anxiety Disorders that include Social Anxiety Disorder, otherwise known as Social Phobia, Agoraphobia and Specific Phobias (for more detail on each of these specific disorders, see the title article). These disorders can cause mild to serious social and lifestyle restrictions. Phobias are characterized by irrational fear resulting in a conscious avoidance of the object, situation, or activity causing the fear. The patient usually recognizes their reaction as extreme. Social Phobia is a strong, persistent fear of a public or interpersonal situation where embarrassment can occur. In some cases, this phobia is limited to a specific situation, like making presentations or performing in front of an audience. In other cases, it is generalized and can include participation in even the most informal family events or casual social gatherings. Agoraphobia is the fear of being alone in public places and can often include specific situations or locations, like driving over a bridge, taking an elevator, or standing in line at a supermarket. In particular, Agoraphobics are afraid of places where a quick exit would be difficult if they have a panic attack and need to leave. 75% of patients with Agoraphobia also have a diagnosed Panic Disorder. Specific Phobia is more common than Social Phobia, and can include fear of certain animals, of heights, water, storms, needles, planes, elevators and enclosed spaces, among other things. Collectively, Phobic Disorders are the most common form of mental disorder, surpassing mood disorders and substance abuse. Anxiety produced by a specific object or situation is the most common subtype of Phobia. Many Specific Phobias can be traced back to a triggering event, at an early age, while Social Anxiety Disorder (Social Phobias), and Agoraphobia may stem from heredity, imbalanced brain chemistry and/or life experiences.

What are the symptoms?

For more detailed information on the symptoms of each disorder, see the related title article.

The following is a summary of symptoms commonly exhibited when a patient is exposed to the central phobic trigger, object or situation:

• Avoidance of trigger, object or situation that causes the phobic reaction
• Cognitive distortions like fear of scrutiny or judgment by others, fear of being trapped without escape
• Elevated heart rate and blood pressure
• Tremors, shaking, palpitations, sweating, dizziness, shortness of breath, nausea, difficulty talking
• Unreasonable, persistent fear or anxiety triggered by an object, activity or situation, fear is out of proportion to the true threat.
• Fear of having symptoms and being unable to control the symptoms and fear.

How is it diagnosed and treated?

Doctors will perform routine medical and psychological testing to rule out other illness or disease, depression, substance abuse and other disorders. The following is a summary of the diagnostic criteria generally applied to Phobias. For specific diagnostic criteria regarding each of the Phobias in this category of disorders, see the related title article.

• Fear is irrational or extreme when compared to the threat or situation
• Patient avoids trigger, situation or object that causes the anxiety
• Fear of the trigger, situation or object is persistent and patient recognizes that it is extreme
• Fear is accompanied by physical and emotional symptoms of anxiety
• Fear restricts social, work and family activities

For detailed treatment information for each of the Phobias in this category, see the related title article. A summary of the treatment(s) used for these disorders can include:

• Cognitive Behavioral Therapy
• Neurolinguistic Programming
• Psychotherapy
• Medication as appropriate: anti-anxiety, beta blockers, SSRIs, MAOIs, benzodiazepines.
• Graduated Exposure Therapy
• Graduated Exposure Therapy
• Desensitization
• Virtual Reality Exposure to triggers, if appropriate and available

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