Specific phobias involve persistent, unrealistic, intense anxiety about and fear of specific situations, circumstances, or objects.
The anxiety caused by a phobic disorder can interfere with daily living because people avoid certain activities and situations.
The diagnosis is usually obvious based on symptoms.
Treatment usually consists of exposure therapy.
Specific phobias are common anxiety disorders that affect about 8% of women and 3% of men yearly. The most common specific phobias include fear of animals (zoophobia), fear of heights (acrophobia), and fear of thunderstorms (astraphobia or brontophobia). At least 5% of people are to some degree afraid of blood, injections, or injury, which can lead to avoidance of blood tests and/or vaccinations. People who have a specific phobia often have 2 or more phobias.
People who have a specific phobia avoid specific situations or objects that trigger their anxiety and fear, or they endure them with great distress, sometimes resulting in a panic attack. However, they recognize that their anxiety is excessive and therefore are aware that they have a problem.
Some specific phobias cause little inconvenience. For example, a city dweller who is afraid of snakes may have no trouble avoiding them. Other specific phobias greatly interfere with functioning. For example, a city dweller who fears elevators may encounter them frequently and thus be routinely faced with a difficult choice: avoid an important work situation, climb many stairs, or endure the elevator ride with great discomfort.
Symptoms of Specific Phobias
People with a specific phobia develop marked fear or anxiety in response to a specific object or situation. They may try to manage their fears and anxieties through avoidance.
Diagnosis of Specific Phobias
A doctor's evaluation, based on standard psychiatric diagnostic criteria
Doctors diagnose a specific phobia when people have fear or anxiety that involves all of the following:
Is intense and has been present 6 months or longer
Concerns a specific situation or object
Occurs immediately when the situation or object is encountered
Leads to avoidance of the situation or object
Is out of proportion to the actual danger
Causes significant distress or significantly impairs functioning
Also, doctors rule out other mental health disorders that can cause similar symptoms, such as agoraphobia, social anxiety, or a stress disorder. It is also possible for a person to have a specific phobia along with another mental health condition, such as the anxiety disorders already mentioned, depression, bipolar disorder, substance-related disorders, somatic symptom and related disorders, and personality disorders—particularly dependent personality disorder.
Treatment of Specific Phobias
Exposure therapy
Relaxation and/or breathing techniques (for example, hypnosis)
Sometimes limited use of medications (for example, a benzodiazepine or beta-blocker)
Some people do well without treatment because the situation or object they fear is easy to avoid. Bats and caves are examples. If situations or objects (such as thunderstorms) are commonly encountered, treatment is often needed.
Exposure therapy, a type of psychotherapy, is the treatment of choice. Exposure therapy involves exposing people gradually and repeatedly—in their imagination or sometimes in reality—to whatever triggers their fear. People are also taught relaxation and/or breathing techniques to use before and during exposure. Exposure therapy is repeated until people become very comfortable with the anxiety-provoking situation. A therapist can help ensure that the therapy is carried out correctly, although people can do it on their own.
Exposure therapy helps more than 90% of people who do it faithfully. It is almost always the only treatment needed for specific phobias. Even people with a phobia of blood or needles respond well to exposure therapy. For example, such people might begin the exposure by just visiting a doctor's office (or perhaps just walking by the office). The next day (or week), they might sit in an exam room with no intention of getting any blood drawn. The next step might be allowing a needle to be brought close to their skin. Exposure may increase quickly or slowly, but eventually people should allow blood to be drawn.
Medications
More Information
The following English-language resource may be useful. Please note that THE MANUAL is not responsible for the content of this resource.
National Institute of Mental Health, Specific Phobia: General information on many aspects of specific phobias, including prevalence statistics
