Phobias are a strong fear or anxiety towards a specific object or situation. They are irrational fears, that can either be very specific, such as fear of spiders (arachnophobia), or more general in nature, such as agoraphobia.
- Can induce panic and resulting symptoms
- Vary in severity
- Can usually be treated with CBT and antidepressants
Most people with a phobia are not affected by it on a day-to-day basis, as they do not have to encounter the object or situation that they fear regularly. However, some people have severe phobias, where it is a constant worry and they require medical attention. If you are worried about your phobia, our doctors are available to speak to via our online video consultation service.
What is a phobia?
A phobia is a fear of a particular object or situation. It is one of the most common psychiatric conditions, and it has a good prognosis, depending on the severity. A phobia is usually triggered by exposure to the stimuli, however in severe cases of phobia, the person can panic and have anxiety at just the thought of the object or situation.
Some of the most common phobias include aerophobia (fear of flying), arachnophobia (fear of spiders), trypanophobia (fear of injections), acrophobia (fear of heights) and cynophobia (fear of dogs). Agoraphobia and social phobia are examples of more complex phobias, where the situation is difficult to avoid, which can have negative consequences. For example, agoraphobia can lead to some people being completely housebound. Agoraphobia in particular often overlaps with other phobias, such as being afraid of confined spaces (claustrophobia), travelling alone (hodophobia) and not being able to escape in a crowd.
Who develops a phobia?
In the UK, the average prevalence of diagnosed phobias is around 18 in 1000. In the US, the lifetime prevalence is thought to be between 9-13%, making it the most common of the anxiety disorders. Women are significantly more likely to develop phobias than men, except in the case of trypanophobia, where the prevalence is the same. One report from BMJ claims that around 7 in 10 people with a phobia claim that they have more than one stimuli that triggers their phobia.
What causes a phobia?
Phobias can have a number of causes, and it isn't always easy to pinpoint them. Phobias of animals can often occur through physical contact which has led to a traumatic experience, but this is not always the case. It can result from simply observing something negative in various media or seeing someone else react fearfully. There are four main categories for defining phobic stimuli:
- Animal (most commonly dogs, followed by spiders, and snakes)
- Situational (flying, enclosed spaces, etc.)
- Environment (the dark, lightning, heights, etc.)
- Other (fear of clowns, guns, etc.)
The two most notable complications that can result or co-exist with phobias are depressive and anxiety disorders. Depression can affect treatment in terms of someone's engagement with CBT. Anxiety disorders can occur if the person’s phobia is particularly severe. For instance, in the case of agoraphobia, the panic associated with the phobia can lead to the development of panic disorder.
Phobias are very treatable with CBT, and you should contact your local GP if you think your phobia is affecting your daily life. Alternatively, you can use our video consultation service. By booking an appointment, you will be able to speak to one of our UK doctors about your phobia at a time that’s best for you.
How does someone know they have a phobia?
Anxiety UK recommends asking yourself three questions to determine whether or not you have a phobia:
- Do you feel an intense fear towards a particular object or situation?
- Do you try to avoid this?
- Do you get feelings of panic, worry and an eagerness to escape when you come into close contact with the object or situation?
If you answer yes to two or more of these questions, it’s likely that you have a phobia. However, these questions do not account for the possibility of a mild phobia, which may just make you feel uncomfortable without producing panic and worry. Agoraphobia and social phobia are known as complex phobias and are generally far more significant than phobias of specific objects.
How are phobias diagnosed?
Phobias can be diagnosed by a doctor asking questions and looking for behavioural indications, and also by using stimuli to measure someone’s response. It is likely that a questionnaire will have to be completed as well.
A doctor will look to establish some background context: when the phobia began, and to what extent the phobia affects daily life. They will ask you about the nature of the symptoms when you are confronted with the phobia, and how you react to it.
There is unlikely to be any physical examination, but a doctor may want to speak to family members, who may be able to provide more insight if the phobia manifested at an early age.
Do phobias require treatment?
It depends on the severity of the phobia. In mild cases, treatment is not usually required. However, more severe cases where functionality is affected require treatment.
A doctor will not insist that someone with a phobia takes treatment; it is likely that there will be a discussion about what the patient wants from the treatment, and the extent to which they need it.
What treatments are there for phobias?
The first-line treatment for phobias is cognitive behavioural therapy (CBT). This involves educating the person on the psychology of their phobia and challenging the negative thinking that comes with it. Furthermore, the healthcare professional conducting the session will implement gradual exposure to the phobia and relaxation training.
The therapeutic exposure uses objects to expose someone to with increasing intensity. Over the course of the treatment, the exposure will increase in time, which reduces the feelings of fear and changes the behavior of the person when presented with their phobia.
Doctors are also starting to use virtual reality, in combination with CBT, to recreate scenarios in a controlled environment. It's particularly effective for treating fear of heights and fear of flying.
Antidepressants can also be effective in phobias which are severe, and particularly in cases where the person has anticipatory anxiety surrounding the phobia, such as agoraphobia.
What should I do if I think I might have a phobia?
A phobia is a common condition, and many people have a mild one that is not diagnosed. If your phobia causes symptoms similar to that of panic (an increased heart rate, feeling sick, sweating and a dry mouth) you should contact your local GP, who can discuss your phobia and refer you to a specialist to begin CBT.
Are there side effects of phobia treatment?
There are unlikely to be any side effects from phobia treatment. CBT is centred on a process of gradual exposure to a feared stimulus, with a view to reducing panic or associated anxiety.
It is possible however that someone may struggle with the level of fear that stems from replicating a scenario in V.R-related treatment.
Can I consult a doctor about agoraphobia online?
You can consult a doctor online by using our private video consultation service.
Our UK doctors are available to speak to at a time that’s convenient for you, and will be able to help you discuss your phobia in confidence. They can also refer you to a specialist if you need to be treated with CBT.