Can interfere with daily life
Irrational fear may be sign of phobia
by By Sylvia Lantz, M.Ed., Coordinator, Psychiatric Program Services, Adult Psychiatric Program

Most of us suffer from some type of fear. As a child, you might not have wanted to turn off the light when you went to bed at night because you were afraid of the dark or the bogeyman that lived in your closet. As an adult you might become anxious about flying, your first day in a new job, germs on countertops, snakes in the basement or bats in the attic.

It is not abnormal to feel uncomfortable about certain objects or situations. However, if you feel intense fear, your heart starts pounding, you have difficulty breathing, your hands sweat, you feel faint and you want to flee from the object or situation, you are suffering from a phobia.

You are not alone. Phobias—persistent, irrational fear of activities, situations or objects that most people consider harmless—are extremely common. Eight to 13 percent of Americans suffer from phobias, and as many as 60 percent of the population has been affected by them at some point in life.

Phobias can interfere with the ability to work, socialize and go about daily routines. They frequently lead to or are accompanied by other problems, such as social isolation, depression, anxiety disorders, substance abuse and eating disorders.

Type of phobias

There are three categories of phobias:

Specific: An irrational fear of specific objects or situations, such as a fear of animals (dogs, cats, snakes, insects, mice), closed spaces or heights.

Social: The fear of being watched or humiliated while doing something in front of other people, such as writing a check, eating a meal or speaking in public.

Agoraphobia: The fear of being alone in any place or situation from which there seems to be no easy means of escape. People suffering from agoraphobia avoid being in busy or crowded places. Some agoraphobics become so disabled they will not leave their homes.
No one really knows what causes phobias, although they tend to run in families and are more common in women than men. Phobias can develop at any point in life, and appear to be more behavioral than genetic. The following causes are associated with phobias:

Externalism: A person who is having difficulties in life may externalize his or her problems into something else, such as a cat.

Trauma: A traumatic event may cause a person to go to great lengths to avoid encounters with the source of fear. For example, someone stung by a bee or bitten by a dog may avoid the outdoors.

Child/parent reaction: A child may learn to fear an object or situation because of parental behavior. This learned behavior may grow into an irrational fear.
A person suffering from a phobia experiences immediate uncontrolled physical and emotional responses to the feared object or situation. Reactions include panic, dizziness, nausea, intense anxiety and difficulty breathing. The anxiety of simply thinking about the source of fear will cause a person to go to great lengths to avoid the object or situation. For example, someone who is afraid of tunnels will drive miles out of the way to avoid going through one.

Help is available

Most people who suffer from phobias recognize the problem, but many don't realize help is available or they are too embarrassed to seek treatment. Any phobia that causes an inability to function in the normal paths of life should be treated.

The first step in seeking help is to have a medical evaluation by a family physician to rule out physical causes. A follow-up appointment with a mental health professional will help to identify triggers and determine if there are co-existing issues such as depression or anxiety disorders.

Treatment for phobias focuses on reducing anxiety and fear and helping the person manage his or her reaction to the feared object or situation. Effective treatment involves medication, behavioral therapy and cognitive behavioral therapy.

Medications including beta-blockers, antidepressants and sedatives are used to control the panic felt during a phobic situation as well as the anxiety caused by anticipation of the situation.

In behavioral therapy, a therapist helps the person become accustomed to the feared object or situation in a planned, gradual way. Cognitive behavioral therapy, the most commonly used approach, teaches skills to master or gain control over the feared object or situation. The goal is to effect a change in the person's belief system through coping strategies to master the fear.

The American Psychiatric Association says most people who seek treatment for phobias completely overcome their fears and are symptom-free for years, if not for life.