Phobia - simple/specific

• Causes, incidence, and risk factors

  Specific phobias are a type of anxiety disorder in which exposure to the feared stimulus may provoke extreme anxiety or a panic attack. Specific phobias are among the most common of all psychiatric disorders, affecting up to 10% of the population.

  Common phobias include the fear of:

  • Blood
  • Certain animals (for instance, dogs or snakes)
  • Flying
  • High places
  • Insects or spiders
  • Lightning

  People with specific phobias often realize their fear is irrational, but are unable to prevent it.

• Symptoms
  • Exposure to the feared object provokes an anxiety reaction.
  • The anxiety and discomfort is out of proportion to the real threat of the feared object.
  • The person may experience excessive sweating, poor motor control, or rapid heart rate.
  • The person avoids situations in which contact with the feared object or animal may occur -- for example, avoiding driving through tunnels, if tunnels are the subject of the specific phobia. This type of avoidance can interfere with job and social functioning.
  • The person may feel weak or cowardly and lose self-esteem when avoiding the object of the phobia.
• Signs and tests

  The health care provider will ask about your history of phobia, and will get a description of the behavior from you, your family, and friends.

  Signs include:

  • Elevated blood pressure
  • Rapid heart rate
• Treatment

  The goal of treatment is to help you function effectively. The success of the treatment usually depends on the severity of the phobia.

  Systematic desensitization is a technique used to treat phobias. You are asked to relax, then imagine the components of the phobia, working from the least fearful to the most fearful. Gradual exposure to the real-life situation has also been used with success to help people overcome their fears.

  Anti-anxiety and antidepressant medications are sometimes used to help relieve the symptoms of phobias. Phobia clinics and group therapy are available in some areas to help people deal with common phobias, such as a fear of flying.

• Expectations (prognosis)

  Phobias tend to be chronic, but they can respond to treatment.

• Complications

  Some phobias may have consequences that affect job performance or social functioning. Some anti-anxiety medications used to treat phobias, such as benzodiazepines, may cause physical dependence.

• Calling your health care provider

  Call for an appointment with your health care provider or a mental health professional if a simple phobia is interfering with life activities.

• References

  Moore DP, Jefferson JW. Specific phobia. In: Moore DP, Jefferson JW, eds. Handbook of Medical Psychiatry. 2nd ed. Philadelphia, Pa: Mosby Elsevier;2004:chap 85.

  Katon W, Geyman JP. Anxiety disorders. In: Rakel RE, ed. Textbook of Family Medicine. 7th ed. Philadelphia, Pa:Saunders Elsevier;2007:chap 57.

Review Date: 12/15/2008

Reviewed By: Linda Vorvick, MD, Family Physician, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Timothy A. Rogge, MD, private practice in Psychiatry, Kirkland, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.