Persistent and irrational fears of, and a compelling desire to avoid, particular objects, activities, or situations

  • Most commonly develop from late childhood to early adulthood
  • Gender and genetics as risk factors depend on the type
  • Lifestyle is not a significant factor

Many people have particular fears, such as a fear of dogs or heights, that are upsetting occasionally but do not disrupt their everyday activities. A phobia is a fear or anxiety that has been carried to extremes. A person with a phobia has such a compelling desire to avoid contact with a feared object or situation that it interferes with normal life.

Being exposed to the subject of the phobia causes a panic reaction of severe anxiety, sweating, and a rapid heartbeat. A person with a phobia is aware that this intense fear is excessive or unreasonable but still feels anxiety that is alleviated only by avoiding the feared object or situation. This may disrupt routines and limit the person’s capacity to take part in new experiences. About 1 in 10 people in the UK has a phobia. Phobias usually develop in late childhood, adolescence, or early adult life.

What are the types?

Phobias take many different forms, but they can be broadly divided into two types: simple and complex phobias.

Simple phobias

Phobias specific to a single object, situation, or activity, such as a fear of spiders, heights, or air travel, are called simple phobias. For example, claustrophobia, a fear of enclosed spaces, is a simple phobia. A fear of blood is a common simple phobia that affects more men than women.

Complex phobias

More complicated phobias that have a number of component fears are described as complex phobias. Agoraphobia is an example of a complex phobia that involves multiple anxieties. These fears may include being “looked at” when outdoors or being trapped in a public area with no exit to safety. The kind of situations that provoke agoraphobic anxiety include using public transport and lifts, and visiting crowded shops. Tactics to avoid these situations may disrupt work and social life, so that a person with severe agoraphobia may eventually become unable to leave the house. Agoraphobia occasionally develops in middle age and is more common in women.

Social phobias are also classified as complex phobias. People with a social phobia have an overwhelming fear of embarrassing themselves or of being humiliated in front of other people in social situations, such as when they are eating or speaking in public.

What are the causes?

Often, there is no reasonable explanation for the phobia, but occasionally a simple phobia can be traced to an earlier experience. For example, being trapped temporarily in a confined enclosed space during childhood may lead to claustrophobia in later life. Simple phobias appear to run in families, but this is thought to be because children “learn” rather than inherit their fear from a family member with a similar phobia.

The causes of complex phobias, such as agoraphobia and social phobia, are unclear, but they may develop from a tendency to be anxious. Agoraphobia sometimes develops after an unexplained panic attack. Some people recall a stressful situation as the trigger for their symptoms and then become conditioned to be anxious in similar circumstances. Most social phobias also begin with a sudden episode of intense anxiety in a social situation, which then becomes the main focus of the phobia.

What are the symptoms?

Exposure to or simply thinking about the object, creature, or situation that generates the phobia leads to intense anxiety accompanied by:

  • Dizziness and feeling faint.

  • Palpitations (awareness of an abnormally rapid heartbeat).

  • Sweating and trembling.

  • Nausea.

  • Shortness of breath.

A factor that is common to every phobia is avoidance. Activities may become limited because of fear of unexpectedly encountering the subject of the phobia, and this may lead to depression. Persistent anxiety and panic attacks (see Anxiety disorders) may develop. Sometimes, a person with a phobia attempts to relieve fear by drinking too much alcohol or abusing drugs.

What might be done?

If you have a phobia that interferes with your life, you should seek treatment. Many simple phobias can be treated effectively using a form of behaviour therapy, such as desensitization (see Desensitization therapy). During treatment, a therapist gives support while you are safely and gradually exposed to the object or situation that you fear. Inevitably, you will experience some anxiety, but exposure is always kept within bearable limits. In addition, you may be prescribed antidepressant drugs as some are useful in the treatment of certain complex phobias.

Members of your family may be given guidance on how to help you cope with your phobic behaviour. You may benefit from contacting a self-help group.

What is the prognosis?

A simple phobia often resolves itself as a person gets older. However, complex phobias, such as social phobias and agoraphobia, tend to persist unless they are treated. More than 9 in 10 people with agoraphobia are treated successfully with desensitization therapy.

From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.

The subjects, conditions and treatments covered in this encyclopaedia are for information only and may not be covered by your insurance product should you make a claim.

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