What is a phobia?

A phobia is an uncontrollable, irrational, and lasting fear of a certain object, situation, or activity. This fear can be so overwhelming that a person may go to great lengths to avoid the source of this fear. One response can be a panic attack. This is a sudden, intense fear that lasts for several minutes. It happens when there is no real danger.

Who is affected by phobias?

About 19 million Americans have one or more phobias that range from mild to severe. Phobias can happen in early childhood. But they often first occur between ages 15 and 20. They affect both men and women equally. But men are more likely to seek treatment for phobias.

What causes phobias?

Research suggests that both genetic and environmental factors contribute to the start of phobias. Certain phobias have been linked to a very bad first encounter with the feared object or situation. Mental health experts don’t know if this first encounter is necessary or if phobias can simply occur in people who are likely to have them.

What are the main types of phobias?

Specific phobia

Specific phobia is an extreme fear of an object or situation that typically isn't harmful.

Examples may include a fear of:

• Flying (fearing the plane will crash)

• Dogs (fearing the dog will bite or attack)

• Closed-in places (fear of being trapped)

• Tunnels (fearing a collapse)

• Heights (fear of falling)

What causes specific phobia?

People with a specific phobia know that their fear is extreme. But they can't overcome it. The problem is diagnosed only when the specific fear interferes with daily activities of school, work, or home life.

There is no known cause, although they seem to run in families. They are also found slightly more often in women. If the object of the fear is easy to avoid, people with phobias may not seek treatment. But sometimes they may make important career or personal decisions to avoid a situation that includes the source of the phobia.

Treatment for specific phobia

When phobias interfere with a person's life, treatment can help. For specific phobias, cognitive behavioral therapy (CBT) with exposure treatment is advised. In exposure therapy, people are gradually exposed to what frightens them until the fear starts to fade. Relaxation and breathing exercises also help to ease symptoms.

Social phobia

Social phobia is an anxiety disorder in which a person has significant anxiety and discomfort related to a fear of being embarrassed, humiliated, or scorned by others in social or performance situations. Even when they manage to confront this fear, people with social phobia usually:

• Feel very anxious before the event or outing

• Feel intensely uncomfortable throughout the event or outing

• Have lingering unpleasant feelings after the event or outing

Social phobia often happens with the following:

• Public speaking

• Meeting people

• Dealing with authority figures

• Eating in public

• Using public restrooms

What causes social phobia?

Although this disorder is often thought of as shyness, they are not the same. Shy people can be very uneasy around others, but they don't have the extreme anxiety in anticipating a social situation. Also, they don't necessarily avoid circumstances that make them feel self-conscious. In contrast, people with social phobia are not necessarily shy at all and can be completely at ease with some people most of the time.

Most people with social phobia will try to avoid situations that cause distress.

Diagnosing social phobia

Social phobia is diagnosed when the fear or avoidance significantly interferes with normal routines or is excessively upsetting.

Social phobia disrupts normal life, interfering with career or social relationships. It often runs in families and may happen along with depression or alcoholism. Social phobia often starts in early adolescence or even younger.

Treatment for social phobia

People with social phobia often find relief when treated with cognitive behavioral therapy, medicine, or a mix of both.

Agoraphobia

Agoraphobia involves the fear of having a panic attack in a place or situation from which escape may be hard or embarrassing.

The anxiety of agoraphobia is so severe that panic attacks are not unusual. People with agoraphobia often try to avoid the location or cause of their fear. Agoraphobia involves fear of situations like the following:

• Being alone outside their home

• Being at home alone

• Being in a crowd

• Traveling in a vehicle

• Being in an elevator or on a bridge

People with agoraphobia typically stay out of crowded places like streets, crowded stores, churches, and theaters.

What causes agoraphobia?

Most people with agoraphobia get it after first suffering a series of panic attacks. The attacks happen randomly and without warning and make it impossible for a person to predict what will trigger the reaction. This unpredictability of the panic causes the person to anticipate future panic attacks and, eventually, fear any situation in which an attack may happen. As a result, they avoid going into any place or situation where previous panic attacks have happened.

People with the disorder often become so disabled that they literally feel they can't leave their homes. Others who have agoraphobia do go into potentially "phobic" situations, but only with great distress, or when accompanied by a trusted friend or family member.

People with agoraphobia may also have depression, fatigue, tension, alcohol or drug abuse problems, and obsessive disorders, making treatment crucial.