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Health: Phobia

Posted on 29/06/2017 by

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What is a phobia?

A phobia is a type of anxiety disorder. It is an extreme form of fear or anxiety triggered by a particular situation (such as going outside) or object (such as spiders), even when there is no danger.

For example, you may know that it is safe to be out on a balcony in a high-rise block, but feel terrified to go out on it or even enjoy the view from behind the windows inside the building. Likewise, you may know that a spider isn’t poisonous or that it won’t bite you, but this still doesn’t reduce your anxiety.

Someone with a phobia may even feel this extreme anxiety just by thinking or talking about the particular situation or object.

Is a phobia a mental health problem?

Many of us have fears about particular objects or situations, and this is perfectly normal. A fear becomes a phobia if:

  • the fear is out of proportion to the danger
  • it lasts for more than six months
  • it has a significant impact on how you live your day-to-day life

To live in a world full of fear is not living, it is survival.

When should I get help?

It can be difficult to know when to seek treatment for a phobia. If avoidance of the object, activity or situation that triggers your phobia does interfere with your everyday life, or keeps you from doing things you would otherwise enjoy, it may be time to seek help.

Consider getting treatment for your phobia if:

  • it causes intense and disabling fear, anxiety or panic
  • you recognise that your fear is out of proportion to the danger
  • you avoid certain situations and places because of your phobia
  • your avoidance interferes with your normal routine or causes significant distress
  • it stops you getting support for other health problems – for example, it stops you using the phone or seeing the doctor
  • you’ve had the phobia for at least six months

See our information on the self-help and treatment options that are available to help you manage your phobia.

A phobia is only as big as we make it and only as small as we make it. It is what we choose to make it and it can be beaten.

What treatments are available?

If you want treatment for your phobia, the first place to go is normally your GP. They can provide an assessment and explain what treatments are available.

Your GP should explain all of your options, and your views should be taken into account before starting any treatment.

What if my phobia prevents me from seeking help?

It can sometimes be very difficult to seek help for a phobia, especially if making or attending an appointment with your doctor involves experiencing the situation or object that you are fearful of, such as talking on the telephone or leaving the house. If you are worried about visiting your GP you could try:

  • Asking the doctor if they offer home visits or telephone assessments. If not, they might be able to book you an appointment at a time when the surgery is normally at its quietest.
  • Some GP practices will allow you to give consent for someone you trust to ring up and book appointments on your behalf, and sit with you during consultations. If your GP practice won't allow this, it can sometimes help to just have someone walk with you to your appointments and wait for you in the waiting room.
  • If you are worried about talking to your GP, it may help to see our guide on finding the wordsto help you express your feelings and experiences in your appointment.

See our guide to taking the first steps to seeking help for a mental health problem.

There are no treatment guidelines specifically about phobias, but three main types of treatment are recommended for anxiety and panic disorders by the National Institute for Health and Care Excellence (NICE). These should be included in your options:

  • advice and information about self-help – such as self-help books or online programmes, support groups or relaxation (for more information, see our section on self-care)
  • talking treatments
  • medication

Talking treatments

Our talking treatments section has full details on these therapies, and information on how to access them – through the NHS, charities or privately.

Your doctor or mental health professional can explain the options available in your area and help you find the right talking treatment for you. Unfortunately, sometimes NHS waiting lists for talking treatments can be long.

Cognitive behavioural therapy

Cognitive behavioural therapy (CBT) aims to identify connections between thoughts, feelings and behaviour, and to help develop practical skills to manage any patterns that might be causing you problems. When CBT is used to treat phobias, it can include a range of techniques, including exposure therapy (or desensitisation). See our CBTsection for further details.

You may be offered a programme of CBT using a workbook or a computer, which you can follow either by yourself or in addition to sessions with a therapist. This might be particularly helpful if you experience social phobia or agoraphobia, as you can complete the therapy in your own home.

Cognitive Behavioural Therapy changed my life. Through using self-help books, to having professional CBT from my local Community Mental Health Team, I slowly learned how to change my negative thoughts to more realistic ones, and to finally overcome some of my deeply entrenched phobias.

Exposure therapy

Exposure therapy involves gradually exposing you to the object or situation you fear, in a safe and controlled way. For example, if you have a phobia of going to the dentist, you might read about the dentist, then look at a picture of a dentist’s chair, sit in the waiting room and talk to the dentist, before finally sitting in the dentist’s chair. You will agree each of these steps with your therapist.

Through repeated experiences of facing your fear, you may feel an increasing sense of control over your phobia. This technique needs to be carefully managed to avoid causing distress and anxiety, so it is important that you understand the treatment fully and feel comfortable with your therapist.

Hypnotherapy

Many people who have phobias find hypnotherapy helpful for relieving their symptoms. The Complementary and Natural Healthcare Council (CNHC) has a register of hypnotherapists who have trained to national standard level.

Medication

If your phobia causes significant anxiety, you may be offered medication. Currently, there are three classes of drugs considered useful in managing anxiety. These are:

These are only available through your GP and are not available over the counter.

Antidepressants

The most commonly prescribed drugs to treat anxiety are selective serotonin reuptake inhibitor (SSRI) antidepressants. These drugs can be helpful but may cause side effects such as sleep problems and increased anxiety. If SSRIs don't work or aren't suitable, you may be offered a tricyclic antidepressant. (See Antidepressants and A-Z of antidepressants.)

If you have social phobia, you may be offered the reversible MAOI (monoamine oxidase inhibitor) antidepressant moclobemide (Manerix). MAOI antidepressants interact dangerously with certain foods and a warning about which foods to avoid is given with the drugs in the Patient Information Leaflet (PIL).

Tranquillisers

If you experience very severe anxiety that is having a significant impact on your day-to-day life, you may be offered a benzodiazepine tranquilliser, such as diazepam (Valium), to reduce anxiety. Benzodiazepines can be addictive so they should be taken at a low dose and for a short period of time, preferably as a one-off dose and for no longer than four weeks. (See Sleeping pills and minor tranquillisers for more information.)

Beta-blockers

Beta-blockers such as propranolol are sometimes used to treat the physical symptoms of anxiety, such as a rapid heartbeat, palpitations and tremors (shaking). However, beta-blockers are not psychiatric drugs so they don’t reduce any of the psychological symptoms. They may be helpful in certain situations if you have to face a phobia, such as going on an aeroplane.

Beta-blockers can cause side effects, such as sleep problems and nightmares, but they don’t have withdrawal symptoms and are not addictive. Due to the effects they have on the heart and blood pressure, you should stop taking them gradually, by slowly reducing the dose. (For more information, see Coming off psychiatric drugs.)

Source: MIND.org

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