Phobias

Fear is a normal response to a threat or danger, but phobias are an irrational, or exaggerated response when there is no threat or danger present. They are commonly triggered by animals, objects, or situations. Phobias are a type of anxiety disorder. 

Symptoms of phobia include: 

• shortness of breath
• fast heartrate or palpitations
• nausea (feeling sick)
• dizziness
• trembling
• feeling lightheaded
• upset stomach

Many people with phobias live normal lives by avoiding whatever triggers their phobia, but sometimes phobias can disrupt your daily life and impact your mental health. 

 You may need help dealing with a phobia if: 

• avoiding coming into contact with your phobia affects your everyday life or stops you from doing normal activities. For example, a fear of injections may prevent you from going to the dentist
• being exposed to your phobia causes symptoms of a panic attack (described above)
• you`ve had the phobia for at least six months
• you are aware that your response to the phobia is out of proportion to the actual threat or danger

Many people with phobias don’t experience symptoms until they come into contact with whatever triggers the phobia, but for others even thinking about the phobia can cause anxiety. Some people may even organise their lives to avoid coming into contact with the phobia. 

Phobias fall into 2 main categories, specific or simple phobias, and complex phobias. 

Specific or simple phobias involve a panic response to a specific situation, animal, object, or activity. These types of phobias usually start in childhood or adolescence and often improve as you get older. How much they impact your life depends on how often you come into contact with the source of the phobia. 

Common simple or specific phobias include:

• animals such as spiders, snakes, rats, or dogs
• situations like going to the dentist, flying, or elevators
• environmental phobias like heights, darkness, water, or germs
• body-based phobias like blood, vomit, injections, or medical procedures
• sexual phobias like nudity, performance anxiety, or fear of sexually transmitted infections (STIs) 
• other phobias like costumed characters, certain foods, or objects 

Complex phobias often develop in adulthood and usually have a significant impact on a person’s life. The 2 most common complex phobias are social phobia and agoraphobia. 

Social phobia is characterised by extreme anxiety in social situations. It is sometimes called social anxiety disorder.  If you have social phobia you may worry a lot before, during, and after a social event. You may feel nervous about saying or doing something to embarrass yourself or feel that other people are judging you. In extreme cases, you may avoid social situations, become isolated, and have difficulty forming or keeping relationships. 

Agoraphobia is commonly thought of as a fear of open spaces, but in reality, it is much more complicated. People with agoraphobia have a fear of being in places or situations that might be difficult or embarrassing to escape from if they experience a panic attack. This may include:

• being in an open space
• being alone outside
• being on public transport 
• being in a crowded place
• being in an enclosed space like a shop or elevator

Agoraphobia can have a serious impact on your day-to-day life and many people with the condition find it difficult to leave the house. 

The exact cause of phobias is not known. Simple or specific phobias may be triggered by a past traumatic event, such as being bitten by a dog or trapped in a confined space. 

Phobias can also be learned responses to a situation or object, for example, if your mother had a phobia of spiders, you may “learn” to have the same phobia. 

Other factors that may contribute to phobias include genetics and family environment. Some people may be more genetically likely to develop anxiety-related disorders like phobias and growing up in an environment with anxious parents may influence how you deal with anxiety as an adult. 

It is not known what causes complex phobias such as agoraphobia and social phobia. Possible causes include genetics, brain chemistry, life experiences, or a combination of the three.  

Treatments for phobias include self-help techniques, talking therapies, and medication. The right treatment for you will depend on the kind of phobia you have, and to what extent it impacts your life. Talk to your GP about which treatment may be right for you. 

Problems seeking help for phobias

Sometimes asking for help with your phobia may present problems, especially if your phobia involves fear of medical settings, using the phone, or leaving the house. Here are some things you can do to make asking for help easier:

• Ask your GP if they offer online, phone appointments, or home visits. 
• Make an appointment for the quietest time of day.
• Make an online GP appointment through an online doctors service like Medicspot.
• Ask a friend or family member to accompany you to the appointment. If the GP doesn’t allow them to be with you in the doctor’s office, they can wait for you outside.
• Prepare, or write down what you want to say before your appointment. This may help you to be clearer and reduce anxiety. 

Self-help techniques

Sometimes phobias don’t require medical intervention and self-help techniques can be a good place to start when trying to overcome your phobia. Some things you can try include:

• joining a support group
• making healthy lifestyle choices such as eating a healthy diet, taking regular exercise, getting enough sleep, stopping smoking, and reducing your intake of caffeine and alcohol 
• learning relaxation, visualisation, and breathing techniques 
• talking to someone you trust
• keeping a journal
• reading self-help books
• taking a course for people with your specific phobia 

Talking therapies

Talking therapies such as counselling or cognitive behavioural therapy (CBT) can be very effective in treating phobias. CBT looks at patterns between thoughts, emotions, and behaviour and teaches practical skills to cope with negative behaviour patterns. CBT may also include exposure therapy (desensitisation).

Exposure therapy

Exposure therapy or desensitisation involves gradual exposure to the source of your phobia in a safe, controlled way. The aim is that you will eventually become desensitised and no longer experience symptoms of extreme fear and panic. 

Hypnotherapy

Hypnotherapy involves putting you into a deep state of relaxation (hypnosis) and changing habits or behaviour patterns by examining your memories, thoughts, and subconscious beliefs. Some people find hypnotherapy useful in combatting phobias. 

Medications aren’t usually prescribed for phobias unless your phobia is causing severe anxiety and impacting your quality of life. 

Medications that may be used to treat anxiety include: 

• antidepressants
• tranquilisers 
• beta-blockers

Our doctors can offer some treatments for phobias, but please note they are not able to prescribe benzodiazepines and tranquilizers.

Antidepressants known as selective serotonin reuptake inhibitors (SSRIs) are most commonly used to treat anxiety, social phobia, or panic disorder. If these aren’t suitable for you, your GP may prescribe a different type of antidepressant. Antidepressants normally take 2 to 4 weeks to have an effect, so keep taking your medication even if you feel it isn’t working. As with all medications, antidepressants can cause side effects in some people, so read the patient information leaflet carefully before use. 

Tranquilisers called benzodiazepines are sometimes prescribed to treat severe anxiety that affects your day-to-day life. Benzodiazepines can be addictive and therefore should be prescribed at a low dose for no longer than 4 weeks at a time. 

Beta-blockers work by reducing the physical symptoms of anxiety like fast heart rate, palpitations, or shaking (tremors). They do not help with the psychological (mental) symptoms of anxiety but may make panic attacks easier to deal with. 

NHS: Overview. Phobias  July 27th 2022 (Accessed September 7th 2022) 

Mind: Phobias February 2021  (Accessed September 7th 2022) 

NIH National Library of Medicine: Specific Phobia May 8th 2022 (Accessed September 7th 2022) 

PubMed:  Neurobiology of fear and specific phobias September 2017 (Accessed September 7th 2022) 

PubMed: Recent developments in the intervention of specific phobia among adults: a rapid review March 19th 2020 (Accessed September 7th 2022)