Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Symptoms of phobias often involve having a panic attack -- in that they include feelings of panic, dread, or terror, despite recognition that those feelings are excessive in relationship to any real danger -- as well as physical symptoms like shaking, sweating, trouble thinking clearly, nausea, rapid heart beat, trouble breathing, and an overwhelming desire to escape the situation that is causing the phobic reaction. Also, extreme measures are sometimes taken to avoid or escape the situation.
How are phobias assessed?
Many providers of health care may help diagnose
phobias, including licensed mental-health therapists, family physicians, or other
primary-care medical providers, specialists whom you see for a medical
condition, psychiatrists, psychologists, and social workers. If one of these
professionals suspects that you may be suffering from a phobia, you will likely
be asked a number of questions to understand all the symptoms you may be
experiencing and you may need to submit to a medical interview and physical
examination. A phobia may be associated with a number of other mental-health
conditions, especially other anxiety disorders. In addition to panic disorder, examples of other anxiety disorders include generalized anxiety disorder (GAD), obsessive compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). As anxiety disorders in general
may be associated with a number of medical conditions or can be a side effect of
various medications, routine laboratory tests are often performed during the
initial evaluation to rule out other possible causes of the symptoms.
What is the treatment for phobias?
Helping those who suffer from phobias is thought to be most effective when psychotherapy and medications that are specific to the treatment of phobia are both used. One form of psychotherapy involves the supportive and gradual exposure of the individual with phobias to circumstances that are increasingly close to the one they are phobic about (desensitization). These situations can either consist of actual or computer-generated anxiety-provoking stimuli.
Cognitive behavioral therapy (CBT) has been found to significantly decrease
phobic symptoms by helping the phobia sufferer change his or her way of
thinking. CBT uses three techniques to accomplish this goal:
Didactic
component: This phase involves educating the individual about phobias and treatment and helps to set up positive expectations for therapy and promote the cooperation of the person with a phobia.
Cognitive component: It helps to
identify the thoughts and assumptions that influence the person's behavior,
particularly those that may predispose him or her to being phobic.
Behavioral
component: This employs behavior-modifying techniques to teach the individual with a
phobia more effective strategies for dealing with problems.
Selective serotonin
reuptake inhibitor (SSRI) medications are often used to treat phobias,
particularly when desensitization and CBT are inadequately effective. These
medications affect levels of serotonin in the brain. Examples of these
medications include fluoxetine (Prozac), sertraline (Zoloft), paroxetine
(Paxil), fluvoxamine (Luvox), citalopram (Celexa), and escitalopram (Lexapro).
The possible side effects of these medications can vary greatly from person to
person and depend on which medication is being used. Common side effects of this
group of medications include dry mouth, sexual dysfunction, nausea, tremors,
trouble sleeping, blurred vision, constipation or soft stools, and dizziness. In
very rare cases, some people have been thought to become more acutely more
anxious or depressed once on the medication, even trying to or completing
suicide or homicide. Children and teens are thought to be particularly
vulnerable to this rare possibility.
Phobias are also
sometimes treated using beta-blocker medications, which decrease the physical symptoms associated with panic by blocking the effects that adrenaline has on the body. An example of a beta blocker is propranolol. These
disorders are less commonly treated with drugs in a medication class known as
benzodiazepines. This class of medications causes relaxation but is used much
less often these days to treat anxiety due to the possibility of addiction and
the risk of overdose, especially if taken when alcohol is also being consumed.
Examples of medications from that group include diazepam (Valium), alprazolam
(Xanax), lorazepam (Ativan), and clonazepam (Klonopin).
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Panic attacks are sudden feelings of terror that strike without warning. These episodes can occur at any time, even during sleep. A person experiencing a panic attack may believe that he or she is having a heart attack or that death is imminent. The fear and terror that a person experiences during a panic attack are not in proportion to the true situation and may be unrelated to what is happening around them. Most people with panic attacks experience several of the following symptoms: racing heartbeat, faintness, dizzyness, numbness or tingling in the hands and fingers, chills, chest pains, difficulty breathing, and a feeling of loss or control. There are several treatments for panic attacks.
Stress occurs when forces from the outside world impinge on the individual. Stress is a normal part of life. However, over-stress, can be harmful. There is now speculation, as well as some evidence, that points to the abnormal stress responses as being involved in causing various diseases or conditions.
Alcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law.
Post-traumatic stress disorder (PTSD), a psychiatric condition, can develop after any catastrophic life event. Symptoms include nightmares, flashbacks, sweating, rapid heart rate, detachment, amnesia, sleep problems, irritability, and exaggerated startle response. Treatment may involve psychotherapy, group support, and medication.
Bipolar disorder (or manic depression) is a mental illness characterized by depression, mania, and severe mood swings. Treatment may incorporate mood stabilizer medications, antidepressants, and psychotherapy.
Agoraphobia is a fear of being outside or of being in a situation from which escape would be impossible. Symptoms include anxiety, fear, disorientation, rapid heartbeat, diarrhea, or dizziness. Treatment may incorporate psychotherapy, self-exposure to the anxiety-causing situation, and medications such as SSRIs, benzodiazepines, and beta blockers.
Separation anxiety disorder is a common childhood anxiety disorder that has many causes. Infants, children, older kids and adults can suffer from symptoms of separation anxiety disorder. Common treatment methods include therapy and medications.
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