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.
Ways that phobia sufferers can work toward overcoming their fears include talking about their fears, refraining from avoiding situations they find stressful, imagining themselves facing their fears (visualization), and making positive self-statements like, "I will be OK." In fact, when self-help approaches are combined with brief psychotherapy, people with phobias may achieve significant improvement in symptoms.
Where can people get information and help for phobias?
How well phobias respond to various treatments over the course of years as
well as how age-related changes in thinking ability (cognition) may interact
with anxiety are areas being focused on for future research studies. The use of herbal and other dietary supplements in the treatment of phobias is being explored as well.
Phobias At A Glance
The definition of a phobia is the unrelenting fear of a situation,
activity, or thing that causes one to want to avoid it.
The three classes of
phobias are social phobia (fear of public speaking, meeting new people or other
social situations), agoraphobia (fear of being outside), and specific phobias
(fear of other items or situations).
Although phobias are largely
underreported, the number of people who suffer from phobias is estimated at more
than 6 million people in the United States.
The average age that phobias begin is about 10 years of age.
Women tend to be twice as likely
to suffer from a phobia compared to men.
While there are nearly as many
phobias as there are situations, the most common kinds of phobias include social
phobia, agoraphobia, claustrophobia, coulrophobia, aerophobia, zoophobia,
arachnophobia, dentophobia, aichmophobia, ophidiophobia, acrophobia, mysophobia,
and a fear of fear of blood.
Agoraphobia often coexists with panic disorder.
If left untreated, a phobia may worsen to the point where the person's life is
seriously affected by the phobia and by attempts to avoid or conceal it, leading
to problems with personal health, friends and family, failures in school, and/or lost jobs while
struggling to cope.
Phobias tend to run in families, can be influenced by
culture and parenting style, and can be triggered by life events.
Phobia sufferers have been found
to be more likely to manage stress by avoiding the stressful situation and by
having difficulty minimizing the intensity of the fearful situation.
Symptoms
of phobias often involve panic attacks.
Assessment of phobias often includes
questions by a trained professional that explore the symptoms being experienced,
a medical interview, and a physical examination.
Phobias are often treated
using desensitization, cognitive behavioral therapy, and/or medications.
The
groups of medications doctors tend to choose from when treating a phobia include
selective serotonin reuptake inhibitors, beta blockers, and occasionally,
benzodiazepines.
Phobia sufferers sometimes cope with their fears by talking
about it, refraining from avoiding situations they find stressful,
visualization, and making positive self-statements.
REFERENCES:
Albert, C.M., C.U. Chae, K.M. Rexrode, et al. "Phobic Anxiety and Risk of Coronary Heart Disease and Sudden Cardiac Death Among Women." Circulation 111 (2005): 480-487.
Davey, G.C., I. Burgess, and R. Rashes. "Coping Strategies and Phobias: The Relationship Between Fears, Phobias and Methods of Coping With Stressors."
British Journal of Clinical Psychology 34.3 Sept. 1995: 423-434.
Fernandes, P.P. "Rapid Desensitization for Needle Phobia." Psychosomatics 44 June 2003:
253-254.
Gersley, E. "Phobias: Causes and Treatments." All Psych Journal
17 Nov. 2001. <http://www.allpsych.com>.
Kawachi, I., G.A. Colditz, A. Ascherio, et al. "Prospective Study of Phobic Anxiety and Risk of Coronary Heart Disease in Men." Circulation
89 (1994): 1992-1997.
Knappe, S., K. Beesdo, L. Fehm, et al. "Associations of Familial Risk Factors With Social Fears and Social Phobia: Evidence for the Continuum Hypothesis in Social Anxiety Disorder." Journal of Neural Transmission 116.6 June 2009: 639-648.
Leinonen, E., U. Lepola, H. Koponen, J. Turtonen, A. Wade, and H. Lehto. "Citalopram Controls Phobic Symptoms in Patients With Panic Disorder: Randomized Controlled
Trial." Journal of Psychiatry Neuroscience 25.1 (2000): 25-32.
Lissek, S., J. Levenson, A. Biggs, et al. "Elevated Fear Conditioning to Socially Relevant Unconditioned Stimuli in Social Anxiety Disorder." American Journal of Psychiatry 165.1 Jan. 2008: 124-132.
Medical College of Wisconsin. Facing Fears: Most Patients Can Overcome
Phobias. Feb. 26, 2007.
Parsons, T.D., and A.A. Rizzo. "Affective Outcomes of Virtual Reality Exposure Therapy for Anxiety and Specific Phobias: A Meta-Analysis." Journal of Behavior Therapy and Experimental Psychiatry 39 (2008): 250-261.
Pull, C. "Recent Trends in the Study of Specific Phobias." Current Opinion in Psychiatry 21.1 Jan. 2008: 43-50.
Rapee, R.M., M.J. Abbott, A.J. Baillie, and J.E. Gaston. "Treatment of Social Phobia Through Pure Self-Help and Therapist-Augmented Self-Help." The British Journal of Psychiatry 191 (2007): 246-252.
Saeed, S.A., R.M. Bloch, and D.J. Antonacci. "Herbal and Dietary Supplements for Treatment of Anxiety Disorders." American Family Physician 76.4 Aug. 2007: 549-556.
Schultz, S.K., D.J. Moser, J.R. Bishop, and V.L. Ellingrod. "Phobic Anxiety in Late-Life in Relationship to Cognition and 5HTTLPR Polymorphism." Psychiatric Genetics 15.4 Dec. 2005:
305-306.
Straube, T., M. Glauer, S. Dilger, H.J. Mentzel, and W.H. Miltner. "Effects of Cognitive-Behavioral Therapy on Brain Activation in Specific Phobia."
Neuroimaging 29.1 Jan. 1, 2006: 125-135.
Thomas, S.E., A.K. Thevos, and C.L. Randall. "Alcoholics With and Without Social Phobia: A Comparison of Substance Use and Psychiatric Variables." Journal of Studies on
Alcohol 60 (1999).
Villafuerte, S., and M. Burmeister. "Untangling Genetic Networks of Panic, Phobia, Fear and Anxiety." Genome Biology 4.8 (2003): 224.
Walker, J.R., M.A. Van Ameringen, R. Swinson, R.C. Bowen, P.R. Chokka, E.
Goldner, et al. "Prevention of Relapse in Generalized Social Phobia: Results of a 24-Week Study in Responders to 20 Weeks of Sertraline Treatment." Journal of Clinical Psychopharmacology
20.6 Dec. 2000: 636-644.
Walkup, J.T., A.M. Albano, J. Piacentini, et al. "Cognitive Behavioral Therapy, Sertraline, or a Combination in Childhood Anxiety." New England Journal of Medicine 359.26 Dec. 2008.
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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