Specific phobias

Overview

Specific phobias are an extreme fear of objects or situations that pose little or no danger but make you highly anxious. So you try to stay away from these things. Unlike the brief anxiety you may feel when giving a speech or taking a test, specific phobias are long-lasting. Without treatment, specific phobias tend to last a lifetime.

Phobias can cause strong physical, mental and emotional responses. They also can affect how you act at work or school, or in social situations.

Specific phobias are common anxiety disorders. Overall, they happen more often in females. Not all phobias need to be treated. But if a specific phobia affects your daily life, several types of therapies are available to help you work through and conquer your fears — often forever.

Symptoms

A specific phobia involves a strong, lasting fear of a certain object or situation that's much greater than the actual risk. There are many types of phobias. It's common to have a specific phobia about more than one object or situation. Specific phobias also can happen along with other types of anxiety disorders.

Common types of specific phobias are fears of:

• Situations, such as airplanes, driving, enclosed spaces or going to school.
• Nature, such as thunderstorms, heights or the dark.
• Animals or insects, such as dogs, snakes or spiders.
• Blood, shots or injuries, such as needles, accidents or medical procedures.
• Others, such as choking, throwing up, loud noises or clowns.

Each specific phobia has a name. Phobia comes from the Greek word "phobos," which means fear. Examples of more common names include acrophobia for the fear of heights and claustrophobia for the fear of confined spaces.

No matter what specific phobia you have, you may:

• Feel intense fear, anxiety and panic right away when exposed to or even thinking about what causes your fear.
• Know that your fears are not reasonable or not as big as you think they are, but you cannot control them.
• Have anxiety that gets worse as the situation or object gets closer to you physically or in time.
• Do everything possible to stay away from an object or situation or face it with extreme anxiety or fear.
• Have trouble with daily activities because of your fear.
• Have physical reactions and feelings, including sweating, rapid heartbeat, tight chest or trouble breathing.
• Feel like throwing up, or you get dizzy or faint, especially around blood or injuries.

Children may have tantrums, or they may cling, cry or refuse to leave a parent's side or approach their fear.

When to see a doctor

An extreme fear can make life hard — for example, taking long flights of stairs instead of an elevator. But it is not a specific phobia unless it seriously disrupts your life. If anxiety negatively affects the way you act at work or school, or in social situations, talk with your doctor or another health care professional, or a mental health professional.

Childhood fears, such as fear of the dark, monsters or of being left alone, are common. Most children outgrow them. But if your child has an ongoing, strong fear that interferes with how they act at school or work daily, talk to your child's doctor.

The right therapy can help most people. And the sooner you ask for help, the more likely that therapy will be effective.

Causes

Much is still not known about what causes specific phobias. Causes may include:

• Bad experiences. Many phobias start because of a bad experience or panic attack related to a specific object or situation. Sometimes even seeing or hearing about a bad experience can be enough to trigger a phobia.
• Genetics or learned behavior. There may be a link between your specific phobia and the phobia or anxiety of your parents. This could be due to a blend of genetics and learned behaviors.
• Brain function and structure. Those with specific phobias trigger certain parts of the brain, while a person without these phobias does not have the same response in the brain. Also, a person with a specific phobia can have a different brain structure than a person without that specific phobia.

Risk factors

These factors may increase your risk of specific phobias:

• Age. Specific phobias can first appear when you're a child, typically by age 10. But they can occur later in life too.
• Your relatives. If a family member has a specific phobia or anxiety, you're more likely to develop it too. This could be something passed down to you from a blood relative. Or children may learn specific phobias by watching how a family member reacts to an object or a situation.
• Your temperament. Your risk may increase if you're more sensitive to anxiety or you're more reserved or negative than what's typical.
• A bad experience. A specific phobia can start when something distressing happens to you, such as being trapped in an elevator or attacked by an animal.
• Learning about bad experiences. Hearing about bad experiences, such as a plane crash, can cause a specific phobia to start.
• Changing your behavior. Avoidance is the most common way people cope with phobias. By doing so, their anxiety typically gets worse.

Complications

Although specific phobias may seem silly to others, they can be distressing and damaging to the people who have them. These phobias can cause problems that affect many areas of life.

They can result in:

• Social isolation. Staying away from places and things that are feared can cause problems at work or school, or in connections with others. Children with these disorders are at risk of problems at school and loneliness. They also may have trouble in social situations if their behaviors are very different from their peers.
• Mood disorders. Many people with specific phobias have depression and other anxiety disorders.
• Substance misuse. The stress of living with a severe specific phobia may lead to misuse of drugs or alcohol.
• Suicide. Some people with specific phobias may be at risk of suicide.
• Strain on loved ones. To try to keep from feeling anxious, people often rely too much on being reassured by others. Sometimes this leads to others becoming too protective over the person with anxiety. For example, a parent may become too protective of a child, resulting in more stress for the parent.