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Specific Phobia

The term "phobia" refers to a group of symptoms brought on by certain objects or situations.

The commonest is the phobia of spiders (arachnophobia), particularly in women. The prevalence of simple phobias is 7% in the general population. Other common phobias include insects, moths, bats, dogs, snakes, heights, thunderstorms and the dark. Children are particularly phobic about the dark, ghosts and burglars, but the large majority grow out of these fears.

Specific Phobia is characterized by the excessive fear of an object or a situation, exposure to which causes an anxious response, such as a Panic Attack. Adults with phobias recognize that their fear is excessive and unreasonable, but they are unable to control it. The feared object or situation is usually avoided or anticipated with dread.

There are over 275 types of Specific Phobias that are listed according to some sources. Specific phobias strike more than 1 in 10 people. No one knows just what causes them, though they seem to run in families and are a little more prevalent in women. Phobias usually first appear in adolescence or adulthood. They start suddenly and tend to be more persistent than childhood phobias; only about 20 percent of adult phobias vanish on their own. When children have specific phobias--for example, a fear of animals--those fears usually disappear over time, though they may continue into adulthood. No one knows why they hang on in some people and disappear in others.

What are the causes of Specific Phobias?

The exact cause of specific phobias is not known, but most appear to be associated with a traumatic experience or a learned reaction. For example, a person who has a frightening or threatening experience with an animal, such as an attack or being bitten, can develop a specific phobia. Witnessing a traumatic event in which others experience harm or extreme fear can also cause a specific phobia, as is receiving information or repeated warnings about potentially dangerous situations or animals.

Fear can be learned from others, as well. For example, a child whose parents react with fear and anxiety to certain objects or situations is likely to also respond to those objects with fear.

Diagnostic Criteria for Specific Phobia

A phobia is a fear which is caused by a specific object or situation. The fear may be by the actual presence of, or by, the anticipation of the presence of that object or situation. Anxiety, triggered by the fear, may approach the intensity of panic.

  • The patient experiences a strong, persistent fear that is excessive or unreasonable. It is cued by a specific object or situation that is either present or anticipated.
    The phobic stimulus almost always immediately provokes an anxiety response, which may be either a panic attack or symptoms of anxiety that do not meet criteria for a panic attack.
  • The fear is unreasonable or out of proportion, and the patient realizes this.
  • The patient either avoids the phobic stimulus or endures it with severe anxiety or distress.
  • Patient is under the age of 18, but must have had the symptoms for 6 months or longer.
  • Either there is marked distress about this fear or it markedly interferes with the patient's usual routines or  social, job or personal functioning.
  • The symptoms are not better explained by a different mental disorder, including Anxiety Disorders, Obsessive Compulsive Disorder (OCD), Post Traumatic Stress Disorder (PTSD), Social Phobia, Panic Disorder, Panic Disorder with Agoraphobia.

What are the types of Specific Phobias?

The DSM-IV-TR defines five types of specific phobias:

(1) Animal Type: These include fears of animals such as dogs, cats, spiders, bugs, mice, rats, birds, fish, and snakes.

(2) Natural Environment Type: These include fears of heights, storms, and being near water.

(3) Blood-Injection-Injury Type: These include fears of seeing blood, receiving a blood test or injection, watching medical procedures on television, and for some individuals, even just talking about medical procedures.

(4) Situational Type: These include fears of situations such as driving, flying, elevators, and enclosed places.

Other Type: These include other specific fears, including fears of choking or vomiting after eating certain foods, fears of balloons breaking or other loud sounds, or fears of clowns.

How Are Specific Phobias Treated?

When the phobias interfere with a person's life, treatment can helpTreatment for specific phobias may include one or a combination of:

  • Relaxation techniques: such as deep breathing, may also help reduce anxiety symptoms.
  • Patient education - Patients need to understand their condition and receive reassurance that they are not "going crazy" and that their condition can be managed. Because they may have received some explanation that their symptoms are caused by a medical disease, they need to be educated about Specific phobias.
  • Exposure and response prevention - There is a wealth of evidence that suggests that exposure and response prevention is the most effective treatment for specific phobias. This form of treatment is used to treat other anxiety disorders, including obsessive-compulsive disorder ( see treatment of OCD ).
  • Progressive desensitization is not as effective as exposure and response prevention, but is used in people with specific phobias who have great difficulty facing the object or situation that causes their fear. This treatment involves learning relaxation and visualization techniques. The patient is exposed to the source of fear gradually. For instance, a person with fear of heights looks down from a second-story window of a skyscraper. Once the person begins to experience anxiety, they are removed from the situation. They then learn to visualize being in the situation without experiencing anxiety. Once they are able to look out that window without experiencing anxiety, they move up to the third-story window, and so on.
  • Medication:There is currently no proven drug treatment for specific phobias, but sometimes certain medications may be prescribed to help reduce anxiety symptoms before someone faces a phobic situation. Tranquilizers (benzodiazepines) such as Ativan, Librium, Valium and Xanax may be prescribed to help reduce anxiety.

    Benzodiazepines have been known to reduce anticipatory anxiety in people with specific phobia. For example, people who are afraid of flying may find that these drugs help control their fear and make flying possible.

    SSRIs, like Paxil (Paroxetine), can be effective in controlling specific phobias. These drugs may be particularly helpful in people whose phobia interferes with their ability to function in normal daily activities, like riding the train to work or speaking in front of groups.

Facts and Tips about Specific Phobia

  • Specific phobia indicates any type of fear disorder or mental disorder that leads to illogical fear or anxiety.
  • Specific phobias are common in children and adults but phobias are mostly experienced by women than men.
  • There are many types of phobias like animal phobia, water phobia, blood and height phobia, etc.
  • Excessive sweating, discomfort, stress, depression, giddiness and panic attacks are the most common symptoms of specific phobias.
  • Lemon juice with salt and sugar is a valuable home remedy to control giddiness because of fear.
  • Talk therapy, cognitive therapy and some anti-depressant medications are very efficient treatments to control fear or anxiety.
  • Phobias can be cured by doing yoga, relaxation exercise and dance because it can reduce the feeling of anxiety and tension.

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