Phobias

In many circumstances, it's normal to feel fear. But a phobia is more than just fear. According to the National Institute of Mental Health (NIMH), a phobia is an intense fear of something that poses little or no actual danger. People can develop a phobia about just about anything, but some of the more common ones revolve around:

• closed-in places such as elevators or tunnels
• open areas or large crowds
• heights
• escalators
• driving
• water
• flying
• speaking in public
• animals such as snakes or dogs

A person can develop a specific phobia of anything, but in most cases, the phobia is shared by many and has a name. Animal phobias are common, and include cynophobia (dogs), equinophobia (horses), zoophobia (all animals), arachnophobia (spiders) and ophidiophobia (snakes). There's also the fear of flying (pterygophobia), heights (acrophobia), confined spaces (claustrophobia) and even dentists (odontophobia).

In addition to these specific types, there is also one called social phobia (Read about "Social Phobia"), which is characterized as the presence of extreme fear and/or avoidance of social situations. According to the American Psychological Association (APA), social phobias are more common than once thought, affecting eight percent of Americans at some point in their lives.

Such phobias aren't just extreme fear; they are an irrational fear of a particular thing. Unfortunately, simply realizing your fear is irrational is not enough. NIMH says many adults are aware of the fact that their fear is irrational, but even so, continue to experience it. In fact, in many cases, they don't even have to be facing the object of their fear; simply thinking about it can be enough to induce a reaction.

A common concern

Phobias are classified as anxiety disorders. (Read about "Anxiety") The National Alliance for the Mentally Ill (NAMI) says anxiety disorders are among the most common in the United States, affecting an estimated 20 million Americans. Phobias alone affect over six million adult Americans and are twice as common in women as in men. Phobias can often start in childhood and last through adulthood. NIMH says we don't exactly know what causes specific phobias, although there may be a tendency towards them in families.

Some people deal with their phobias by avoiding the cause. But that may not always be possible. Avoidance can also lead to other problems; for example, an irrational fear of being outside the home (agoraphobia) can cause someone to remain a shut-in.

The Food and Drug Administration (FDA) says treatment can include cognitive-behavior therapy and medications. FDA says that, while no drug is approved specifically for phobia, other classes of drugs can be used for this disorder. In addition to the anti-anxiety drugs and beta-blockers, medications may include serotonin specific reuptake inhibitors (SSRIs) and the monoamine oxidase (MAO) inhibitor antidepressants.

NAMI says talk therapy is often effective in treating anxiety disorders such as phobias. The most common forms of talk therapy are behavioral therapy and cognitive-behavioral therapy. Behavioral therapy involves relaxation techniques and gradual exposure to the thing or situation that causes the anxiety. Cognitive-behavioral therapy tries to help people figure out why they're reacting as they are, and then change the thought patterns that lead to that reaction. APA says cognitive-behavioral therapy techniques can desensitize patients to the triggers of anxiety, and help them to confront their fears.

Exposure to the feared situation can be actual or imagined. APA says hypnosis is sometimes used. Exposure can even be done through computer simulations. For example, APA says Virtual Reality Exposure (VRE) allows a user to be an active participant within a computer-generated three-dimensional virtual world. VRE can be useful is situations such as fear of flying or fear of heights.

Medications, such as antidepressants, may also be used in cases where phobias are interfering with a person's ability to function. Many people with anxiety disorders also benefit from joining a self-help group. The key is to realize you're not alone; that phobias are a very real and a very common problem, and that help is available.

NIMH supports research into the causes, diagnosis, prevention and treatment of anxiety disorders and other mental illnesses. Studies examine the genetic (Read about "Genetics") and environmental risks for major anxiety disorders, their course - both alone and when they occur along with other diseases such as depression - and their treatment. The ultimate goal is to be able to cure, and perhaps even to prevent, anxiety disorders.

Several parts of the brain (Read about "The Brain") are key actors in a highly dynamic interplay that gives rise to fear and anxiety. Using brain imaging technologies and neurochemical techniques, scientists are finding that a network of interacting structures is responsible for these emotions. Much research centers on the amygdala, an almond-shaped structure deep within the brain. The amygdala is believed to serve as a communications hub between the parts of the brain that process incoming sensory signals and the parts that interpret them. It can signal that a threat is present, and trigger a fear response or anxiety. It appears that emotional memories stored in the central part of the amygdala may play a role in disorders involving very distinct fears, like phobias, while different parts may be involved in other forms of anxiety.

Other research focuses on the hippocampus, another brain structure that is responsible for processing threatening or traumatic stimuli. The hippocampus plays a key role in the brain by helping to encode information into memories. Studies have shown that the hippocampus appears to be smaller in people who have undergone severe stress (Read about "Stress") because of child abuse or military combat. This reduced size could help explain why individuals with post-traumatic stress disorder (Read about "Post-Traumatic Stress Disorder") have flashbacks, deficits in explicit memory and fragmented memory for details of the traumatic event.

Also, research indicates that other brain parts called the basal ganglia and striatum are involved in obsessive-compulsive disorder.

By learning more about brain circuitry involved in fear and anxiety, scientists may be able to devise new and more specific treatments for anxiety disorders.

Related Information:

    Mental Health

    Depressive Illnesses

    Obsessive Compulsive Disorder

    Panic Disorder

    Addiction

    Suicide Prevention