Phobias are excessive, intense or irrational fears of certain objects or situations that result in avoidance or extreme distress.
Although these objects or situations pose little or no danger, some people experience such great fear or anxiety that it becomes a phobia and interferes with everyday life.
Experiencing phobias can be overwhelming, frightening and isolating. People may feel bewildered by their emotions when confronted with their phobias but feel powerless to control them.
Who gets phobias?
Phobias are one of the more common anxiety disorders and can be experienced by people of any age, gender, culture, and socioeconomic status. Many types of phobias are common across cultures, but other phobias vary from country to country and are culture-specific. For example, in Northern Australia, crocodile phobia is common because of the higher crocodile population.
Conversely, in New Zealand, some people have a phobia about snakes, even though we don’t have them in the wild here.
What causes phobias?
Often there is no obvious cause for a phobia. Phobias do run in families. If someone in your family has a specific phobia or anxiety, you are more likely to develop it too. This could be due to tendencies inherited through genetics or as a result of learning from observing a family member’s phobic or anxious response.
Some specific phobias start after a frightening experience or a panic attack related to a specific object or situation. For example, being attacked by a dog can lead to a phobia of dogs, and having a panic attack in public can lead to agoraphobia. However, many people with phobias have not had a negative experience with the feared object. It is thought that hearing about negative experiences can lead to the development of a specific phobia; for example, hearing about plane crashes can lead to a phobia of flying.
Agoraphobia and social phobia are more common in people who are anxious or nervous by nature. Some people with social phobia are generally shy, but some are not and only have problems in certain social situations. Specific phobias happen just as often in people who are not otherwise anxious.
It's important to remember that it’s not your fault if you are experiencing anxiety or a phobia.
Signs to look for (symptoms)
The way you experience a phobia is unique to you. Symptoms will range from mild anxiety or concern through to a full-blown panic attack when confronted with the object, creature or situation you’re most concerned about.
The types of panic symptoms you experience could include:
- shaking or trembling
- choking feelings
- racing or pounding heart
- chest pain or tightness
- nausea, stomach pain or diarrhoea
- hot and cold feelings
- shortness of breath or feeling smothered
- dizziness or light-headedness
- tingling or numbness, often in the fingers
- feeling cut off from reality
- fainting (this symptom is unique to blood-injection-injury phobia, although people experiencing other phobias often fear it will happen to them).
Through all of this, you may feel you need to escape before you lose control. You may also know that you are overreacting but feel powerless to control your reactions.
People with phobias can develop other problems. These can include other anxiety disorders, depression or substance-use disorders (alcohol or other drugs). For that reason, if you suspect you or a loved one is experiencing a phobia, it’s important to see your doctor or a mental health professional and talk to them about what you are going through.
Without treatment, phobias can last for years or for life, but most people with phobias make a good recovery once they seek help. Even if you continue to have episodes, you can still experience recovery and live a happy and worthwhile life.
Understanding your phobia is an important step in overcoming or learning how to live with it. The majority of people who suffer from phobias find relief from their symptoms when treated with therapy, medications and education, or a combination of these.
Psychoeducation (providing education)
Education can be extremely important to help you, your family/whānau and your supporters to understand phobias and help in the recovery. Your doctor or mental health professional will give you information about the disorder, suggest different ways to handle it, and discuss any complications which may occur.
There are also numerous self-help books available which some find to be a useful first stage in getting help. They can teach you about some of the ways of dealing with your phobia, and they can also get you used to reading about or discussing problems that you have previously kept completely to yourself. They are generally written by medical experts, drawing on the experience of people who have phobias.
You may also find that reading books written by other people with phobias makes you feel less alone and helps break down the stigma attached to phobias.
Medication is not usually recommended for treating phobias. Medication may be prescribed when CBT with exposure is not available or feasible, when there has been a limited response to CBT, or when someone does not engage with CBT. For most people, medication on its own is less effective than CBT on its own.
If you are prescribed medication you are entitled to know:
- the names of the medicines
- what symptoms they are supposed to treat
- how long it will be before they take effect
- how long you will have to take them for and what their side effects are (short and long term)
- what the process of stopping taking them could look like.
You should be told about risks and side effects of any medication and receive clear instructions about how you should take them and what precautions are necessary.
If you are pregnant or breastfeeding, seek advice from your GP before taking any medication.
Important strategies that support recovery
If your fear is great, you may need to have some professional help to do this. But you can do a lot for yourself.
If you are aware that you have a phobia and feel that you are able to confront it, then the best strategy is to face the object or situation as often as possible. If you have recovered from a phobia, it is good to keep in practice at being in a situation you used to fear. For example, if you know you are quite anxious about meeting new people, do not avoid doing this. If you take every opportunity to meet new people your confidence will grow.
The term complementary therapy is generally used to indicate therapies and treatments that differ from conventional western medicine and that may be used to complement and support it.
Certain complementary therapies may enhance your life and help you to maintain wellbeing, although they alone are not treatments for phobia. In general, mindfulness, hypnotherapy, yoga, exercise, relaxation, massage, mirimiri and aromatherapy have all been shown to have some effect in alleviating mental distress.
It is also really important to look after your physical wellbeing. Make sure you get an annual check-up with your doctor, and do what you can to reduce stress, get enough sleep, eat a balanced diet and exercise. Being in good physical health will also help your mental health.
Peer support groups
Peer support means people who have been through similar experiences coming together to support each other. A support group provides an opportunity to share your journey with people who have been through something similar.
Other strategies that help include:
- Make sure you go out often if you have mild agoraphobia and have some anxieties about leaving home because of panic or feeling unsafe. Ask family/whānau and friends to keep you company if this helps. Explain your experience to them. If they know that you might have to wait for a panic attack to pass, or even to go home, this can help you feel less pressured or embarrassed.
- Practise relaxation techniques. If you are anxious much of the time (in addition to having a phobia), relaxation can be helpful. If you already have some way of relaxing, do this regularly. If you need to, learn a relaxation technique such as breathing exercises, which are good if you over-breathe (hyperventilate). Find something to do with your family/whānau or friends that is relaxing and enjoyable. Phobias usually affect only one part of your life. Keep up all your other activities, especially those you enjoy.
- Limit alcohol and other drugs. These are not good ways of relaxing to overcome a phobia. You’ll probably feel more anxious afterwards, and you risk becoming addicted. Many people without social phobia feel a bit more relaxed socially with a few drinks, but if you are unable to socialise without drinking, you are at risk of becoming dependent on alcohol.
- Notice your reactions to caffeine and nicotine, as these have the potential to increase anxiety. If you have agoraphobia and panic, you may be sensitive to these substances.
Thanks to Natasha de Faria, clinical psychologist, and members of the Thriving Madly peer support network in Christchurch for reviewing this content. Date last reviewed: September, 2022.
Thanks also to Sutherland Self-Help Trust for making the 2022 updates possible.