Specific Phobia

What is specific phobia?

  • Specific phobia, or SP, is a condition where you have strong fear of a specific object or situation (certain place and time). You become anxious when faced with the feared object or situation. You may be afraid that you will be hurt by the object, or in the situation. With specific phobia, you know that you are more afraid than you should be, but you cannot talk yourself out of the fear. You may try to avoid certain things so that you do not have to face your fear. Because of your fear, you may not be able to do your daily activities.

  • There are different types of SP. You may have more than one type at the same time. When you have SP, you may also have one or more other types of anxiety disorders. SP usually starts when you are a child, and often lasts many years. Getting treatment for specific phobia can help you control your anxiety, and make your fear go away. Your specific phobia can come back even after treatment. By learning and practicing ways to cope with your fear, you may be able to overcome it.

What are the types of specific phobia?

  • Animal: This type includes the fear of animals or insects. Some examples are fear of snakes, insects, bats, birds, rats, mice, rodents, cockroaches, cats, dogs, or spiders.

  • Blood-injection-injury (BII): This type includes the fear of seeing blood or an injury, or getting an injection. It includes fear of procedures that cut or stab your skin, or having an object put in your body. You may be afraid of going to a dentist or doctor, and visiting or being in a hospital. You may also fear sharp objects, such as knives and needles.

  • Natural environment: This includes fear of heights, water, swimming pools, lakes, thunder, lightning, wind, or storms.

  • Situational: This is the fear that is brought about by a certain place and time. It includes fear of flying in an airplane, driving, or traveling in buses, cars, or trains. It also includes fear of being in closed spaces, crowds, or dark places. You may be afraid of being inside a small room, tunnel, elevator, or subway, or on a bridge or boat.

  • Other: This is fear that does not fit into the first four types. This can include the fear of choking, vomiting (throwing up), or catching an illness. You may fear dead bodies, graveyards, and funerals. Space phobia also falls under this type. This is the fear of falling down if you stand or walk away from walls or something you could hold on to.

What causes specific phobia?

No one knows for sure what causes SP. It may be from a problem in the brain that causes you to feel fear more easily. SP may occur when you think you will be hurt by the object, or in the place and time that you fear. If you fear dogs, it may be because you think a dog will bite you. In certain situations, you may think that you will faint, scream, or be unable to control your actions.

What increases my risk of having specific phobia?

  • Having a bad experience with a certain object or place and time, or seeing someone get hurt.

  • Having a close family member with a phobia or another anxiety problem.

  • Having mental health problems such as separation anxiety disorder, or generalized anxiety disorder during childhood.

  • Having parents who show too much fear and worry about certain things.

What are the signs and symptoms of specific phobia?

  • Fear level and duration: You have a very bad, ongoing fear of an object, or a certain place and time.

  • Knowledge of fear level: You know that your fear is more than other people. You know that your worrying is too much, is not needed, and is more than it should be.

  • Response to feared situations: Seeing the object or being in the setting that you fear makes you anxious. You may try to stay away from it. You may try to cope with it, but you dread having to. You may feel fear when you first see the object, or enter the situation. You may feel afraid after you are already in the feared setting.

  • Physical signs and symptoms: Your symptoms may be worse when the object or situation is close to you, and you see no way to escape. Your symptoms may not be as bad if it is further away, and you see a way to escape. You may have any of the following when you are faced with your fear:

    • Fast or pounding heartbeat.

    • Feeling dizzy, unsteady, light-headed, or faint (pass out).

    • Feeling short of breath, or having trouble breathing.

    • Shaking, trembling, or tense (tight) muscles.

    • Sweating.

How is specific phobia diagnosed?

  • Psychiatric assessment: Caregivers will ask if you have a history of psychological trauma, such as physical, sexual, or mental abuse. They will ask if you were given the care that you needed. Caregivers will ask you if you have been a victim of a crime or natural disaster, or if you have a serious injury or disease. They will ask you if you have seen other people being harmed, such as in combat. You will be asked if you drink alcohol or use drugs at present or in the past. Caregivers will ask you if you want to hurt or kill yourself or others. How you answer these questions can help caregivers decide on treatment. To help during treatment, caregivers will ask you about such things as how you feel about it and your hobbies and goals. Caregivers will also ask you about the people in your life who support you.

  • Tests and guides: Tests may need to be done to check for medical conditions that may be causing your symptoms. A guide may be used to help your caregiver learn if you have specific phobia. Your caregiver will talk with you about your behavior, fears, and worries. He will look for signs and symptoms of SP. If you have all four signs and symptoms of SP, you may have this problem. With SP, your signs and symptoms cause problems with your social skills, relationships, and other areas of life. With SP, your fear and anxiety is not caused by another mental health or medical problem. SP is not a side effect of a medicine, or caused by using alcohol or drugs too much or too often (substance abuse).

How is specific phobia treated?

You may need one or many therapy sessions to treat your specific phobia. The following are types of therapy used to treat specific phobia:

  • Exposure therapy: This is also called desensitization therapy. It helps you face a feared object, or place and time. Imagined (not real) or real-life settings are used with this therapy. You may also be exposed using a computer. This is called virtual reality exposure. During this therapy, you are slowly placed in contact with the feared object or situation. The goal of this therapy is to help decrease your anxiety until you get over your fear.

  • Cognitive therapies: Caregivers help you learn which thoughts bring anxiety, and help you change these thoughts to make them real and more pleasant. This therapy may be done by itself, or with exposure therapy.

  • Applied relaxation therapy: This is muscle relaxation therapy done with exposure therapy. Muscle relaxation therapy includes exercises to calm your body, or tense your muscles when you need to. This may be done for fears that may cause fainting, such as the fear of blood or surgery.
Medicines may be given if your fear needs to be treated right away, such as if you need to have a medical procedure, or ride a plane. The following are medicines used to treat specific phobia:
  • Sedative: This medicine is given to help you stay calm and relaxed.

  • Anti-depressants: This medicine is given to decrease or stop the symptoms of depression. It can also be used to treat other behavior problems.

How can I help myself if I have specific phobia?

  • Keep a diary of how you feel when you face your fear. Write down any signs and symptoms, including what you did to cope with facing your fear. The diary will help you and your caregiver see if you have less fear over time. Take your diary with you every time you visit your caregiver.

  • Learn more about specific phobia. Ask caregivers where to find more information about specific phobia. The more you know about your condition, the better you can help yourself.

  • Practice being around things that you fear while at home. Facing your fears from time to time even after treatment will help decrease the chances of your specific phobia coming back. Practice the ways that you learned for how to cope with your fear. Ask caregivers for the names of books that might help you manage worry and anxiety.

What are the risks that may come with having specific phobia?

Your phobia could get worse if you are not treated for it. SP can get in the way of work and daily activities. A fear of blood-injection-injury can get in the way of seeking medical care when you need it. You may have problems with your relationships with your family and friends. You are more likely to have another type of SP or anxiety disorder if you are not treated. You have a greater chance of using drugs, drinking alcohol, or smoking. SP can come back even after treatment, so it is important to keep in contact with the feared object, or time and place. Doing this from time to time can help prevent the fear from returning.

When should I call my caregiver?

Call your caregiver if:

  • You cannot make it to your next meeting with your caregiver.

  • You have new symptoms since you last saw your caregiver.

  • Your worry keeps you from doing tasks, such as work, or caring for yourself or your family.

  • You have questions or concerns about your condition, treatment, or care.

When should I seek immediate help?

Seek care immediately or call 911 if:

  • You feel light-headed or dizzy, or you faint.

  • You have sudden trouble breathing, chest pain, or a fast heartbeat.

Where can I find support and more information?

Having specific phobia may be hard. Your condition may make you feel angry or sad. Talk to your caregivers, family, or friends about your feelings. Join a support group with other people who have SP. Contact the following for more information:

  • Anxiety Disorders Association of America (ADAA)
    8730 Georgia Avenue, Suite 600
    Silver Spring , MD 20910
    Phone: 1- 240 - 485-1001
    Web Address: http://www.adaa.org
  • National Institute of Mental Health (NIMH), Public Information & Communication Branch
    6001 Executive Boulevard, Room 8184, MSC 9663
    Bethesda , MD 20892-9663
    Phone: 1- 301 - 443-4513
    Phone: 1- 866 - 615-6464
    Web Address: http://www.nimh.nih.gov/

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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