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Many people experience specific phobias, intense, irrational fears of certain things or situations–dogs, closed-in places, heights, escalators, tunnels, highway driving, water, flying, and injuries involving blood are a few of the more common ones. Phobias aren’t just extreme fear; they are irrational fear. You may be able to ski the world’s tallest mountains with ease but panic going above the 10th floor of an office building. Adults with phobias realize their fears are irrational, but often facing, or even thinking about facing, the feared object or situation brings on a panic attack or severe anxiety.
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 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.
The fear is persistent, typically lasting at least 6 months.
Exposure to the phobic stimulus almost invariably provokes an immediate anxiety response, which may take the form of a situationally bound or situationally predisposed Panic Attack. (In children, the anxiety may be expressed by crying, tantrums, freezing, or clinging.)
The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and is not a typical response in the person’s social or cultural context. Most adults will recognize that their fear is excessive or unreasonable and are bothered by the fact that they have this fear.
The phobic situation or situations are avoided or else are endured with intense anxiety or distress.
The avoidance, anxious anticipation, or distress in the feared situation(s) interferes significantly with the person’s normal routine, occupational (or academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.
The anxiety, Panic Attacks, or phobic avoidance associated with the specific object or situation are not better accounted for by another mental disorder.
General Treatment for Specific Phobias
Many people experience specific phobias, intense, irrational fears of certain things or situations–dogs, closed-in places, heights, escalators, tunnels, highway driving, water, flying, and injuries involving blood are a few of the more common ones. Phobias aren’t just extreme fear; they are irrational fear. You may be able to ski the world’s tallest mountains with ease but panic going above the 10th floor of an office building. Adults with phobias realize their fears are irrational, but often facing, or even thinking about facing, the feared object or situation brings on a panic attack or severe anxiety.
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 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.
The fear is persistent, typically lasting at least 6 months.
Exposure to the phobic stimulus almost invariably provokes an immediate anxiety response, which may take the form of a situationally bound or situationally predisposed Panic Attack. (In children, the anxiety may be expressed by crying, tantrums, freezing, or clinging.)
The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and is not a typical response in the person’s social or cultural context. Most adults will recognize that their fear is excessive or unreasonable and are bothered by the fact that they have this fear.
The phobic situation or situations are avoided or else are endured with intense anxiety or distress.
The avoidance, anxious anticipation, or distress in the feared situation(s) interferes significantly with the person’s normal routine, occupational (or academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.
The anxiety, Panic Attacks, or phobic avoidance associated with the specific object or situation are not better accounted for by another mental disorder.
The DSM-5 diagnostic code for a specific phobia is based on the phobic stimulus:
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 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.
Specific Symptoms of Specific Phobias:
Marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood).The fear is persistent, typically lasting at least 6 months.
Exposure to the phobic stimulus almost invariably provokes an immediate anxiety response, which may take the form of a situationally bound or situationally predisposed Panic Attack. (In children, the anxiety may be expressed by crying, tantrums, freezing, or clinging.)
The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and is not a typical response in the person’s social or cultural context. Most adults will recognize that their fear is excessive or unreasonable and are bothered by the fact that they have this fear.
The phobic situation or situations are avoided or else are endured with intense anxiety or distress.
The avoidance, anxious anticipation, or distress in the feared situation(s) interferes significantly with the person’s normal routine, occupational (or academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.
The anxiety, Panic Attacks, or phobic avoidance associated with the specific object or situation are not better accounted for by another mental disorder.
General Treatment for Specific Phobias
Many people experience specific phobias, intense, irrational fears of certain things or situations–dogs, closed-in places, heights, escalators, tunnels, highway driving, water, flying, and injuries involving blood are a few of the more common ones. Phobias aren’t just extreme fear; they are irrational fear. You may be able to ski the world’s tallest mountains with ease but panic going above the 10th floor of an office building. Adults with phobias realize their fears are irrational, but often facing, or even thinking about facing, the feared object or situation brings on a panic attack or severe anxiety.
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 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.
Specific Symptoms of Specific Phobias:
Marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood).The fear is persistent, typically lasting at least 6 months.
Exposure to the phobic stimulus almost invariably provokes an immediate anxiety response, which may take the form of a situationally bound or situationally predisposed Panic Attack. (In children, the anxiety may be expressed by crying, tantrums, freezing, or clinging.)
The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and is not a typical response in the person’s social or cultural context. Most adults will recognize that their fear is excessive or unreasonable and are bothered by the fact that they have this fear.
The phobic situation or situations are avoided or else are endured with intense anxiety or distress.
The avoidance, anxious anticipation, or distress in the feared situation(s) interferes significantly with the person’s normal routine, occupational (or academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.
The anxiety, Panic Attacks, or phobic avoidance associated with the specific object or situation are not better accounted for by another mental disorder.
The DSM-5 diagnostic code for a specific phobia is based on the phobic stimulus:
- 300.29 for a phobia towards an animal (e.g., spiders, insects, dogs), natural environment (e.g., heights, storms, water), or blood-injection-injury (e.g., needles, invasive medical procedures).
- 300.29 if the phobia is situational (e.g., airplanes, elevators, enclosed places) or other (e.g., situations that may lead to choking or vomiting; in children, e.g., loud sounds or costumed characters).
Specific Phobias
The term "phobia" refers to a group of anxiety symptoms brought on by certain objects or situations.
A specific phobia, formerly called a simple phobia, is a lasting and unreasonable fear caused by the presence or thought of a specific object or situation that usually poses little or no actual danger. Exposure to the object or situation brings about an immediate reaction, causing the person to endure intense anxiety (nervousness) or to avoid the object or situation entirely. The distress associated with the phobia and/or the need to avoid the object or situation can significantly interfere with the person's ability to function. Adults with a specific phobia recognize that the fear is excessive or unreasonable, yet are unable to overcome it.
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There are different types of specific phobias, based on the object or situation feared, including:
- Animal phobias: Examples include the fear of dogs, snakes, insects, or mice. Animal phobias are the most common specific phobias.
- Situational phobias: These involve a fear of specific situations, such as flying, riding in a car or on public transportation, driving, going over bridges or in tunnels, or of being in a closed-in place, like an elevator.
- Natural environment phobias: Examples include the fear of storms, heights, or water.
- Blood-injection-injury phobias: These involve a fear of being injured, of seeing blood or of invasive medical procedures, such as blood tests or injections
- Other phobias: These include a fear of falling down, a fear of loud sounds, and a fear of costumed characters, such as clowns.
A person can have more than one specific phobia.
What Are the Symptoms of Specific Phobias?
Symptoms of specific phobias may include:
- Excessive or irrational fear of a specific object or situation.
- Avoiding the object or situation or enduring it with great distress.
- Physical symptoms of anxiety or a panic attack, such as a pounding heart, nausea or diarrhea, sweating, trembling or shaking, numbness or tingling, problems with breathing (shortness of breath), feeling dizzy or lightheaded, feeling like you are choking.
- Anticipatory anxiety, which involves becoming nervous ahead of time about being in certain situations or coming into contact with the object of your phobia. (For example, a person with a fear of dogs may become anxious about going for a walk because he or she may see a dog along the way.)
Children with a specific phobia may express their anxiety by crying, clinging to a parent, or throwing a tantrum.
How Common Are Specific Phobias?
The National Institute of Mental Health estimates that about 5%-12% of Americans have phobias. Specific phobias affect an estimated 6.3 million adult Americans.
Phobias usually first appear in adolescence and adulthood, but can occur in people of all ages. They are slightly more common in women than in men. Specific phobias in children are common and usually disappear over time. Specific phobias in adults generally start suddenly and are more lasting than childhood phobias. Only about 20% of specific phobias in adults go away on their own (without treatment).
What Causes 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 can receiving information or repeated warnings about potentially dangerous situations or animals.
Fear can be learned from others, as well. A child whose parents react with fear and anxiety to certain objects or situations is likely to also respond to those objects with fear.
How Are Specific Phobias Diagnosed?
If symptoms of a specific phobia are present, the doctor will begin an evaluation by performing a medical and psychiatric history and may perform a brief physical exam. Although there are no lab tests to specifically diagnose specific phobias, the doctor may use various tests to make sure that a physical illness isn't the cause of the symptoms.
If no physical illness is found, you may be referred to a psychiatrist, psychologist, or other mental health professional who is specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use clinical interviews and assessment tools to evaluate a person for a specific phobia.
The doctor bases his or her diagnosis of specific phobias on reported symptoms, including any problems with functioning caused by the symptoms. A specific phobia is diagnosed if the person's fear and anxiety are particularly distressing or if they interfere with his or her daily routine, including school, work, social activities, and relationships.
How Are Specific Phobias Treated?
Treatment for specific phobias may include one or a combination of:
- Cognitive behavioral therapy: Psychotherapy is the cornerstone of treatment for specific phobias. Treatment usually involves a type of cognitive behavioral therapy, called systematic desensitization or exposure therapy , in which patients are gradually exposed to what frightens them until their fear begins to fade.
- Medication: For situational phobias that produce intense, temporary anxiety (for example, a fear of flying), short-acting sedative-hypnotics (benzodiazepines) such as Ativan, or Xanax may be prescribed on an occasional, as-needed basis to help reduce anticipatory anxiety. Unless a phobia is accompanied by other conditions such as depression or panic disorder, long-term or daily medicines are generally not used. Occasionally, serotonergic antidepressants such as Paxil may have potential value for some patients.
- Relaxation techniques, such as deep breathing, may also help reduce anxiety symptoms.
What Is the Outlook for People With Specific Phobias?
For most people, specific phobias can be successfully treated with therapy and, in some cases, medication.
Can Specific Phobias Be Prevented?
Although many specific phobias cannot be prevented, early intervention and treatment following a traumatic experience, such as an animal attack, may prevent the person from developing a severe anxiety disorder.
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