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Author: Dr Sabina DosaniConsultant Child & Adolescent Psychiatrist

A fear becomes a phobia when it is excessive, arises in response to imaginary dangers and impacts on the child’s life.

What are phobias?

A phobia is a persistent, excessive and unreasonable fear of an object or situation. It is thought 5% of children and 16% of teenagers have a phobia in the UK.

It’s very normal for children to have fears about certain things – it is a natural stage of development. Children might be afraid of the dark, of dogs or going to the doctor. These fears are all part of how they begin to understand the world and will very often disappear over time.

Phobias are different from everyday fears as they usually become more severe as children get older. Children and teenagers with phobias will often feel ashamed about their fears, and try and hide them from others, particularly their peer group, because they worry they will be seen as overreacting.

Having a phobia can have a very real impact on your quality of life, particularly if your phobia is something that is present in every day life. If your teenager is afraid of the dark, going to sleepovers will be incredibly difficult. Having a phobia of dogs can make going to a park or a friend’s house impossible tasks.

Most phobias develop before the age of 10


What are the symptoms of a phobia?

Whilst we all have objects or situations that we don’t like and will positively try to avoid (spiders and snakes are the most common), those with a phobia have a very severe reaction that they simply can’t control.

Symptoms of a phobia include:

  • Increased heart rate
  • Sweating
  • Trembling
  • Shortness of breath
  • Feelings of choking
  • Upset stomach
  • Feeling dizzy or faint
  • Fear of dying
  • Numbness
  • Running away from the situation
  • Clinging to an adult
  • Crying or tantrums

Why do some children develop phobias?

It is thought that phobias develop for both genetic and environmental reasons (nature and nurture).

We are hard wired to fear certain things – this reaction developed as a survival technique early humans used to temper their natural curiosity and keep them safe. We don’t fully understand the genetic reasons behind phobias but research has shown they often run in families.

Phobias arise for different reasons but a bad experience in early years can trigger a pattern of thoughts that result in a powerful fear of a situation – for instance if your child falls ill after having an injection, they may develop an ongoing fear to injections, which can get worse over time.

Children may also ‘learn’ to have a phobia - for instance if a close family member is afraid of spiders and the child witnesses them screaming when they see one, they may also develop that fear.

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How can I help my child with a phobia?

As a first step, your child may benefit from an assessment with a psychiatrist – a doctor with expertise in mental health. Not only with this assessment look at the anxiety symptoms your child is experiencing, but will look at whether there are any other underlying factors or conditions that need to be considered, in order to find the most effective treatment.

CBT and other talking therapies can be really helpful for children and teenagers with a phobia in addressing their thought patterns and helping them formulate healthier coping mechanisms.

Graded exposure techniques can be incredibly useful to help overcome the fear a child or teenager may have, but it needs to be carefully administered by an expert, as if done incorrectly can make the situation a lot worse and damage the child’s ability to trust.

Parents I have worked with have taught me that having a child with a phobia can be hugely distressing. It can feel impossible for them to calm their child down and if the thing they are afraid of is unavoidable, for instance dogs or the dark, the fear can severely affect the family’s life (for instance not being able to visit grandparents). Parents are often relieved to find out that phobias are treatable and that they don’t have to live like this.
MBBS, MSc, MRCPsych

Consultant Child & Adolescent Psychiatrist
London

Dr Sabina Dosani is a highly experienced Consultant Psychiatrist currently working for the Anna Freud Centre looking after Children and Adolescents. She has a Bachelor of Medicine and Bachelor of Surgery as well as being a member of the Royal College...

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