Fears and Phobia's

Approximately 2% of the UK population will have a phobia with women twice as likely as men to suffer. Phobias can be very disabling and often cause huge shame to the sufferer.

Mental Health Foundation

What is a phobia?

A phobia is a deep fear of a specific thing or situation, such as spiders or open spaces. Whilst many fears are perfectly understandable and do not interfere with our daily lives, others can create recurrent, even debilitating anxiety or prompt elaborate avoidance strategies.

There are three main types of phobias

1. Agoraphobia:
   a fear of public places and open spaces, which can induce panic attacks
2. Social Phobia:
   a fear of social situations and the feeling of embarrassment and public humiliation (see social anxiety for more)
3. Specific phobias such as:
   Aviophobia:
   a fear of flying, particularly debilitating for family and work life
   Emetophobia:
   a fear of being sick; some women develop this following morning sickness in a pregnancy and it can be so severe that they choose not to have further children

Phobias can express themselves in a bewildering range of fears, many can be difficult for others to understand and lead the person involved to feel huge shame and embarrassment.

Common symptoms of phobias

There are both physical, behavioural and emotional symptoms associated with a phobia – when faced with the source of the phobia, it’s common for someone to feel intense panic and fear.

• A desire to run away from the situation
• Absolute terror when faced with the fear inducing object or situation
• Avoidance behaviour such as not going out, not touching objects in public or not socialising
• Physical symptoms including trembling, heart palpitations, feeling sick and dizziness, panic attacks
• Obsessing about the fear and not being able to think of anything else
• Anxiety at the thought of the fear

Whilst we might all have fears, phobias can be overwhelming and distressing to live with and for many affected with fears of common situations, such as public spaces or flying, can have a serious impact on their lives and those of their family.

Is my phobia a problem?

Whilst most of us will have a strong fear about something, for instance spiders or flying, on the whole such fears won’t have much of an impact on our daily lives and won’t need any specific treatment.

For others though, their phobias and fears can have a very significant impact on their lives, holding them back from doing the things they want to do and causing them a huge amount of emotional distress. Phobias can even make it hard to hold down a job, continue in education or socialise with friends. For these people, professional help is advisable and can make a huge difference to their quality of life.

To understand if your phobia needs professional help:

If you aren’t sure whether your fears would constitute a phobia or if you should seek professional help, it might be worth considering the following:

Looking at the following, give each statement a score out of ten (1 = low, 10 = very high) thinking about how your phobia has impacted and disrupted the following parts of your life in the last month.

1. My symptoms have disrupted my work / educational life
2. My symptoms have disrupted my social life
3. My symptoms have disrupted my family life / household responsibilities

If you score 5 or above, it’s likely your phobias are becoming severe and would benefit from some professional help.

Ref: Sheehan Disability Scale

Understanding Phobias

1. Phobias are among the most effectively treated of all anxiety disorders – but effective treatment for phobias needs to be appropriate and geared towards the long-term relief of symptoms.
2. Misdiagnosis is often common – particularly for phobias like public speaking, social and flight phobia and agoraphobia are often misdiagnosed.
3. A thorough assessment with a Psychiatrist is the first step towards getting a full understanding of the issues that are affecting you. The Psychiatrist will also look at whether you are suffering with another condition, such as depression.
4. Medication can help - the Psychiatrist may advise that you start on a treatment course of antidepressants – these can be highly effective at treating anxiety disorders like Phobias and also make it easier for the individual to engage in a therapy – like CBT.
5. Talking therapies like CBT or REBT are also very effective at helping those with a phobia. They can help the individual understand their feelings and also teach ways of overcoming these feelings. Your therapist may suggest some sort of emersion therapy to bring you closer to the source of your fear. This will need to be done with a therapist or psychologist you trust – so finding someone you can build a relationship with is key to effective recovery.

It’s important to get your phobias diagnosed – it might be that there is another condition at play that is causing your symptoms and we need to rule anything else out before finding the most effective treatment.

Dr Muffazal Rawala

MBBS, MSc, MRCPsych

Consultant Adult Psychiatrist

London

Dr Muffazal Rawala is an experienced NHS Consultant Psychiatrist, currently working for East London NHS Foundation Trust. He has a Medical Degree, a Masters in Transcultural Mental Health, has a postgraduate certificate in Psychopharmacology and is a...