What are phobias?
What are phobias?Everyone feels afraid or overwhelmed at times—we all have fears. But if the fear of a specific situation or object is so extreme that it gets in the way of you living your life, you might be dealing with a phobia.
Phobias can cause intense fear, and avoiding that fear or its triggers can make your world feel smaller and limited. But, getting better is possible. Many people with specific phobias learn to cope and thrive with the right treatment.
Types of phobias
Experts group specific phobias into five categories:
- Animals, such as snakes, dogs, or insects
- Situations such as public speaking, driving, or taking an elevator
- Natural environments/weather, such as heights, dark places, bodies of water, or thunderstorms
- Blood, injuries, or medical content, such as needles, surgery, or dental pain
- Other – Clowns, choking, fear of clusters/groups of holes, children
Symptoms of phobias
SymptomsSomeone with a phobia may experience a range of symptoms—psychological, physical, and behavioral—when confronted with or thinking about their fear. Symptoms can include:
- Extreme anxiety or panic
- Physical reactions to a trigger/fear, such as a racing heart, nausea, trouble breathing, sweating, shaking, dizziness, or feeling lightheaded
- Taking measures to avoid your fear, even if it interferes with day-to-day life or activities you enjoy
- Feeling like you need to escape or get away
- Feeling disconnected from your body (depersonalization) or surroundings (derealization)
- A sensation of tunnel vision
- Crying and tantrums (more common in young children with phobias)
Phobia causes & risk factors
CausesThe cause of specific phobias is still unknown to experts, but some phobias may be linked to:
- Traumatic experience – Having a bad experience—or witnessing something bad happening to someone else—tied to a certain place, object, or situation. For instance, someone who was bitten by a dog as a child may develop a phobia of dogs.
- Genetics – Some phobias, such as situational, animal, or blood/medical-related phobias, are more likely if you have a family member with the same type of phobia
- Learned behavior – Watching a parent, caregiver, or sibling react with fear to certain situations or objects
Complications
ComplicationsPhobias, especially when severe, can make daily life challenging and even lead to other physical, mental, and social problems. Phobias may increase the risk of issues such as:
- Mental health conditions – Anxiety, depression, substance abuse, and somatic symptom disorders are more likely in people with a specific phobia
- Relationship/social issues – Someone with a phobia may look for a lot of reassurance about their specific fear, which can take a toll on their loved ones. Avoiding certain triggers and activities can also lead to social isolation and difficulty connecting with others.
- Physical health – The stress and symptoms of phobias can make certain conditions, such as heart disease, Parkinson’s disease, and COPD, worse
How are phobias diagnosed?
DiagnosisIf you’re struggling with a particular fear, talking with a mental health professional is a good place to start. Your provider can help determine if your fear meets the criteria for a specific phobia and work with you on a treatment plan that meets your needs.
Diagnosing a phobia doesn’t require lab work or diagnostic imaging—instead, your mental health provider will talk with you to better understand your fear and how it’s affecting you. Questions or discussion topics may include:
- Your symptoms, how intense they feel, and when they started
- How these symptoms affect your routines, social life, and work
- What triggers your phobia or symptoms
- If you’ve experienced any traumatic events
- Your medical and psychological history
- Family history
Treatment & getting help
TreatmentPhobias can be challenging and scary, but they don’t have to take over your life. Therapy, medication, or a combination of the two can make a big difference for those living with one or more phobias.
Exposure therapy
Exposure therapy is one of the most effective treatments for specific phobias. During this type of treatment, a trained provider will expose you to your triggers (often gradually) as you practice managing your anxiety and fear. Exposure therapy can be done “in vivo,” meaning in real life, or through imagining. For instance, if you have a phobia of snakes, your therapist may have you visit a reptile exhibit at the zoo or ask you to write a detailed description of a snake.
Talk therapy
Cognitive behavioral therapy (CBT) is a type of “talk therapy” done with a trained therapist. The goal of this type of therapy is to shift your thinking around a specific fear. During CBT, you may also learn how to manage uncomfortable feelings and thoughts when they arise.
Medication
Medications, such as beta blockers, sedatives, and common medications used for depression or anxiety, can help ease the symptoms that come up when thinking about or confronted by a phobia. Taking medications can also make other interventions feel less intimidating and help you engage with the work of exposure therapy or CBT.
The Center for Youth Mental Health at NewYork-Presbyterian
Get CareThe Center for Youth Mental Health is a rich resource, bringing together doctors from Columbia University Vagelos College of Physicians and Surgeons and Weill Cornell Medicine to lead research and treatment programs that give young people the care they need. Learn more.