About Mental Illness

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Phobias

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This factsheet aims to explain phobias. You will find a description of phobias, their symptoms, and the treatments available. If you are experiencing a phobia, you will find suggestions of ways that you may help yourself and the options open to you. You will also find ideas on how friends and family may help.

What are phobias?

A phobia is an intense fear of a particular object or situation. Almost all phobias involve a fear of places, situations or animals that for most people hold little or no fear at all, however, for someone with a phobia these things can inspire feelings of fear, terror or panic.

If you have a phobia, you may experience symptoms only when exposed to the object or situation that you fear while at other times there may be no symptoms. However, some phobias can place severe restrictions on your life; in the case of agoraphobia, for example, someone may find it extremely distressing to even contemplate going outside their own home. Other phobias, such as fear of spiders, will probably have significantly less impact on daily life.

What are the common phobias?

There are a vast number of phobias but they can be roughly divided into two categories: simple phobias and complex phobias. Simple phobias are related to one particular object or situation, for example a fear of dogs. Complex phobias, such as agoraphobia, can have far-reaching effects; the situations that provoke anxiety and avoidance can extend until the affected person is a virtual prisoner in their own home. Here are some examples of each:

Simple phobias

  • Fear of spiders (arachnophobia)
  • Fear of thunder and lightning (astraphobia)
  • Fear of heights (acrophobia)

Complex phobias

  • Fear of leaving home or entering open spaces (agoraphobia)
  • Fear of enclosed or crowded places (claustrophobia)
  • Fear of social gatherings or attracting attention (social phobia)

What are the symptoms of phobias?

Phobias vary in severity among individuals. Some people simply dislike or avoid the subject of their fear and experience only mild anxiety as a result. Others may experience extreme anxiety and panic attacks with all the associated disabling symptoms.

Psychological effects of phobias

  • Fear
  • Anxiety
  • Depression
  • Obsessions (with the object of the phobia)
  • Loss of control

Physical effects of phobias

  • Feelings of tightness in the chest
  • Chest pains
  • Nausea
  • Rapid shallow breathing
  • Butterfly feelings in the stomach
  • Headaches and dizziness
  • Muscle tension
  • Pounding heart
  • Faintness
  • Sweating
  • Panic attacks

What causes phobias?

Most simple phobias can be traced back to a specific triggering event, usually a traumatic experience at an early age, for example being bitten by a dog, or being scared by a storm. Complex phobias, such as social phobias and agoraphobia, have less easily explained causes. It is believed that heredity, genetics and brain-chemistry combine with life-experiences to play a major role in the development of these phobias.

How common are phobias?

Phobias are the most common form of anxiety disorder; current estimates are that there are around 10 million people with phobias in the UK. Phobias can occur in people from all backgrounds, any occupation, and at any time of life. Simple phobias, such as fear of the dentist, are common in children but usually fade by adolescence presenting few problems in adulthood. A smaller number of simple phobias start in adult life after a stressful experience, for example after being thrown by a horse. Complex phobias, such as agoraphobia, usually begin in early to mid adulthood and can continue for many years.

What treatments are available?

Most people experiencing simple phobias do not require any treatment; simply avoiding the object of their fear is satisfactory for them. Most simple phobias are not debilitating and do not affect everyday quality of life. Some simple phobias such as fear of flying or of the dentist can however present frequent problems so people may seek help with these. For others who experience more severe symptoms or complex phobias a variety of treatments are available.

Most people diagnosed with a severe phobia are treated by their family doctor, although a small minority of people may be referred to a psychiatrist or a member of the local Community Mental Health Team for more specialised help. Depending on your symptoms, the severity of the phobia, and your circumstances, the doctor may suggest some form of talking treatment, antidepressant drugs, anxiolytic drugs, or a combination of these treatments.

Talking treatments
For some people talking treatments alone can be effective in treating phobias, for others a combination of talking treatments and drug treatment may be most effective. Talking treatments aim to help people recognise the stress factors in their lives, and work out coping strategies in order to be able to deal with them. Cognitive behaviour therapy and graduated exposure therapy are particularly effective in treating phobias. These treatments both work towards the goal of desensitising a person to the cause of their fear and changing the thought patterns which contribute to their panic.

A referral for talking treatments can be arranged by your doctor. However, frequently there are long waiting lists for these types of treatment on the NHS. Free or low-cost counselling is also provided by a number of charities and voluntary organisations and, for those who can afford to pay, there are many private practitioners.

For more information on talking treatments please see Psychological Methods of Treatment

Antidepressants
Antidepressant drugs are used to treat anxiety as well as depression. They work by affecting the chemicals in the brain that lift your mood. These drugs can be effective in treating the anxiety associated with your phobia, however, in themselves they are not a cure for anxiety. The drugs treat the symptoms of the condition, but cannot treat the root cause of the phobia itself. This is why talking treatments are often prescribed in conjunction with antidepressants, so that people can be helped to address the reasons why they developed a phobia in the first place.

It may be a few weeks before the drugs begin to have a noticeable effect, but it is important that you continue to take them or the treatment will not be effective. As with any medication, some people may experience unwanted side-effects. If this happens, it is important that you discuss this with your doctor as they may be able to prescribe a different antidepressant drug for you. It is normally recommended that you stay on the drug treatment for a period of around six months in order to minimise the chance of the condition recurring.

Anxiolytic drugs
Anxiolytic drugs, also known as minor tranquillisers, can bring the anxiety symptoms of phobias under control quickly. However, anxiolytics should not be used for long as people can develop a dependency very quickly. Therefore, drugs such as diazepam are usually only prescribed for the temporary relief of the most distressing symptoms. Some people may experience unwanted side-effects. If this happens to you, it is important that you discuss this with your doctor as they may be able to prescribe a different drug for you.

For more information on drug treatments please see Medical Methods of Treatment

Which treatment may be right for me?

Individuals respond to different treatments in different ways. What works well for one person may not work well for another. Drug treatment may be extremely effective for some people, while some may find talking treatments the best option. Others may find a combination of drug and talking treatments works best for them. Speaking to your doctor will help you weigh up the pros and cons of the different treatments available. Your doctor should be able to provide you with information on how treatments work, how effective they are, and what side-effects you may experience.

What can I do to help myself?

There are many ways in which you can help yourself cope with a phobia. It is important that you come to understand the nature of your phobia, its causes and symptoms. If you can recognise the early signs of a relapse or deterioration in your mental health, you can seek help and treatment before your condition worsens.

When you are feeling anxious or fearful, it can be difficult to see beyond the day-to-day problems in life. It can be very difficult finding the energy and motivation to actively try and help yourself. However, if you are able to take an active part in your treatment it should help your situation improve.

Self-help groups
Many people find it helpful to meet others in a similar position. It can be very useful to share experiences with other people who may be going through the same thing you are. There are opportunities for mutual support, and you may get ideas of what things other people have found helpful to them. Above all, it is an opportunity to help you realise that you are not alone in how you are feeling.

Fighting negative attitudes
Anxiety and fear can cause people to sink into a cycle of negative thinking. The more anxious you become, the less you are able to find the motivation to help you fight the anxiety. It can be extremely helpful if you are able to recognise patterns of negative thinking, challenge these yourself, and try and replace them with more positive, constructive thoughts.

Physical Activity
Many of the physical symptoms of anxiety can be attributed to an excess of hormones, such as adrenalin, in your system. Although it may be difficult finding the motivation to exercise, it can be very therapeutic to take part in physical activities. Jogging, swimming, sports, even brisk walking can help to use up any excess adrenalin.

Care for yourself
When you are feeling anxious or fearful it is extremely important that you care for yourself. You will feel better if you are able to eat properly, pay attention to your physical appearance, and don't abuse alcohol or drugs. Be kind to yourself, allow yourself treats, and try not to cut yourself off from other people.

Complementary therapies
There are non-medical treatments that some people find helpful, however it is important that you discuss such treatments with your doctor first in case of any interaction with what they have prescribed. Massage can help to alleviate stress and anxiety making make you feel better. Some people benefit from meditation, yoga, homeopathy and acupuncture.

What can friends and family do to help?

Supporting a friend or relative with a phobia can be hard work and frustrating. However, it can also be immensely satisfying and an opportunity to build a closer relationship. Complex phobias can make people withdraw from social situations and relationships and make them reluctant to confide in people and ask for help and support. Friends and relatives can be of great help. They can provide emotional and practical support and encourage people to seek appropriate professional support and treatment. Friends and family can become involved in treatment plans and, above all, make a person feel wanted, needed and loved.

Where can I find help and support?

There is a wide a range of services available that can help provide care, support and information to people experiencing anxiety, their friends, relatives and carers. You may find some of the following useful:

SANEline/SANEmail
1st Floor Cityside House, 40 Adler Street, London, E1 1EE
helpline:0845 767 8000, fax: 020 7375 2162
email: sanemail@sane.org.uk
web: www.sane.org.uk
SANEline and SANEmail offer emotional support, and information to those experiencing mental health problems, their families and carers.

British Association for Behavioural and Cognitive Psychotherapies (BABCP)
Victoria Buildings, 9-13 Silver Street, Bury, BL9 0EU
tel. 01254 875 277, fax: 01254 239 114
email: babcp@babcp.com
web: www.babcp.com/
A directory of psychotherapists is available online.

British Association for Counselling and Psychotherapy (BACP)
BACP House, 15 St John's Business Park, Lutterworth, Leicestershire, LE17 4HB
tel. 0870 443 5252
email: bacp@bacp.co.uk
web: www.bacp.co.uk/
See website for details of local practitioners.

British Psychoanalytic Council
West Hill House, 6 Swains Lane, London N6 6QS
tel. 020 7267 3626, fax: 020 7267 4772
email: mail@psychoanalytic-council.org
web: http://www.bcp.org.uk/
A linking body of psychoanalytical psychotherapist societies.

Carers UK
20–25 Glasshouse Yard, London EC1A 4JT
carers line: 0808 808 7777, tel. 020 7490 8818 fax: 020 7490 8824
email: info@ukcarers.org
web: http://www.carersonline.org.uk/
Information and advice on all aspects of caring.

First Steps to Freedom
PO Box 476, Newquay, TR7 1WG
helpline: 0845 120 2916
email: first.steps@byconnect.com
web: www.first-steps.org
Information and help for people with anxiety problems, 10am -10pm 7days.

National Phobics Society
Zion Centre, 339 Stretford Road, Hulme, Manchester, M15 4ZY
tel: 0870 122 2325 fax: 0161 226 7727
email: info@phobics-society.org.uk
web: http://www.phobics-society.org.uk/
Information and help for people with obsessions and anxiety problems

No Panic
93 Brands Farm Way, Randlay, Telford, Shropshire, TF3 2JQ
helpline: 0808 808 0545
email: ceo@nopanic.org.uk
web: www.nopanic.org.uk
Helpline for people experiencing anxiety problems, 10am -10pm 7days

Samaritans
The Upper Mill, Kingston Road, Ewell, Surrey KT17 2AF
helpline: 08457 90 90 90, fax: 020 8394 8301
email: jo@samaritans.org
web: http://www.samaritans.org/
24-hour telephone helpline offering emotional support for people who are experiencing feelings of distress or despair.

Triumph Over Phobia (TOP UK)
PO Box 3760, Bath, BA2 3WY
helpline: 0845 600 9601
email: info@triumphoverphobia.org.uk
web: http://www.triumphoverphobia.com/
Helpline offering emotional support for people experiencing obsessions or phobias

United Kingdom Council for Psychotherapy (UKCP)
2nd Floor, Edward House, 2 Wakley Street, London EC1V 7LT
tel. 020 7014 9955, fax: 020 014 9977
email: info@psychotherapy.org.uk
web: http://www.psychotherapy.org.uk/
Umbrella organisation for psychotherapy in UK. Regional lists of psychotherapists are available