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Confronting Your Phobias
Being afraid is natural, but irrational fear of harmless things isn't. With therapy, almost anyone can get over their phobias.
WebMD Feature
Refuse to fly?
Can't drive across a bridge? Will do anything to avoid speaking in public? You, like millions of others, may be suffering
from a phobia.
The bad news is
- as you know all too well - that phobias are uncomfortable & can disrupt your life.
But the good news is that phobias aren't dangerous & what's more important, they can
be cured.
In "doctor-speak,"
a phobia is an irrational or excessive fear of a situation or a particular object, says Michael Kahan, MD, a psychiatrist who specializes in the treatment of phobias at Hillside Hospital, part of North Shore-LIJ Health System in New York.
Being afraid of something isn't the same thing as a phobia, says Kahan. "Many people are afraid of snakes, i.e., but it's not a phobia if it doesn't interfere with your life or sense
of well-being," he explains.
Phobias can be
classified by category, says Kahan: specific & social. Specific phobias
are fears of such things as animals - snakes, mice, dogs, cats, insects are particularly common - heights, bridges & elevators.
Between 6% & 12% of people in the U.S. suffer from a specific phobia.
Social
phobias - which afflict more than 13% of the population - have to do with the fear of such situations as public speaking, stage fright & meeting new people.
Social phobias
are frequently overlooked by healthcare professionals, says clinical psychologist Barbara Markway, PhD, author of Painfully
Shy: How To Overcome Social Anxiety and Reclaim Your Life. So it may be up to you to determine if that could be causing
your discomfort. Markway suggests asking yourself the following questions:
- Do you literally become "sick
with fear" at the thought of being in certain social or performance situations (such as speaking in public,
participating in class, attending meetings, meeting strangers, going to parties, dating)?
- When did you first begin
feeling this way?
- How much does it affect your
everyday life?
- Do you have any other conditions,
such as depression, that frequently go hand-in-hand with phobias & anxiety?
If it looks like social
anxiety is a chronic problem that's limiting your activities, you should seek treatment, says Markway, as she
herself did when she first realized that she suffered from social anxiety.
In the meantime,
says Markway, there are a few tips you can follow on your own:
- Accept yourself. Don't worry about what others are thinking
of you. "There's a place in the world for people who are thoughtful & quiet," says Markway.
- Go with the flow. If your heart is racing & you're short
of breath, realize that it's just anxiety. "It's uncomfortable, but it's not life-threatening," Markway says.
- Face your fears. Set small goals for yourself. Go to a party. Raise your hand in a meeting. Ask a friend to lunch. "What's the big deal if
it doesn't go as planned?" Markway asks.
Anxiety disorders
(including social anxiety) can lead to
another kind of phobia, known as agoraphobia, says Julian
Herskowitz, PhD, director of the TERRAP Anxiety & Phobia Program in Huntington, N.Y.
Contrary to popular thought,
says Herskowitz, agoraphobia isn't the fear of leaving home or the fear of open spaces - as it's frequently defined - but is really the fear of having another panic attack, that sudden rush of anxiety that can strike you out of
the blue & that frequently leads to your avoiding the type of situation in which you first had the attack - perhaps at
the supermarket or in the car.
Phobias can strike
anyone, says Kahan, although there is some indication that if someone in your family suffers from a phobia,
you'll be more likely to develop one yourself.
People with phobias
also tend to be more excitable, more sensitive & more reactive to stimuli, says Herskowitz. They also are likely to be
perfectionists, have a strong need for approval, a desire to be "in control" & suppress their feelings, especially of
anger & sadness.
Being the victim of abuse, having overprotective parents & growing up in a rigid household may also lead to phobias,
but understanding what causes the problem does little to solve it.
That's where treatment
comes in. As a rule, 80% to 90% of people who suffer from phobias recover with the
proper therapy, says Kahan. The treatment approach that has been proven most effective is cognitive behavioral therapy, combined with medication (antidepressants or antianxiety drugs) if necessary.
During cognitive therapy,
the phobic person is taught how to correct his or her thinking, says Kahan. "The degree
of fear that a person with a phobia has is distorted. Cognitive therapy retrains the thought process."
"In cognitive behavioral therapy, you learn how to change the way you think instead of fighting how you feel," says Herskowitz.
The behavioral component
involves learning to relax, Kahan says, which will calm the physical sensations (shortness of breath, rapid heartbeat,
lightheadedness) that the phobia may give rise to.
Effective breathing techniques
can also help you calm those troubling physical sensations. Herskowitz offers this suggestion:
- Breathe in thru your nose, expanding your diaphragm, to the
count of 4.
- Breathe out slowly thru your mouth to the count of 7.
- Hold for 2 seconds.
- Repeat the exercise.
Taking a brisk walk
will also help you burn extra oxygen & restore your body's equilibrium, Herskowitz says.
Therapy has also gone high-tech, says Kahan, with the use of virtual reality technology. Part of therapy, he explains, is
to expose the phobic person to the phobia in gradually
increasing doses - taking the elevator one flight, i.e., then the next time, 2 flights & so on.
When it's not practical
to do this - such as flying on a plane - a virtual reality system that uses computer technology, specially designed
software & a headset can simulate the real thing.
The length of time
you may spend in therapy can range from 3 months to 2 years, says Herskowitz, depending on the severity of the phobia.
Though there can be setbacks later on during stressful times, the relapse rate is low.
Although seeking
professional help is highly recommended, if you want to help the process along, Herskowitz says, learn as much as you can
on your own. Lucinda Bassett & Claire Weekes are two authors he particularly recommends for their books on coping with anxiety disorders & phobias.
"The more you know," says Herskowitz, "the less
you imagine."
source: WebMd
  Phobias What are They?
By Ian Bracegirdle
What is a phobia?
Forgive me if I seem to go around the house a bit
but all will come clear to you as you follow along.
For you, if you're the sufferer, it's a compelling fear. A real
gut wrenching feeling "I have got to get away!" instinct. In the situation where the fear happens it can feel unbearable.
i.e.,
A friend of mine, a teacher, was walking along Blackpool Promenade. It was a beautiful sunny day. To her left people were
enjoying the beach, playing games, swimming in the sea & sunning themselves.
Hundreds
of other people were walking along the promenade coming & going as people do on their holidays. The parallel road was
busy with slow moving traffic & the old Blackpool trams rattled by.
A brilliant holiday day was being enjoyed by
thousands. BUT!
Lets call my friend Jane, not here real name, but she wishes to remain anonymous.
Jane was walking with her two daughters aged 3 & 5 years, each holding a hand. They were relaxed &
looking forward to playing on the beach & ice-cream & other treats. Even so in that crowd the girls were holding tight
to mums hands as they experienced the sea of legs.
Suddenly everything change! Jane let go of the girls hands, turned
& fled in the opposite direction. Fear had struck right thru Jane's whole caring, motherly nature.
What horror could have sparked this loving mother to behave in such a rash
& seemingly uncaring manner?
Let's just look a bit further down that crowded promenade. Coming towards Jane was
a photographer with a camera around his neck. Like many other seaside photographers he had a live prop to stimulate his trade
& get people to pose for pictures. Around his neck was draped a large python.
Can you feel what spooked Jane?
Yes.
She had seen the python, done what I call "The 400 simultaneous horror movies" & fled, leaving two little girls to their
fate.
Her fear of snakes was so great as to override all her mothering, caring & loving nature.
If you're reading this and don't suffer from such fears you
could well be thinking; "Silly woman why didn't she just turn around & walk the other way?" Or you may be of the hard
school & think; "Stupid woman why can't she keep herself under control?"
For a second place yourself in Jane's
place. What would cause you as a parent to override your basic protective nature towards your offspring? Think about it....
it would really have to be something very powerful. We instinctively protect our children but this mother abandons her two
young daughters in the middle of a crowded holiday resort and runs away because of a snake. She leaves them facing her worse
fear, an eight foot long python.
If you have a phobia you will understand what is going on. If not you could well
be very puzzled and maybe even disturbed by this true story.
What is happening?
This is a step thru of the event: Jane sees snake -panic mode is set in motion - her flight /
fight mechanism is set in motion - adrenaline flooded thru her blood stream - fear overrides all logical thoughts.....
Two options are available - run or fight - she's
too frightened to fight -
her only option is to run she legs it as fast as possible.
At this moment the only thing that matters is her
survival - she is scared of dying. Her only option is survival as she's stopped thinking logically. All this happens
in a split second. In Jane's mind there are no options, fear overrules all thoughts of protecting her two vulnerable daughters.
Once
Jane has calmed down away from the threat she's able to rationalize her fear. She'll probably feel shame & guilty about
her actions. Yet in her mind she would react the same in a similar situation.
She knows that her fear is still there waiting
to be triggered again.
Why does Jane react this way?
Hundreds of people around Jane that day walked
past that same snake, some even had it draped around their necks & had a photograph taken.
Why is Jane the only
person who reacts this way? I'm sure that some people would have had lesser reactions but most could cope with their minor
fear of snakes. Only Jane appears to have had this overriding panic.
 Fears & Phobias
By Krzysztof Sroka
What are you afraid of? I’m sure that like almost everybody else you are afraid of something.
Charles F. Haanel defines fear as “…a powerful form of
thought."
I think it's a very good definition, because mostly fear is in our minds. Phobia is abnormal fear. We are often afraid of things which we have no reason to be afraid of. This is because most of the fears & phobias are only the creations of our minds.
i.e., some people are afraid of flying. Why? Probably because they have heard about some plane
crashes & that all of the people died in those accidents. Of course plane accidents do happen & usually all of the
people who are in such accidents die.
But the same people who are afraid of flying are usually not afraid of traveling
in cars and on buses. Cars accidents cause many more deaths than airplane accidents. The probability of dieing in the car
accident is much higher than in plane accident. Flying is the safest way of traveling. So, why people are afraid of flying?
Like with most phobias the reason is that they do not control their minds.
When we listen about different tragedies
and unhappy news, a subconscious mind accepts everything which comes from a conscious mind. The subconscious mind is a creator,
it makes things happen, but it does not have the power to differentiate between what is good and bad for us. The conscious
mind has the power to differentiate, but most of the people often do not use this power.
So, when you listen to different
news or stories, your conscious mind accepts the news and makes a fearful picture of the situation. Maybe even you or your
loved ones are in this picture. If the feeling of fear is there and it gets to your subconscious mind, it gets deeply rooted
in your sub consciousness and it will be very difficult to get rid of that fear.
Of course there are some techniques
to get rid of different fears and phobias. But first you should be careful to not allow any fears or phobias to get to your
subconscious mind. Avoid dwelling on any pessimistic and negative feelings. Try to cultivate positive feelings. Be optimistic.
Even if you are not happy at the moment, thinking about your unhappiness will not make you feel better. It will make you feel
worse.
Think about something that would make you happy, about something you want very much. Close your eyes. Try to
visualize yourself in a happy situation, in your perfect environment. Think of the reasons why you want what you want. See
yourself as already possessing what you want. Try to really feel it. Let the feeling excites you. Hold on that feeling.
If
you do that you cannot feel unhappy. It might be difficult at first, but if you practice often it will become easy and natural
for you. You will not only feel better but you will start attracting the things you really want. And by concentrating on positive
feelings and by being charged with positive energy you will become immune to any fears and phobias. You will start manifesting
the life you want. Now you are what you thought mostly about in the past. Do not allow your negative thoughts to create the
unhappy future for you.
It Involves a Phobia of Mine...
kathleen howe
I've mentioned in a few places throughout the network.... that I have been diagnosed with post traumatic stress disorder, depression, and that I have experienced
panic attacks, and then left off with, "and other things."
My phobias are those "other things" I so often talk about. When it comes to phobias, no one can understand
the intensity of fear or pain that a phobic person feels within unless they're phobic about something themselves. I've developed
phobias from having an escalation of intense fear due to unresolved emotions & feelings concerning traumatic events in
my life.
You see, stuffing emotions & feelings produces other symptoms to pop out somewhere, either mentally
or physically. Those unresolved emotions & feelings laying dormant inside you aren't actually as dormant as you believe
they are. They're energy, motion, action - "a force" that resides within you as a person. Think about it rationally,
and you'll see that you can't contain energy within you indefinetly. Eventually it shows itself.
I have been in denial about some of my phobias. It's the most simple way to cope. Anyone reading this article who
is phobic about something can probably identify with what I'm saying! If you don't think about it, it doesn't bother
you until you are faced with the phobic element. Then you freeze. Then you try to deny again. It's a virtual link of
chain reactions that you've customized to fit your personally. This is how I am going to cope with what I fear the most.
Personally, I ignore it. Personally, this gets me into lots of hot water most of the time. I end up pleading
my case, exposing myself for who I am - severely phobic - then I end up praying for empathy & compassion.
I ask you, "Is this anyway for someone to live their life?" I don't think so, but it's me. It's me
& I can't deny that.
This is what counseling is for. If you are phobic about something,
get some help. I haven't gone back to counseling because I haven't found the right person. I believe or it's my opinion only
- that cognitive behavioral therapy or even exposure therapy would be my best treatment plans.
My reasoning for this is one of my phobias, effects my life
daily, which is a determining factor as to when you need to seek help, by the way, and I can't think of any other way to get
over the fear than to face it straight on, get used to the possibilities, break the old habit of locking up in fear &
start anew with different, more positive coping mechanisms.
If you reference my "avoidance page" at emotional feelings, the homepage for the emotional feelings network
of sites, you will read my column that states, "I am the queen of avoidance!" I've used avoidance behavior as well as denial
to make it through life with this phobia. The phobia being - the fear of "dealing with mail." I'm not sure if it has a "proper
name," because I won't honor it that much to spend my energy on finding out.
I have been exposed to legal and other personal mail transactions that have been so frightening, shocking
& painful for me that I can't face opening the mail. Should I have to respond, it's almost a sure bet that I won't.
This phobia is interfereing with my daily life. I have been trying to self help it away. I'm making some
progress because I can now talk about it. I have been able to respond to some pieces of mail. But can you imagine having to
tell someone your life story as to why you have a "Mail Phobia" when you've ignored the wrong piece of mail
- i.e., like that from the IRS?
It's hard folks. Being phobic is very difficult. It's not just mind over matter. You need help.
Recently I visited my dentist because my son had an appointment to get his braces checked. I had been
avoiding the dentist because I owed them the balance for the braces, $1,500.00 - but I had been neglectful at my mail
because of my phobia, which caused problems for me in regards to freeing up that $1,500.00 that I was to pay to the dentist.
Long story short, I walked in there and pleaded my case. I told the truth. I didn't give all the gory details
of my past, just the acceptance of my present and how I have been dealing with it. I was in shock at the response I received
from a young lady who I had believed previously was very educated and intelligent.
"Well, that attitude isn't going to work! You'd better snap out of it!"
Well, I am better now. I am able to handle these people now. Because I've recovered partially from my illnesses, my negative coping
actions & because I've educated myself to the truth concerning mental illness; I didn't leave the room transforming into
a defenseless hypervigilent victim of my mental illness.
I simply told her she needed to become more informed on the
subject. I negotiated a deal with her and left. I felt okay with what happened and I proved to myself that it was irrational
to be so afraid of the mail. Reinforcing this positive information for myself is something I have to keep doing to get over
this phobia. I know it.
Get to know yourself better. Get rational about your irrational
self. If you're phobic, educate yourself as much as you can, and then educate yourself some more. It's brain armor against
your own fears and phobias. Keep trying and never give up. Begin to be vocal about your phobia. You've got something
to say. You are still important as a human being. You are especially important as an ambassador for mental illness! We must
educate those who refuse to do it themselves!
Be proud of who you are...
a work of art in progress... get realistic about your phobias. You can recover from them.
How Fear Grows & Spreads
By Mark Ivar Myhre
In a way, fear is a lot like fire. Fire is essential for life, but it can also rage out of control & even kill you. The goal isn't to eliminate fire. You can't. But you can turn it into an ally. You can set the boundaries & the rules & make fire work for you.
Just as you can make your fears work for you. Fear is supposed to be an ally. Like every other emotion. Not an enemy.
Fear on this planet is out of control. It can only be dealt with one person at a time. And it starts with you.
Are you waiting
for somebody else to take charge & end your fears for you? Fear is private. Personal. It attacks in the shadows - the quiet hidden areas of your life. Where nobody else goes. The areas
only you know about.
Only you can deal with your fears. Nobody else can climb inside your heart & your mind & help you.
Fear sneaks in & gains a foothold. Then it grows. If you don't deal with it when it's small, it will only grow larger
& more arrogant. Bolstered by your lack of attention to it. Generally, we'll ignore, deny & discount the fear when it's small. So it grows. Because it can.
We knew it was there, but either we
didn't know how to handle it properly, or didn't see the need to deal with it.
But like a mold or a parasite, it firmly attaches itself &
starts to grow stronger. Until finally it reaches the point where it can no longer be ignored. That's when you start obsessing on it. That's when it really starts to get out of hand.
Eventually,
fear spreads to infest every part of your being; every area of your life. Sometimes it manifests as anxiety or panic. Often it stays as raw painful fear. It can grow so large that it appears to loom over you.
At this stage you start
to feel hopeless, helpless & overwhelmed. You start to feel desperate. You're forced to search for solutions. And there are so few good answers.
I've seen it
over & over with others. And I've lived it myself for decades. Fear can be a bully - totally uncaring - relentless in it's oppression. It'll continue to grow until you take positive, concrete steps to end it. The old ways of denial & manipulating your fears won't work anymore. Maybe you found that out.
The good news is, most of that fear is imaginary.
The bad news is, most of that fear is imaginary. Which means it hurts more. It stays around longer. It causes more damage. And all the while, it seems more intractable.
Real fears come & go in a moment of exhilaration. Imaginary fears seem to linger forever. Slowly digesting you - like a spider sucking the insides of a fly. Until the only thing left is a
hollow shell. That's what imaginary fears can do. They're much worse than real fears.
The first step is to understand the difference between real & imaginary fear. If you experience basically the same thoughts & feelings over & over again - day after day after day - then you can be sure it's imaginary. No matter how real it seems.
See, what happens is we take a tiny bit of real fear & snowball it into this huge monster called 'imaginary fear'. Why? Because we're not cleanly feeling the real fear in the first place.
We end up spinning on a hamster wheel of 'what ifs'.
Fears consume you if you turn your back on them. Or if you try to 'explain' your fears, you'll get eaten alive. If you try to rationalize them... justify them... blame them on something outside yourself...
Or by trying to avoid them, or deny them, or fight them.
The answer lies with consuming your fears rather than letting them consume you. Take your fear story, hold it up to the light of day & then slap it down on the kitchen table. Take what's real & 'eat' it. Throw
the rest away. That's where it begins.
No matter how big your fears may seem, you created them. You are more than your fears.
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Phobias
Giving a public presentation
makes many people nervous. But perhaps it makes you so nervous that you worry for weeks before the event & you may even
start to feel sick if you just think about it.
Or, perhaps you're so anxious
about driving thru a tunnel you go miles out of your way to avoid it. If so, you may have a phobia.
A phobia
is a persistent irrational fear of an object or a situation that's generally considered harmless. Accompanying the fear is a strong desire to avoid what you fear & in some cases, an inability to function at normal tasks in your job & in social settings.
Phobias are among several
anxiety disorders, which also include
- panic disorder
- post-traumatic stress disorder
- obsessive-compulsive disorder
- generalized anxiety disorder
More than 12% of the population experiences a phobia at some point in life, making this
disorder the most common mental illness in the United States.
Treatment of phobias
may help you reduce your fears & help you better manage the object or situation that makes you anxious.
Signs and symptoms
Common phobias include:
- Specific phobias.
These include a fear of enclosed spaces (claustrophobia); animals, particularly spiders, snakes or mice; heights (acrophobia);
flying (pterygophobia); water (hydrophobia); storms; dentists; injections; tunnels; bridges; and not being able to get off
public transportation quickly enough. There are many other specific phobias.
- Social phobia.
More than just shyness, social phobia involves a combination of excessive self-consciousness, a fear of public scrutiny or
humiliation in common social situations, and a fear of negative evaluation by others.
- Fear of open spaces (agoraphobia).
Most people who have agoraphobia developed it after having one or more panic attacks. Agoraphobia is a fear of being on your
own in a place, such as a mall or an elevator or a room full of people, with no easy means of escape if a panic attack should
occur.
Having a phobia may produce the following signs and symptoms:
- A persistent, irrational fear of a specific
object, activity or situation
- An immediate response of uncontrollable anxiety
when exposed to the object of fear
- A compelling desire to avoid what you fear
and taking unusual measures to stay away from what you fear
- An impaired ability to function at normal
tasks because of the fear
- Often, the knowledge that these fears are
out of proportion with the stimulus
- When facing the object of your phobia, an
experience of panicky feelings, such as sweating, rapid heartbeat, avoidance behavior, difficulty breathing and intense anxiety
- In some cases, anxious feelings when merely
anticipating an encounter with what you fear
Children may develop symptoms of specific phobia as young as
age 5, especially phobias related to the natural environment — such as storms or animals — or to bodily injury.
Social phobia and situational phobias, such as fear of heights or of closed-in spaces, typically appear by the mid-20s.
Causes
Much is still unknown about phobia causes. However, there may
be a strong correlation between your phobias and the phobias of your parents. Children may learn phobias by observing a family
member's phobic reaction to an object or a situation. An example of a common learned phobia may be the fear of snakes.
Brain chemicals, genetics and traumatic experiences also appear
to influence the development of phobias.
When to seek medical advice
Simply feeling uncomfortable or uncertain about an object or
situation may be normal and common. If your fear isn't disrupting your life, it's not considered a disorder, and you may not
need treatment. But if your fear becomes irrational and uncontrollable to the point that it affects your social interactions
or job duties, you may have a disorder that requires medical or psychological treatment.
Get evaluated first by a medical doctor, such as your family
doctor or a psychiatrist, who can rule out other causes for your anxiety. You may then be referred for treatment to a mental
health professional, such as a psychologist, who can help you cope with your fears.
Screening and diagnosis
Your doctor will likely ask you to describe your symptoms, how
often they occur and what triggers them.
Sometimes physical disorders occur along with anxiety disorders.
You'll probably undergo a complete physical exam so that your doctor can determine whether health conditions other than phobias
could be causing your symptoms of anxiety.
Phobias sometimes occur along with other anxiety disorders and
may be accompanied by depression, abuse of alcohol or other substances, or eating disorders. Your doctor may try to identify
other mental disorders that may exist before suggesting a course of treatment.
Complications
Having a phobia may cause other problems, including:
- Social isolation.
If you have a phobia, you may find that you avoid social situations and public places. Financial, professional and interpersonal
problems often result from social phobia and agoraphobia.
- Depression.
The avoidance of many activities that other people find enjoyable in their personal and professional lives may lead you to
become depressed.
- Substance abuse.
Some people with phobias turn to alcohol or other drugs to deal with stress. This unwise and unhealthy choice can lead to
abuse of alcohol or other drugs.
Treatment
Your doctor or a mental health professional may suggest medications or behavior therapy or both
to treat phobias. Most people don't get better on their own and require some type of treatment. The objective of phobia treatment
is to reduce anxiety and fear and to help you better manage your reactions to the object or situation that causes them.
Medications
- Beta blockers. These medications work by blocking the stimulating effect
of epinephrine (adrenaline). They block some of the peripheral signs of adrenaline's stimulation and anxiety, including increased
heart rate, elevated blood pressure, pounding of the heart, and shaking voice and limbs. These can be very effective for people
who have stage fright, but must give a presentation before other people. However, not all beta blockers are effective for
this purpose, and they're only available by prescription, so check with your doctor.
- Antidepressants. Antidepressants also can reduce anxiety. The most commonly
used antidepressants are selective serotonin reuptake inhibitors (SSRIs). These medications act on the chemical serotonin,
a neurotransmitter in your brain that's believed to influence mood. SSRIs include citalopram (Celexa), escitalopram (Lexapro),
fluoxetine (Prozac), fluvoxamine, paroxetine (Paxil) and sertraline (Zoloft). If SSRIs aren't effective or cause intolerable
side effects, your doctor may prescribe a monoamine oxidase inhibitor (MAOI), which blocks the chemical monoamine oxidase
in the nervous system. MAOIs include phenelzine (Nardil) and tranylcypromine (Parnate).
- Sedatives. Medications called benzodiazepines help you relax by reducing
the amount of anxiety that you feel. They include lorazepam (Ativan), diazepam (Valium), alprazolam (Xanax) and chlordiazepoxide
(Librium). Sedatives need to be used with caution because they can be addictive. It's generally safe to use low doses of sedatives
infrequently or only for short periods. However, sedatives should be avoided if you have a previous history of abusing alcohol
or other drugs.
Behavior therapy
Desensitization or exposure therapy focuses on changing your response to
the feared object or situation. Gradual, repeated exposure to the cause of your phobia may help you learn to conquer your
fear. For example, if you're afraid of flying, your therapy may progress from having you think about flying to looking at
pictures of airplanes, to going to an airport, to sitting in an airplane, and to finally taking a flight. Some major airlines
offer programs to help you adjust to flying. For example, a group of people with the same fear may all sit in an airplane
together, but the airplane won't take off.
Cognitive behavior therapy is a more comprehensive form of therapy. It involves you and your
therapist learning ways you can view and cope with the feared object or situation differently. You learn alternative beliefs
about the feared object or situation and the impact it has on your life. There's special emphasis on learning to develop a
sense of mastery and control of your thoughts and feelings.
Treatment choices
Specific phobias usually are treated with behavior therapy. Social phobias
may be treated with antidepressants or beta blockers, along with behavior therapy. Agoraphobia, especially when it's accompanied
by a panic disorder, is usually treated with SSRIs and behavior therapy.
Coping skills
Many childhood fears are common, such as fear of the dark, monsters
or being left alone. Most of the time, your child will outgrow these fears. However, if your child has a persistent, excessive
fear of an object or situation, he or she may have a phobia.
Although some phobias are outgrown, they may become worse if
they're not addressed. Talk to your child's doctor if your child appears to have a phobia that's limiting his or her ability
to function in daily life.
To help your child cope with fears:
- Talk to your child about
his or her fears. Don't trivialize the problem or belittle your child for having fears. Instead, let your child know
that you're there to listen, and to help.
- Don't reinforce phobias.
Instead, take advantage of opportunities to help your child overcome his or her fears. If your child is afraid of the neighbor's
friendly dog, for example, don't go out of your way to avoid the animal. Instead, help your child cope when confronted with
the dog. For example, you may offer to be your child's home base, waiting and offering support while your child steps a little
closer to the dog and then returns to you for safety. Over time, encourage your child to keep closing the distance.
- Pursue positive approaches.
Help your child learn to breathe deeply and repeat positive statements such as "I can do this" when facing a fear. Your child
also may benefit from rating his or her fear on a scale of 1 to 10. Recognizing that the fear rates only a 5 on the scale,
for example, may help your child see the feeling as being less overwhelming.
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How would it make you feel if your diagnosis turned out to be something called,
"agoraphobia?"
Agoraphobia is a type of anxiety disorder related to fear. With
agoraphobia, you fear being in places where it may be difficult or embarrassing to get out quickly or where you may have a
panic attack and can't get help. Because of your fears, you avoid places where you think you may have a panic attack or panic-like
symptoms.
People with agoraphobia often have a hard time feeling safe
in any public place, especially places where crowds gather. Commonly feared places and situations are elevators, sporting
events, lines, bridges, public transportation, driving, shopping malls and airplanes. The fears can be so overwhelming that
some people are essentially trapped in their own homes — it's the only place they feel truly safe, so they don't venture
out into public at all.
Agoraphobia treatment can be challenging because it usually
means confronting your fears. Both medications and psychotherapy have been found to be helpful. With treatment, you can escape
the trap of agoraphobia and live a more enjoyable life.
Signs and symptoms
A phobia is the excessive fear of a specific object, circumstance
or situation. Agoraphobia is excessive worry about having a panic attack in a public place. Typical agoraphobia symptoms include:
- Fear of being alone
- Fear of being in crowded places, such as a shopping mall or
sports stadium
- Fear of losing control in a public place
- Fear of being in places where it may be hard to get out of,
such as an elevator or train
- Inability to leave your house for long periods (housebound)
- Sense of helplessness
- Overdependence on others
- A sense that your body is unreal
In addition, you may also have signs and symptoms similar to
a panic attack, including:
- Lightheadedness
- Trouble breathing
- Dizziness
- Excessive sweating
- Rapid heart rate
- Flushing
- Nausea
- Upset stomach or diarrhea
- Chest pain
- Feeling a loss of control
- Trouble swallowing
Causes
Researchers are still trying to better understand what causes
someone to have agoraphobia. As with most mental illnesses, agoraphobia is probably caused by a complex mix of:
- Biology and genetics
- Your life experiences
- Your temperament and traits
Risk factors
Agoraphobia usually starts during late adolescence or early
adulthood, but younger children and older adults also can develop agoraphobia. About 5 percent of people in the United States
have agoraphobia. Women are diagnosed with agoraphobia more often than men are.
Although researchers don't know exactly what causes agoraphobia,
they do know several risk factors involved, or the things that make you more likely to get agoraphobia. These risk factors
may include:
- Having panic disorder
- Experiencing stressful life events
- Having a tendency to be nervous or anxious
- Alcohol and substance use disorders
- Female gender
When to seek medical
advice
Agoraphobia can make you feel
like a prisoner in your own home. You may be so fearful of having a panic attack that you can't venture into public.
Some people with agoraphobia have "safe zones," or places, areas or situations they can go without severe worry. i.e., you may
be able to walk around your neighborhood, but no farther.
Or, you may be able to go
places as long as a trusted relative or friend is with you. Sometimes you may muster up the courage to go somewhere but feel
severely distressed & anxious.
Agoraphobia, whether extreme
or not, can severely limit your life. You may not be able to socialize as you'd like. You may not be able to go to school
or work. You may not be able to run errands for your family, attend your child's soccer game or go shopping with friends.
If you anticipate having a
panic attack, you may indeed have one & you may constantly worry about the next one - causing a vicious cycle. The number of places
you're able to go may become fewer & fewer.
At the same time,
these fears, as well as embarrassment, can make it extremely difficult to visit your health care professional. Consider starting,
instead, with a phone call to your health care professional.
Some health care professionals,
particularly mental health experts who specialize in agoraphobia and anxiety disorders, may initially be able to meet with you in your own home. Don't let agoraphobia make your
world smaller than you'd like it to be.
Screening and diagnosis
Agoraphobia is diagnosed based on signs and symptoms, as well
as a thorough psychological evaluation. Your doctor or mental health professional will ask you to describe the signs and symptoms
you're experiencing — what they are, when they occur, how intense they are and how long they last, for example. You
also might discuss how your life is affected or limited by your symptoms, such as places or situations you avoid.
You may also have a physical exam. A physical exam is important
because some of the signs and symptoms of a panic attack are similar to those of heart, lung or other conditions.
To be diagnosed with agoraphobia, someone must meet criteria
spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric
Association and is used by mental health professionals to diagnose mental conditions and by insurance companies to reimburse
for treatment.
For agoraphobia to be diagnosed, you must meet these criteria:
- Anxiety about being in places or situations
that it may be difficult or embarrassing to get out of, or in which you may not be able to get help if you develop panic-like
symptoms
- Avoiding places or situations where you fear
you may have a panic attack, or having great distress and anxiety in those situations
In addition, your mental health professional will try to determine
if you might have panic disorder, social phobia or another specific type of phobia, rather than agoraphobia, since these all
can resemble one another.
Complications
Agoraphobia can greatly limit your life's activities, depending on how severe it is. In severe cases, you may not be able to leave your house at all.
Without treatment, some people
become housebound for years. You may not be able to visit with family & friends, go to school or work, walk your dog,
run errands or take part in other normal daily activities.
You may have to become extremely
dependent on others for help, such as grocery shopping.
Agoraphobia can also lead
to depression & anxiety. And people with agoraphobia may turn to alcohol or substance
abuse to help cope with the fear, guilt, hopelessness, isolation & loneliness.
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