Phobias: A Fear for All Reasons

March 17, 2008
More than 12% of the population will experience a phobia at some point in their life, making this disorder the most common mental illness in the United States.

You respond to a routine check the welfare call. A family member has not been able to contact an invalid relative. There is no answer at the front door. As you go through the gate to investigate, you see an animal 50 yards away, slinking towards you. Your heart races, you remove your OC, and have your hand on your firearm. You tell yourself; stay calm, there is nothing to be afraid of, you are in control. But suddenly, panic seizes you in a death grip; it squeezes the breath out of you; your heart races; you sweat profusely; you feel faint. What is this wild, man-eating beast? A tiger, a pitbull, a lioness? No, it is Lassie, a sweet border collie with her tail wagging. Why were you so afraid? You could be one of many people who suffer from Cynophobia, a phobia that usually begins in childhood, resulting from a traumatic encounter involving a dog.

You make a routine traffic stop for expired tabs. As you approach the car you see a woman driver, with two small children in the back seat. The woman is hyperventilating, trembling, clutching her chest, and is unable to speak. The children are crying. You immediately call for FD and paramedic assistance. You try to calm her by touching her and symptoms worsen. You are certain she is having a heart attack. In this case you are wrong. The woman has a fear of law enforcement, a phobia called Policophobia.

Understanding Phobias

Phobias are the most common psychological disorder among women and the second most common disorder among men over 25. The American Psychiatric Association reports that each year 7.8% of American adults suffer from a phobia. More than 12 percent of the population will experience a phobia at some point in their life, making this disorder the most common mental illness in the United States.

Psychiatrically, phobias are classified as forms of anxiety disorders. Other anxiety disorders include panic disorder, post-traumatic stress disorder, obsessive-compulsive disorder and generalized anxiety disorder. Quite simply, a phobia is a persistent, excessive, or unreasonable fear of a specific object or situation that is generally considered harmless. Accompanying this fear is a strong desire to avoid whatever is feared. Additionally, these irrationally exaggerated fears effect an individual’s daily life functioning. A person can literally develop a phobia of anything: elevators, clocks, mushrooms, flying, wasps, writing, etc.

For law enforcement officers, fear can save your life. Recognizing real danger allows you to respond appropriately. Phobia is a fear gone awry. Giving a public presentation makes most people anxious. Ideally this anxiety provokes an individual to prepare conscientiously. However, if the anxiety intensifies and begins to consume your life (you worry for weeks, you feel ill just thinking about the presentation) you may have a phobia called Glossophobia. Frequently, when an individual with a phobia confronts a feared situation or object he/she experiences a panic attack. This initiates a vicious self-defeating circle, as the individual is not only afraid of the object or situation, they are terrified of another panic experience.

The Three Main Types of Phobia

Social phobia is a complex and frequently disabling disorder. Social phobia is characterized by an overwhelming fear of being criticized, scrutinized, or humiliated in social situations. Social phobia disrupts normal life by interfering with career, familial, and social relationships. Individuals with social phobia are afraid to enter into conversations for fear of saying something embarrassing. They may avoid eating or drinking in public, using public restrooms, or signing a check in the presence of another. Social phobias generally develop after puberty and without treatment can last the individual’s life. The disorder often runs in families and is frequently associated with depression or alcoholism.

Agoraphobia is a fear of being someplace, with no easy means of escape or help if a panic attack should occur. Agoraphobia is the most disabling of all the phobias, and treatment is difficult because there are so many associated fears (crowds, elevators, traffic, bridges). People who suffer agoraphobia avoid places and situations associated with previous panic experiences. As the fear of panic attacks increase, the agoraphobic's world narrows to only a few places where he/she feels safe. In some cases, this is limited to the home. Symptoms of agoraphobia usually develop between late adolescence and the mid thirties.

Specific (also called simple) phobias are the most common form of phobias. Specific phobias produce an intense and disproportionate fear of a particular object or situation. People who suffer from specific phobias are aware that their fear is irrational, but the thought of facing the object or situation often brings on anxiety symptoms including panic attacks. Specific phobias are very common. They usually begin in childhood or adolescence and as many as 50% subside on their own within five years. There are five subtypes of specific phobias: animal phobias (snakes, spiders, rodents, dogs, etc); natural environment phobias (heights, storms, water, darkness, etc); situational phobias (enclosed spaces, elevators, flying, dentists, tunnels, etc); blood injection/injury phobias; and everything that doesn't fall in the above four categories (clowns, death, vomit, choking, etc)

Signs and Symptoms

People with phobias experience immediate anxiety-related symptoms when exposed to their feared object or situation. Often the individual knows that his/her fears are out of proportion with the actual threat. However, their reactions are automatic and uncontrollable. These symptoms of phobias are identical to those that occur in the fight-or-flight response to genuine danger. The associated anxiety can range from mild feelings of apprehension to dread, horror, terror, or a panic attack. The closer you are to the thing you're afraid of, the greater your reaction to the fear will be. Your reaction will be further intensified if escape from the feared object or situation is difficult.

Common phobia symptoms and feelings include: shortness of breath or smothering sensation; palpitations, pounding heart, or accelerated heart rate; chest pain or discomfort; trembling or shaking; feeling of choking; sweating; nausea, diarrhea; feeling unsteady, dizzy, lightheaded, or faint; feelings of unreality or of being detached from yourself; fear of losing control or going crazy; fear of dying; numbness or tingling sensations; hot or cold flashes; jelly legs; dry throat; restricted or blurry vision or hearing.

Causes

Much is still unknown about what causes phobias. However, research has shown a strong correlation between an individual's phobias and the phobias of their parents; indicating that children may learn fears by observing a family member's phobic reaction to an object or a situation. Sometimes the start of a phobia may be triggered by a stressful life event, such as bereavement, illness or divorce. Additionally, some people can trace back their phobia to a certain frightening event during their childhood.

Treatment

Any phobia that significantly interferes with daily living should be treated. With appropriate treatment, most phobic individuals can completely overcome their fears and be symptom-free for years, if not for life. Effective relief can usually be gained through cognitive behavior therapy, medication, or a combination of both.

In cognitive therapy the individual works with the therapist to confront the feared object in a gradual and planned way, while learning skills to control their physical and emotional reactions.

Medications are prescribed to control panic and reduce anticipatory anxiety associated with agoraphobia and social phobia. SSRI antidepressants (specifically Cipramil, Cipralex, and Seroxat) are usually the drug of choice. Benzodiazepines (Valium, Xanax, Ativan, and Tranzene) are prescribed for severe anxiety. There is a strong potential for dependence on these medications, and should not be taken for longer than four months. Additionally, beta-blockers (cardiovascular drugs) may be prescribed to reduce the physical symptoms of anxiety such as palpitations, elevated blood pressure, and increased heart rate.

Other treatments include the use of relaxation techniques including progressive muscle relaxation, breathing techniques, and mental imaging of calming scenarios or successful confrontation of a phobic experience. Hypnosis has also been demonstrated as an effective treatment by providing individuals with posthypnotic suggestions that help them control their breathing, slow their heart rate, and achieve a relaxed state of mind. Additionally, self-help books are available to individuals. Some individuals benefit by sharing experiences and methods of coping with others in support groups.

The 20 Most Common Specific Phobias

  • Arachnophobia (possibly the most common phobia): fear of spiders. Almost 50 percent of women and 10 percent of men reportedly share this phobia, and it generally does not interfere with daily life unless it escalates to extreme cases of anxiety.
  • Aerophobia: fear of flying
  • Claustrophobia: fear of enclosed or confined spaces
  • Acrophobia: fear of heights
  • Carcinophobia: fear of cancer
  • Brontophobia: fear of thunderstorms
  • Necrophobia: fear of death or dead things (corpses, coffins, etc)
  • Ophidiophobia: fear of snakes
  • Cynophobia: fear of dogs
  • Trypanophobia: fear of injections or hypodermic needles
  • Cnidophobia: fear of insect stings
  • Mysophobia: fear of germs or dirt. This is often related to an obsessive-compulsive disorder.
  • Odontiatophobia: fear of dentists
  • Glossophobia: fear of speaking in public
  • Hydrophobia: fear of water
  • Homophobia: fear of homosexuality or becoming homosexual
  • Thanatophobia: fear of death or dying
  • Nyctophobia: fear of the dark or night
  • Emetephobia: fear of vomit
  • Demophobia: fear of being in crowded places

20 Specific Phobias to Ponder (Who Would have Known!)

  • Algophobia: fear of garlic
  • Arachibutyrophobia: fear of peanut butter sticking to the roof of the mouth
  • Automatonophobia: fear of wax statues
  • Barophobia: fear of gravity
  • Bogyphobia: fear of bogies or the bogeyman
  • Defecaloesiophobia: fear of painful bowels movements
  • Geniophobia: fear of chins
  • Geumaphobia: fear of taste
  • Helminthophobia: fear of being infested with worms
  • Hippopotomonstrosesquippedaliophobia: fear of long words
  • Homilophobia: fear of sermons
  • Lachanophobia: fear of vegetables
  • Levophobia: fear of things to the left side of the body
  • Peladophobia: fear of bald people
  • Kathisophobia: fear of sitting down
  • Metallophobia: fear of metal
  • Metrophobia: fear of poetry
  • Paraskavedekatriaphobia: fear of Friday the 13th
  • Pentheraphobia: fear of mother-in-law
  • Pteronophobia: fear of being tickled by feathers
  • Symmetrophobia: fear of symmetry

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