Condition Basics

What is a phobia?

Having a phobia means you are extremely afraid of a specific object, situation, or activity. Having a phobia about something is very different from everyday worry or stress. For example, most people feel worry and stress at some time, such as when speaking in front of a large group of people. People with phobias have so much fear that it's hard to do normal activities, such as going to work.

There are many different types of phobias:

• Natural environment phobias, such as being afraid of storms or lightning.
• Animal phobias, such as being afraid of spiders or dogs.
• Blood-injection-injury phobias, such as being afraid of blood or getting a shot (injection).
• Situational phobias, such as being afraid of flying, elevators (and other closed spaces), or bridges.

Many people who have phobias also have another condition such as a different anxiety disorder, depression, or substance use disorder.

What causes them?

The cause of phobias is unknown. If you have a family member with a phobia, you are more likely to have a phobia. Sometimes a person might have a phobia because they:

• Had something bad happen, such as being bitten by a dog.
• Saw someone else who was very scared of something, such as sitting in an airplane near a person who is afraid of flying.
• Learned about something bad happening, such as a plane crash.

Most phobias start when a person is a child or a teenager. Situational phobias usually start when a person is an adult. If a person has one phobia, they are more likely to have another phobia as well.

Sometimes other mental health conditions can cause symptoms that are similar to the symptoms you get from a phobia.

What are the symptoms?

The main symptom of a phobia is an extreme fear of being around an object, being in a situation, or doing an activity. People with a phobia usually feel immediate fear or anxiety when around the object or in the situation that they are afraid of. Even just the thought of these things can cause stress in people who have phobias. Children show their stress by crying, having tantrums, freezing, or clinging to someone else.

People with phobias may:

• Avoid being around the object or in the situation they are afraid of.
• Have issues at school or work because of the phobia.
• Have had symptoms for around 6 months or more.

How are they diagnosed?

Your doctor will ask questions about your symptoms, including how long you've had them. They will also ask questions about your medical history and any medicines you're taking. Your doctor may ask questions to rule out other mental health conditions that have symptoms similar to those of a phobia, such as post-traumatic stress disorder.

How are phobias treated?

Phobias are treated with cognitive-behavioral therapy. This therapy includes imagining or actually being close to the object, situation, or activity that you are afraid of. This is called exposure therapy. Cognitive-behavioral therapy can be done with one person or in a group.

One type of exposure involves a series of steps to get closer to the object, situation, or activity. This is called systematic desensitization. For example, if you have a phobia of heights, you might first imagine yourself in a high place, such as a balcony on the 10th floor of a building. Then you would do an exercise to help you relax until your worry and fear about heights are less. Next, you would try going onto a balcony on a lower floor and do the exercise to help you relax. Finally, over time, you might be able to go onto the 10th-floor balcony without being afraid.

Sometimes your doctor might prescribe medicine. Medicine may help with the symptoms of anxiety that you have because of your phobia. Medicine for phobias is most useful if it is combined with cognitive-behavioral therapy.

Unfortunately, many people don't seek treatment for anxiety disorders. You may not seek treatment because you think the symptoms are not bad enough or that you can work things out on your own. But getting treatment is important.