Phobias are one of the most common mental illnesses in the United States. In this Forbes article, Mindpath Health’s Zishan Khan, MD, explains the difference between a phobia and a fear, and provides tips to cope with its symptoms.
Everyone has a fear of something, whether we shudder at the thought of a blood test or bristle at the sight of a certain animal. Fear is one of our basic emotions and washes over us in response to a danger or threat. But when we feel fear that isn’t warranted by our experiences or surroundings, what we are experiencing may be a phobia.
What is a phobia?
A phobia, often referred to as specific phobia, is a persistent fear or anxiety related to an object or situation. These fears may include everyday activities, such as driving or flying, as well as things like needles, blood and dentists. Phobias cause individuals significant emotional distress and may impair daily functioning, but the fear responses individuals experience are outsized when compared to the actual danger they’re in.
“When it comes to distinguishing between being generally fearful and experiencing a phobia, context matters,” says Zishan Khan, M.D., a psychiatrist with Mindpath Health in Frisco, Texas. “If you are scared to climb down from a 10-foot tree, it is not a phobia because there is an actual danger present. You [may] potentially fall and injure yourself at such a height,” he says. However, an individual with acrophobia—a fear of heights—may experience distress simply by looking out a closed window in a high-rise building, he adds.
Specific phobia is a common diagnosis in the U.S., affecting more than 9% of the adult population. Women are at greater risk and symptoms usually begin in childhood.
Common phobia vs. rare phobia: What’s the difference?
Phobias commonly fall into one of four categories, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the standard manual used by mental health experts in the U.S. These subtypes and examples of the phobias they may induce include:
- Animal: fears of animals such as spiders, snakes and rodents
- Natural Environment: fears of storms and floods
- Blood-Injection-Injury: fears of medical procedures
- Situational: fears of flying or driving
While fears of vomiting, driving, flying and needles are some of the most common phobias, there are others that occur more rarely, such as a fear of falling or a fear of chickens.
The actual symptoms and severity of phobias may vary from person-to-person. However, the diagnostic criteria remain the same, says Kate Cummins, Psy.D. According to Dr. Cummins, diagnosable symptoms of phobia include:
- Unreasonable and/or excessive fear
- Immediate anxiety response
- Avoidance/extreme distress
- Impaired daily functioning
- Persistence for at least six months
- Symptoms are not caused by another mental health disorder, such as agoraphobia, obsessive-compulsive disorder or separation anxiety
“The severity of the phobia determines what one experiences and the intensity of the symptoms that manifest,” Dr. Khan notes, adding that some individuals may even suffer a panic attack when faced with the object of their fear. “Panic symptoms, while often short-lived, can be highly distressing and scary… and can occur abruptly without warning. [They] often involve extreme anxiety, a sense of impending doom, and physical symptoms [such as rapid heart rate and nausea],” he says.
What causes phobias?
There is no singular explanation as to why someone develops a phobia, and sometimes there’s no discernible cause. However, there are a number of potential risk factors that may play a role.
Dr. Khan says that life experiences and traumatic events may also contribute to phobias. For example, he notes that experiencing intense turbulence while flying may increase the risk of a fear of air travel—and even something as quotidian as family dynamics may also be a factor.
“Sometimes people have the same phobia as one of their parents or siblings because they are influenced to feel the same way after witnessing the severe reaction to something the other individual fears,” he adds. “They learn that the particular trigger is something to be wary of and fear.”
Can phobias be cured?
The majority of phobias can be successfully treated and even cured with time, dedication and therapy. Dr. Cummins also emphasizes the importance of educating yourself on your mental health and taking an active role in your recovery. When individuals are armed with the right information, they can better understand their fear responses and work toward change, she says.
As with any mental health condition, the right treatment plan may look different for everyone. Treatment options for specific phobias include:
- Exposure therapy: This is a psychological treatment conducted by a mental health professional. This type of therapy encourages individuals to face their fear in a controlled, safe environment. Exposure, or desensitization, therapy is a method of cognitive behavioral therapy (CBT), a type of talk therapy that helps individuals change the thought patterns that cause them distress.
- Medication: Antidepressants, tranquilizers, and beta blockers may help reduce the symptoms of anxiety associated with phobias.