Phobias: Learning how to face your fears ======================================== * Natalie McGill It’s not uncommon to be a little scared of a spider crawling on your bed or the needle in your doctor’s hand as you get a flu shot. But when the fear becomes so great that you find it difficult to function, you may be more than just scared. You may have a phobia. A phobia is a type of anxiety disorder where you have an excessive fear of a certain object or situation, says Raphael Rose, PhD, associate director of the Anxiety Disorders Research Center and associate clinical professor at the University of California-Los Angeles’ Department of Psychology and Psychiatry and Biobehavioral Sciences. An estimated 19.2 million American adults deal with specific phobias, the National Institute of Mental Health reports. And specific phobias are twice as common in women as in men, NIMH says. Phobias usually develop during childhood or, if not then, by early adulthood, Rose says. Common specific phobias, according to NIMH, include closed-in spaces, heights, highway driving, injuries with blood, tunnels and water. Rose says other common phobias are of flying, insects, needles — for injections or getting blood drawn — and animals, such as snakes and spiders. “Symptoms can be things like increased heart rate, feeling light-headed and feelings of anxiousness in your stomach,” Rose says. “Other signs when it comes to phobias would be behavioral signs, like avoiding places or situations they fear. This means avoiding flying or places where there are heights, avoiding situations where they might encounter spiders, insects or snakes.” Another symptom is being overly worried about the consequences of an upcoming life event, such as what would happen if you went on an airplane or had to go to the doctor to have your blood drawn. ![Figure1](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/45/4/24/F1.medium.gif) [Figure1](http://www.thenationshealth.org/content/45/4/24/F1) Photo by Deeepblue, courtesy of iStockphoto. “The thing about phobias that’s interesting is that there can be lots of times where there’s no anxiety or signs or symptoms that there’s a problem at all because their lives don’t involve facing those situations like flying,” Rose says. “But when they do face those situations where they fear excessively, then the distress can be pretty significant.” The causes of phobias are no different than causes of other anxiety disorders, Rose says. Your genetics and your environment are what fuel your phobia, Rose says. It is possible you may be predisposed to experiencing anxiety. There may be events in your personal environment that trigger anxiety, such as being on a turbulent airplane flight. Even watching other people’s experiences, such as seeing a news report about a plane crash, could trigger anxiety. “I think there’s a general misperception that most people think that if someone has a fear of a snake or spider that they must have been bit by one at one time or had a bad experience,” Rose says. “I think one of the more common misperceptions about the causes of phobias is that you don’t actually have to encounter any of these situations in person. You can just observe it or read about it and see other people who experience it.” If you think you may have the signs and symptoms of having a phobia, it’s important to seek the help of a mental health professional for an accurate diagnosis, Rose says. A trained mental health professional will ask you questions to find out how severe your symptoms are and if there’s any impairment in how you function. Then she or he can work with you to help you overcome your fears. “As a consumer, I’d recommend a prospective patient ask the treating clinician if they’re specialized in cognitive behavioral therapy once it’s determined they have a phobia or any kind of anxiety disorder,” Rose says. “The treatment involves different aspects but they all revolve around education on anxiety, phobias, what they are and why they’d experience it, and cognitive, emotional and behavioral skills to help them overcome their phobia.” ## Dealing with social phobias Aside from phobias of spiders or flying, having a social phobia makes it hard to interact with others out of fear of embarrassment, according to NIMH. Social phobia, also known as social anxiety disorder, can develop in childhood or early adolescence and about 15 million American adults experience it, NIMH reports. People with social phobia tend to shy away from social events, feel self-conscious and fear judgment from others. Physical signs of social phobia include nausea, sweating and trembling around others, NIMH says. See a health professional for guidance if you or someone you know has the symptoms and signs of social phobia. If the symptoms require you to visit a mental health professional you may be able to get treatment with medication, therapy or both, according to NIMH. *For more information on phobias, visit [www.nimh.nih.gov](http://www.nimh.nih.gov)* *Download a podcast with Rose on The Nation’s Health [podcasts](http://thenationshealth.aphapublications.org/site/misc/podcasts.xhtml) page* * Copyright The Nation’s Health, American Public Health Association