Phobia

An excessive, unrealistic fear of a specific object, situation, or activity that causes a person to avoid that object, situation, or activity.

Unlike generalized anxiety, phobias involve specific, identifiable but usually irrational fears. Phobias are common occurrences among a large segment of the population. People with phobias recognize that their fears are irrational, yet avoid the source to spare themselves of the resultinganxiety. Phobias are classified as disorders only when they interfere substantially with a person's daily life.

Psychologists have identified three categories of phobic disorders. The first, simple phobia, is defined in Diagnostic and Statistical Manual of Mental Disorders as a persistent, irrational fear of, and compelling desire to avoid, an object or a situation other than being alone, or in public places away from home (agoraphobia) or of humiliation or embarrassment in certain social situations (social phobia). Simple phobia causes considerable distress when confronted because the person realizes that the fear is excessive and irrational. Such phobias are not indicative of other mental disorders. Almost any object or situation can be the cause of a simple phobia. Common phobias include fear of snakes (ophidiophobia), enclosed places (claustrophobia), and spiders (arachnophobia). Fear of heights, doctors and dentists, loud noises, storms, and the sight of blood also are experienced by large numbers of people. Animal phobias, the most common type of simple phobia, usually develop in early childhood. Most people do not seek treatment for simple phobias; they simply avoid the object or situation.

The second category of phobic disorders are social phobias. People with social phobias avoid social situations because they are afraid of embarrassing themselves. Fear of public speaking, fear of using public toilets, and fear of eating in public are common social phobias. Most social phobias develop over a period of time, beginning in adolescence or the early 20s, and rarely over the age of 30.

Agoraphobia, the third category of phobic disorders, is the most disabling and the most difficult to treat. Agoraphobia can be defined as the fear of being alone, or the fear of being in public places in unfamiliar settings. Some agoraphobics fear open spaces, like large bodies of water or open fields without fences. Most agoraphobics fear more than one situation, which contributes to the disabling nature of the disorder. The list of fears is long and extensive: public transportation, bridges, tunnels, crowded theaters, or simply being home alone. Agoraphobia rarely begins before age 18 or after 35. Sometimes it appears to be precipitated by major illness or stress.

Like other anxiety disorders, phobias can be treated with drugs, behavior therapy or both. Drug therapy usually includes minor tranquilizers like Librium or Valium, taken before a situation in which a phobia is likely to be introduced. Behavior therapy attempts to reduce a patient's anxiety through exposure to the phobia. For example, patients are guided step-by-step from imaginary confrontation of the phobia (visualizing a snake, for example) to actually experiencing it (holding a real snake). Gradualdesensitization is most successful in treating simple phobias.