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Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

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Phobic Disorders

What is it?

Phobic disorders (phobias) involve persistent, irrational fears and avoidance of the situations or objects that induce these fears. They may be the most common form of anxiety. There are different types of phobias.One of the most familiar is agoraphobia, or the fear of being in public places; it often stems from panic disorder as a result of trying to avoid places that have triggered past attacks. Another common form of phobic disorder is social phobia, which is characterized by an undue fear of embarrassment in social situations. Other phobias are classified as "specific," meaning they are related to specific circumstances—for example, a fear of a specific type of animal (such as a fear of dogs, or cyanophobia), which is the most common type of specific phobia. Another example is the fear of heights (acrophobia). While certain situations or objects, such as flying or snakes, provoke a mild degree of anxiety in many, those with a phobic disorder have an excessive amount of fear and anxiety that is out of proportion to the actual threat. In addition, phobic disorders significantly impair the individual's social or occupational performance.

What Causes It?

  • As is the case with other anxiety states, the causes of phobias aren't clearly established. Probably a combination of environmental and genetic factors play a role.
  • Phobias tend to run in families. If you have a family member who suffers from a phobic disorder, you may be more vulnerable to the condition.

Prevention

  • Phobic disorders are not preventable.

Diagnosis

  • Diagnosis is based on a personal account of the disorder.

How to Treat It

  • Behavioral therapy may help desensitize the person to the thing or situation that causes fear and anxiety.
  • The selective serotonin reuptake inhibitors (SSRIs)—a class of antidepressant medication—fluvoxamine and paroxetine can successfully relieve social phobia.Monoamine oxidase (MAO) inhibitors and benzodiazepines may also be used.
  • Beta-blockers, a class of drugs commonly used to treat angina, high blood pressure, irregular heart rhythms, and migraine, may help ease the physical symptoms of phobic disorders but are not recommended for ongoing treatment.
  • A combination of therapy and medication is often recommended.

When to Call a Doctor

  • Call a doctor if certain objects or situations induce excessive fear that interferes with your occupational or social functioning.