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Coping with fears and phobias

A fear becomes a phobia when you have to change your lifestyle to manage it. A phobia is an extreme or irrational fear or dread aroused by a particular object or circumstance, to the point where it severely restricts your life.

If you have a phobia, you’ll go to great lengths to avoid an object or situation that most people consider harmless.

Coming into contact, or even the thought of coming into contact, with the object of the phobia makes you panic.

But you don’t need to live with a phobia. All phobias are treatable, says Professor Isaac Marks of King's College London's Institute of Psychiatry. “There’s no need for anyone to continue to suffer,” he says. “People can overcome phobias.”

Some phobias, such as the fear of snakes (ophiophobia), won’t usually affect everyday life, but others, such as agoraphobia (the fear of open spaces), can make it very hard to lead a normal life.

“People ask for help when a phobia starts to interfere with their life – for example, they may be forced to give up work because they can’t take public transport, or staying indoors to avoid meeting people,” says Marks, author of phobia self-help book Living with Fear.

"It’s a disabling condition that affects about 8% of the UK population at some point in their lives."

Phobias can be specific – such as the fear of spiders, heights or dentists – or more generalised, such as the fear of open spaces, a fear of interacting with other people (social phobia) or even the dread of developing a phobia (phobophobia).

Most common phobias

The 10 most commonly reported phobias in the UK, according to a survey by Anxiety UK, are:

  • social phobia – fear of interacting with other people
  • agoraphobia – fear of open public spaces
  • emetophobia – fear of vomiting
  • erythrophobia – fear of blushing
  • driving phobia – fear of driving
  • hypochondria – fear of illness
  • aerophobia – fear of flying
  • arachnophobia – fear of spiders
  • zoophobia – fear of animals
  • claustrophobia – fear of confined spaces

Social phobia may start off as shyness, which then becomes exaggerated to the point of disrupting your life.

Agoraphobia is often associated with panic attacks. People who have agoraphobia tend to avoid places that spark this panic.

“Agoraphobia and social phobia are usually much more disabling than specific phobias, although occasionally someone with a specific phobia is severely affected by it,” says psychologist Professor Paul Salkovskis of King’s College London.

“Specific phobias are much easier to live with than the more generalised phobias, because you can’t really avoid people and going to crowded places.”

How phobias start

It’s not exactly known how phobias develop, but specific phobias are thought to originate in childhood, between the ages of about four and eight.

“Social phobia and agoraphobia start much later,” says Salkovskis. “Social phobia mostly starts at puberty and agoraphobia usually starts in the late teens or early twenties.”

He says that familiarising children with the things they’re afraid of is a good way to prevent a phobia from developing.

“That way we can wipe out a person's fear of spiders (for example) before it becomes a problem in later life.”

Help for phobias

For specific phobias, treatment involves some kind of exposure to the thing you’re most afraid of.

Self-exposure therapy, a form of cognitive behavioural therapy (CBT), can be done using self-help books, self-help groups or with a computer programme called FearFighter.

FearFighter, which has NHS approval, has been developed specifically to treat people with phobias or who suffer from panic attacks. Research has shown that FearFighter improves the symptoms of anxious or phobic patients by about the same amount as face-to-face therapy. Access to FearFighter requires a medical referral.

Antidepressants may be helpful for some people who have phobias.

It’s important to address your phobia as soon as symptoms appear. Salkovskis says: “Once phobias have been present for a year or longer in adults, they tend to continue if you don't overcome them with guided self-exposure therapy.”

Page last reviewed: 05/08/2014

Next review due: 05/05/2017


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