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Phobia (or irrational fear) Causes, Symptoms and Treatment

The term “phobia” refers to a broad set of psychological disorders, such as agoraphobia, claustrophobia, social phobia, etc. A phobia is characterized by the irrational fear of a particular situation , such as fear of taking the elevator, or a specific object , such as fear of spiders. But the phobia is beyond a simple fear: it is a real anxiety that seizes people who are confronted. The phobic person is fully aware of his fear. Therefore, she tries to avoid, by all means, the situation or the object feared.

In everyday life, suffering from a phobia can be more or less handicapping. If it is an ophidiophobia, that is to say a phobia snakes, the person will, for example, no difficulty in avoiding the animal in question.

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Other phobias are difficult to circumvent on a daily basis, like the fear of the crowd or the fear of driving. In this case, the phobic person attempts, but often in vain, to overcome the anxiety that this situation gives him. The anxiety that accompanies the phobia can then evolve into a crisis of anxiety and quickly exhaust the phobic person, physically and psychologically. It tends to isolate itself little by little to stay away from these problematic situations. This avoidance can then have more or less significant repercussions on the professional and / or social life of people who suffer from phobia.

There are different types of phobias. In the classifications, we first find simple phobias and complexphobias , which mainly include agoraphobia and social phobia.

Simple phobias include:

  • Phobias of animal type that correspond to fear induced by animals or insects;
  • Phobias of the “natural environment” type which correspond to a fear provoked by natural elements such as thunderstorms, heights or water;
  • Blood phobias, injections or wounds that correspond to fears related to medical procedures;
  • Situational-type phobias that relate to situational-specific fears such as taking public transportation, tunnels, bridges, air travel, elevators, driving or enclosed areas.

Prevalence

According to some sources, in France 1 in 10 people suffer from phobia. Women would be more affected (2 women for 1 man). Finally, some phobias are more common than others and some may affect younger or older people.

Most common phobias
Phobia of spiders (arachnophobia)
Phobia of social situations (social phobia)
Phobia of air travel (aerodromophobia)
Phobia of open spaces (agoraphobia)
Phobia of confined spaces (claustrophobia)
Phobia of heights (acrophobia)
Phobia of water (aquaphobia)
Cancer Phobia (Cancerophobia)
Phobia of Thunderstorms, Storms (Cheimophobia)
Phobia of Death (Necrophobia)
Phobia of Heart Malaise (Cardiophobia)

 

Infrequent phobias
Fruit
phobia (carpophobia) Cat phobia (aphorophobia)
Dog phobia (cynophobia) Phobia of
contamination by microbes (mysophobia)
Phobia of childbirth (tokophobia)

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According to a study of 1,000 people aged 18 to 70, researchers have shown that women are more affected by animal phobia than men. According to the same study, the phobias of inanimate objects would rather concern the elderly. Finally, the fear of injections seems to decrease with age .

“Normal” fears during childhood

In children, certain fears are frequent and are part of the normal development of the child. Among the most common fears are: fear of separation, fear of the dark, fear of monsters, fear of small animals, etc …

Often these fears appear and disappear with age without interfering with the overall well-being of the child. However, if certain fears become established over time and have a significant impact on the behavior and well-being of the child, do not hesitate to consult a pediatrician.

Diagnostic of Phobia (or irrational fear)

To make the diagnosis of phobia , it must be ensured that the person has a persistent fear of certain situations or certain objects.

The phobic person is terrified of being confronted with the dreaded situation or object. This fear can quickly become a permanent anxiety that can sometimes evolve into a panic attack. This anxiety prompts the phobic person to avoid situations or objects that arouse in her fear, by pipes avoidance and / or reinsurance (avoid an object or ask a person to be present in order to be reassured).

For the diagnosis of phobia, the medical professional can refer to the phobia the diagnostic criterialisted in the DSM IV ( Diagnostic and Statistical Manual of Mental Disorders – 4 th editions) or ICD-10(International Statistical Classification diseases and related health problems – 10 th revisions). He can conduct a specific clinical interview to look for signs of a phobia.

Numerous scales such as the Scale of Fears (FSS III) or Marks and Mattews’ Fear Questionnaire are available to doctors and psychologists. They can use them to objectively validate their diagnosis and to assess the intensity of the phobia and the repercussions it may have on the patient ‘s daily life.

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Causes of Phobia (or irrational fear)

Phobia is more than a fear, it is a real anxiety disorder. Some phobias develop more easily during childhood, such as the anxiety of being separated from the mother (separation anxiety), while others occur rather in adolescence or adulthood. It should be known that a traumatic event or a very intense stress can be at the origin of the appearance of a phobia.

The simple phobias often develop during childhood. Classic symptoms can begin between 4 and 8 years of age. Most of the time, they follow an event experienced by the child as unpleasant and stressful. These events include, for example, a medical visit, vaccination or blood test. Children who have been trapped in a closed and dark space following an accident risk developing a closed-space phobia called claustrophobia. It is also possible that children develop a phobia “by learning If they are in contact with other phobic people in their home environment. For example, in contact with a family member who is afraid of mice, the child may develop a fear of mice too. Indeed, he will have integrated the idea that one must be afraid of it.

The origin of complex phobias is more difficult to identify. Many factors (neurobiological, genetic, psychological or environmental).

Some studies have shown that the human brain is somehow “preprogrammed” to feel certain fears (snakes, darkness, emptiness, etc …). It seems that some fears are part of our genetic heritage and it is certainly they that allowed us to survive in the hostile environment (wild animals, natural elements, etc.) in which our ancestors lived.

Associated disorders

People suffering from a phobia often have other related psychological disorders such as:

  • an anxiety disorder, such as a panic disorder or other phobia.
  • depression.
  • excessive consumption of substances with anxiolytic properties such as alcohol.

Complications

Suffering from a phobia can become a real handicap for the person who has it. This disorder can have repercussions on the emotional, social and professional lives of phobic individuals. In trying to combat the anxiety that accompanies the phobia, some people may resort, in an abusive way, to certain substances having anxiolytic properties such as alcohol and psychotropic substances. It is also possible that this anxiety evolves into anxiety attacks or generalized anxiety disorder. In the most dramatic cases, phobia can also lead some people to suicide.

Symptoms of Phobia (or irrational fear)

When the phobic person is faced with the object or situation they fear, they may experience the following anxiety symptoms:

  • fast breathing (hyperventilation);
  • an increase in the heart rate;
  • hot flashes
  • excessive sweating
  • dizziness ;
  • gastrointestinal disorders (nausea, diarrhea, etc …);
  • sleep disorders.

In all cases, the person is aware of his problem. She knows that her fear is disproportionate or even irrational. The avoidance of feared situations is also part of the symptoms. Some people will be able to use what is called a “contraphobic” object when it is impossible for them to get around the element that generates their fear. This “object” can be a kind of “grigri” or even a person whose function is to reassure them.

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People at risk for Phobia (or irrational fear)

Phobias affect women more (2 women for 1 man) and are also more common among people with high levels of general anxiety.

Prevention

Prevention is first and foremost about the early management of this disorder. If you suffer from fear and it affects your quality of life and prevents you from doing certain things, do not hesitate to talk to your doctor.

Medical treatments of Phobia (or irrational fear)

Most of the time, the management of a phobia is done in an outpatient setting with psychotherapeutic care and drug treatments . This support helps reduce symptoms and morbidity (occurrence of other disorders) and also improves the psychological and social functioning of the phobic person. In some cases, especially when severe thymic decompensation (Generalized Anxiety Disorder, depression, etc.) is associated, hospitalization may be necessary.

The management of phobias is the responsibility of the attending physician but also the psychiatrist, child psychiatrist or psychologist. The occupational doctor and school doctor can also be part of the circle of professionals that it is important to inform and solicit during this care. Finally, medical-social and educational services are structures that can also help the phobic person.

therapies

  • CBT

cognitive behavioral hérapies have proved effective in the treatment of certain phobias at a rate of 12 to 25 sessions of about 45 minutes. The therapist helps the phobic person to face his fear by gradually exposing him to the object or feared situation. This exhibition is set up via visualization or mental imagery .

Through the relaxation and parallel work on the thoughts and emotions felt by the phobic person, the therapist establishes a list of goals to be achieved throughout the therapy. The ultimate goal is for the patient to be able to face their biggest fears without anxiety thanks to a progressive desensitization. In order to obtain better results, it is possible to combine this type of therapy with appropriate medication management (see the “medicines” section).

  • Virtual reality therapy

Virtual Reality Therapy (VRT) techniques have been used for many years in psychiatry. Thanks to a system of 3D glasses, the patient is immersed in a virtual reality controlled by the therapist. The therapeutics used is inspired by exposure techniques used in cognitive and behavioral therapies (CBT). The results obtained on the treatment of phobias are comparable to the results obtained with CBT.

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  • EMDR

EMDR, or neuro-emotional integration through eye movement, is a therapeutic tool that emerged in the late 1980s. Originally developed to treat people with Post Traumatic Stress Disorders (PTSD). PTSD), it seems to have a good success rate in the treatment of simple phobias.
In this context, the therapist asks his patient to think of a situation that is problematic at the same time as he asks him to fix an object in motion. The rapid eye saccades induced by the pendulum motion control by the therapist would stimulate the passage of information problems into new brain areas.

  • Psychotherapy of Analytical Inspiration

The phobic person is led to question, among other things, the psychological conflicts at the root of his phobia. Where cognitive and behavioral psychotherapies focus on eliminating the symptom, analytic therapy accompanies the patient in discovering the meaning of this symptom in his personal and family history.

  • pharmaceuticals

Antidepressants are part of the therapeutic arsenal available to physicians to support phobic patients in improving their disorder. Even if there is no depression associated with phobia, antidepressants are recommended because their action is much broader than it seems.

Antidepressants acting on serotonin reuptake ( SSRI ) are commonly used in the treatment of phobias. These drugs work by increasing the amount of serotonin (neurotransmitter) present in the brain. Among the most frequently used in the treatment of phobia include: citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft).

If the anxiety that accompanies the phobia is important, anxiolytics such as benzodiazepines (Xanax) can be prescribed over a short period to avoid dependence.

Finally, beta-blockers may also be prescribed in the treatment of phobias. These are drugs such as Propranolol that are used to treat high blood pressure. These medications reduce heart rate and help to relieve troublesome symptoms such as palpitations.

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