Phobias are anxiety disorders

Michelle Carter, RN, ARNP

There are two types of phobias an individual may experience, social phobia and specific phobia.  Over a one year period, eight percent of the adult United States population experiences a type of phobia.  Individuals are usually diagnosed with a phobia if the phobia is causing them significant interference with their normal daily routine, occupational and/or academic functioning, social activities and/or relationships, or there is excessive distress about having the phobia.

Individuals who experience social phobia have an excessive and persistent fear of being scrutinized, embarrassed, or humiliated in social situations.  Many times individuals with social phobia avoid social or performance situations that have the potential of being meaningful and pleasurable because of their fear.  Other times, the individual with social phobia may attend the social or performance situations and experience intense distress or anxiety. 

Individuals who have a specific phobia experience excessive or unreasonable and persistent fear precipitated by the presence or anticipation of a specific object or situation.  There are several subtypes of phobias including:

1.      Animal Type – fear is precipitated by animals or insects.

2.      Natural Environment Type – fear is precipitated by objects in the natural environment like storms, heights, or water.

3.      Blood-Injection-Injury Type – fear is precipitated by seeing blood or injury or by experiencing an injection or other medical procedures.

4.      Situational Type – fear is precipitated by a specific situation like flying in an airplane, driving through a tunnel or over a bridge, riding in an elevator or public transportation, driving, or enclosed places.

Unfortunately, the individual’s phobia may prevent them from experiencing many pleasurable activities because of their irrational fear of something that would cause little or no actual danger.

The good news is that the majority of times individuals with phobias can be successfully treated.  Usually, a combination of psychopharmacology (medications) and psychotherapy (counseling) is the most effective treatment for individuals with a phobia.  Some of the medications used to treat social phobia include Selective Serotonin Reuptake Inhibitors like Paxil and Zoloft.  Usually psychotherapy includes learning how to utilize relaxation techniques in order to combat the symptoms experienced with a phobia.  Also, exposure therapy and rationalization are used during psychotherapy.  Exposure therapy involves the individual being exposed to the object or situation feared in a controlled and safe environment and utilizing the relaxation techniques learned in order to confront the fear.   Rationalization involves the individual learning to put the fear into perspective in order to realize that the object or situation feared usually would cause little or no actual danger.

Michelle L. Carter, RN, ARNP
Adult Psychiatric Nurse Practitioner
Clinical Nurse Consultant
Pattie A. Clay Regional Medical Center
Bluegrass Regional Mental Health-Mental Retardation Board, Inc

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9/04

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