Acrophobia involves an intense and debilitating fear of heights. Because people with acrophobia experience intense anxiety or panic attacks when they are exposed to high places, they tend to avoid them. Acrophobia only develops when a general anxiety about heights causes regular discomfort or distress, or when it begins to interfere with the person’s ability to function and follow their routine.1,3
Like all phobias, acrophobia is treatable with therapy or a combination of medication and therapy.
What Is Acrophobia?
Acrophobia is a specific phobia, or a type of anxiety disorder where the fear is centered around a specific feared object or situation, in this case in response to heights. People with this condition tend to experience severe anxiety and panic attacks when exposed to high places, and they tend to avoid them out of fear.1,2,3
Someone who has a fear of heights but is rarely exposed to high places may not be diagnosed or treated unless their circumstances change and they are exposed to heights on a more regular basis. Many acrophobic people will experience other fears, phobias, and symptoms that coincide with their fear of heights.
How Common Is the Fear of Heights?
Fear of heights is a typical response, and acrophobia is one of the most common phobias someone can have. Experts estimate that between 3% and 6% of people have acrophobia at some point in their lives.12
“Fear of heights is a common and debilitating anxiety-related concern. While nearly one in five individuals experience a significant fear of heights, approximately one in twenty individuals meet clinical criteria for acrophobia.4 Being fearful of heights is adaptive and helpful in that it prevents us from falling from high places and engaging in reckless behaviors. However, in some people, fear of heights can lead them to avoid objectively safe places and significantly interfere with their quality of life. This is when we want to intervene and treat it with exposure therapy.” – Jennifer Hames, Assistant Clinical Professor and Director of Clinical Services for the Notre Dame Psychological Services Center
What Situations Can Trigger the Fear of Heights?
With acrophobia, an expansive variety of situations could trigger the fear of heights. It’s important to remember that one person could find something very triggering, while another with acrophobia could not be impacted at all.
Some common situations that can trigger acrophobia include:
- Climbing up a ladder
- Going onto the roof of a house
- Being on a high floor of a building
- Standing on a steep cliff
- Walking across a bridge
- Riding certain amusement park rides
- Going on elevators or escalators
Even thinking about heights could be enough to trigger panic for some people.
Normal Fear of Heights Vs. Acrophobia
While being afraid of heights is adaptive and serves a purpose (it prevents us from falling from high places and engaging in reckless behaviors), there are people who have an irrational, excessive fear of heights. They experience so much anxiety about heights that it begins to interfere with their quality of life and ability to function. This is a phobia and not a normal fear, and it typically requires treatment for symptoms to improve.
Signs & Symptoms of Acrophobia
All phobias describe specific fears that cause intense symptoms of anxiety and lead to avoidant behaviors. The same criteria are used to diagnose all specific phobias, and are drawn from the Diagnostic and Statistical Manual of Mental Disorders, a reference guide clinicians use to diagnose all mental health conditions.3
Signs and symptoms of acrophobia include:3
- Marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of heights or high places
- Heights or high places almost always provoke immediate fear or anxiety
- The fear or anxiety is out of proportion to the actual danger posed by heights or high places and to the situational context
- Heights or high places are actively avoided or endured with intense fear or anxiety
- The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning
- The fear, anxiety, or avoidance is persistent, typically lasting six months or more
- The disturbance is not better explained by the symptoms of another mental disorder like generalized anxiety disorder, obsessive-compulsive disorder (OCD), or post-traumatic stress disorder (PTSD)
- Feeling panicked when being high off the ground
- Sweating, shortness of breath, dizziness, or racing heart when in high places
- Feeling nauseous or having an upset stomach when exposed to heights
- Feeling nervous, worried, or tense before being in high places
- Changing one’s schedule or routine to avoid heights or high places
- Panicking or having an anxiety attack when in high places
Conditions Related to Acrophobia
Conditions that often coincide with acrophobia are:1,3
- Visual height intolerance (VHI): VHI is being unable to tolerate looking at high places or down from high places, both of which tend to trigger anxiety
- Vertigo: Vertigo is extreme dizziness, sometimes caused by looking down from high places and feeling anxious
- Bathophobia: Bathophobia is fear of depths, such as cliffs, wells and deep water
- Climacophobia: Climacophobia is an intense fear and intolerance of climbing
- Aerophobia: Aerophobia is the specific fear of flying or air travel
What Causes Fear of Heights?
Fear of heights is typically developed after a traumatic or negative event involving heights or high places, however, biology, genetics, and evolution all play a part in the fear as well.
Learned Experience
Phobias develop in response to specific experiences, especially negative or traumatic experiences. For example, falling down and breaking a bone while skiing could result in acrophobia. These kinds of scary and negative experiences can cause people to form a negative association with heights, prompting an intense fear response when they encounter them again.6,7
Learned Response
Some people also develop phobias as part of a learned childhood response. For example, growing up in a home with people who were afraid of heights may cause a child to develop this fear themselves.7
Genetics
Genetics can also play a role in determining a person’s risk for anxiety disorders, meaning that people with a family history of anxiety or phobias may be more likely to develop this condition.5
Evolutionary Instinct
On some level, being afraid of heights is normal; it’s part of our normal survival instincts that lead us to fear situations that could result in harm, injury or death.8 Still, this fear can become excessive, leading to irrational feelings, thoughts, and behaviors. Unfortunately, the more a person avoids their fear, the worse their phobia may become, which is why phobias often get worse when left untreated.
What Are the Risk Factors for Developing Acrophobia?
People who are exposed to more risk factors will have a greater chance of developing acrophobia at some point. Some of the most significant risk factors include:
- Scary life event involving heights
- Family history of high anxiety or phobias
- Traumatic experiences
- Poor coping skills used to manage stress and anxiety
- Being female—women are more likely to note phobias
Impacts of a Fear of Heights
Most people who are diagnosed and treated for acrophobia report significant impacts and impairments as a result of their fear of heights. Often, this is because their lifestyle, job, or living environment causes them to have regular exposure to heights. Phobias often result in avoidant behaviors, which are often closely related to the negative impacts people with these conditions report experiencing.
Hames states, “Those with fear of heights or acrophobia may avoid stairs, balconies, ladders, bridges, and ascending tall buildings. Given the range of feared and avoided situations in everyday life, it is not surprising that acrophobia can lead to high levels of social and functional impairment. Someone with a significant fear of heights may avoid taking a job in a tall building, driving or walking certain routes that involve bridges or overlooks, or changing a lightbulb that requires climbing a ladder. Over time, this avoidance can prevent them from doing the things they would like to do in life.”
How to Get Over a Fear of Heights
People who are struggling with a fear of heights often benefit from finding a therapist and starting treatment. In addition to getting therapy, there are ways for people to work on overcoming their fear of heights on their own.
Here are ten steps to work on overcoming your fear of heights:11
- Challenge irrational fears and beliefs by finding actual statistics and facts about how likely it is that you would fall, your plane would crash, etc.
- Positive visualization techniques can help counteract the worst-case scenario thinking patterns that feed into anxiety. They involve using your imagination to visualize detailed situations, places, or experiences that are positive and enjoyable
- Don’t go out of your way to avoid heights as this can actually worsen your phobia and make you more anxious the next time you are in a high place
- Don’t rely solely on alcohol, drugs, or even a prescribed anti-anxiety medication to cope with your fear. Doing so can foster an unhealthy dependence and make you less confident in your ability to face your fear without the substance
- Use mindfulness skills to bring your attention to something in the present moment that helps you feel safe, stable, and grounded, like focusing on your feet on the ground, your hand on the rail, etc.
- Distract yourself if you’re on long plane trips by bringing books, music, and devices to keep your mind active and engaged
- Talk openly about your feelings and fears with someone who is with you, and rely on them for some support and encouragement instead of bottling or trying to hide your fears
- Build up your courage by starting out with small, easy situations where you are exposed to heights and building up to more difficult exposures
- Manage your stress levels by practicing good self-care, getting adequate nutrition and rest, and working to keep yourself healthy and balanced
- Find ways to enjoy high places by taking pictures, trying skiing or snowboarding, or doing another fun activity that involves heights
What to Do When Your Acrophobia Gets Triggered
With acrophobia, preventing the triggering situation will be a great way to manage symptoms. Of course, all triggers cannot be avoided at all times, so you will need a good plan for what to do when your acrophobia gets triggered.
Some ways to deal with acrophobia in the moment include:
- Contacting and communicating with trusted loved ones or mental health professionals
- Staying grounded and focusing on your safety
- Changing your self-talk to focus on happiness and security
- Having a drink of water
- Engaging in a helpful relaxation technique, like progressive muscle relaxation
- Watching a comforting movie or listening to a beloved song to distract yourself
Treatment of Acrophobia
Acrophobia is a highly treatable condition.8,9,10 Many people are able to reduce or even resolve their symptoms with therapy alone, but some prefer to receive a combination of therapy and medication. Phobias are easy to treat when they are caught early, and even severe phobias respond well to treatment. Below are some of the most commonly used and effective forms of treatment for acrophobia.10
Therapy
Hames recommends, “By far, the most effective therapy for all fears and phobias, including fear of heights, is cognitive-behavioral therapy (CBT) with exposure (also called exposure therapy). In this therapy, someone works closely with a therapist to gradually learn to approach rather than avoid the types of height-related situations that cause them distress. The goal of this therapy is to help the client learn that the outcomes they fear are unlikely to happen in the situations they have been avoiding and to learn that they can tolerate the level of distress they experience when in height-related situations.”
At first, a person may be asked to visualize or think of a high place, and as they are able to tolerate this thought, may be prompted to look at a photo or video shot from a high place. Recently, there has been an increased use of virtual reality technology in exposure therapy, which can provide an imaginal experience that has more realistic qualities.8,10
Medication
Some people who are struggling with acrophobia may want to receive anxiety medication to help with their symptoms of anxiety. While medication can help alleviate symptoms of anxiety, it is not considered an effective standalone treatment for phobias, and is only recommended in conjunction with therapy or other formal treatment.
What’s the Outlook for People With Acrophobia?
The outlook for people with acrophobia is very positive. Acrophobia symptoms can be well-managed with therapy or a combination of therapy and medication. In the best situations, measurable improvements can be achieved after just a few therapy sessions.
Final Thoughts on Acrophobia
While it’s normal to be a little scared of heights, excessive fear that causes regular distress and avoidance may be a sign of acrophobia. Fortunately, all anxiety disorders, including acrophobia, can be treated. People who receive treatment are often able to manage and control their symptoms.10
For Further Reading
- Anxiety & Depression Association of America has a free screening tool for specific phobias
- Overcoming Fear of Heights: How to Conquer Acrophobia and Live and Life Without Limits by Martin Anthony, PhD, and Karen Rowa, PhD
- Mental Health America
- National Alliance on Mental Health
- MentalHealth.gov
Acrophobia Infographics
