Acrophobia: Symptoms, Treatments & How to Cope

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

1. 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.
2. 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
3. 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
4. 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
5. 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.
6. Distract yourself if you’re on long plane trips by bringing books, music, and devices to keep your mind active and engaged
7. 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
8. Build up your courage by starting out with small, easy situations where you are exposed to heights and building up to more difficult exposures
9. Manage your stress levels by practicing good self-care, getting adequate nutrition and rest, and working to keep yourself healthy and balanced
10. Find ways to enjoy high places by taking pictures, trying skiing or snowboarding, or doing another fun activity that involves heights