Phobias are specific fears, and specific phobias are a cluster of disorders within the anxiety disorder family. People suffering from specific phobias experience intense anxiety in response to specific cues. Specific phobias are diagnosed when this fear or the resulting avoidance causes a great deal of distress or impairment in a person’s life.
Specific phobias are often quite treatable with exposure therapy or other forms of talk therapy. Sometimes, the use of medication is also recommended, depending on the severity of symptoms. The timeline for recovery varies depending on the level of anxiety surrounding the specific phobia.
Types of Specific Phobias
Phobic disorders are anxiety disorders where the symptoms of anxiety are experienced only in response to very specific fears. These can include fears of people, places, things, or situations. When a person with a specific phobia encounters their fear, they experience intense anxiety that is excessive in relation to the actual risk they are in. While they are at least partially aware that their anxiety is irrational, they often feel powerless to change their response.
Phobias fall into five distinct categories10, with each category containing several subtypes.
The five categories of specific phobias are:
- Natural/Environmental Type: includes phobias of water, storms, natural disasters, etc
- Blood-Injection-Injury Type: includes phobias of cuts, blood, getting injections or IV’s
- Animal Type: includes phobias of dogs, spiders, snakes or insects
- Situational Type: includes phobias of flying, elevators, driving, being in closed spaces
- Other Miscellaneous Type: includes all other phobias which do not fit in another category (ie: fear of clowns, fear of choking, etc)
Within each of the five categories, there are several specific phobias. Some of the more common ones include:
- Agoraphobia: A fear of public spaces
- Claustrophobia: A fear of small, enclosed spaces
- Arachnophobia: A fear of spiders
- Ophidiophobia: A fear of snakes
- Glossophobia: A fear of public speaking
- Aerophobia: A fear of flying
- Acrophobia: A fear of heights
- Trypanophobia: A fear of medical procedures involving needles
- Mysophobia: A fear of germs and contamination
Social phobia, which is a phobia of specific social settings or interactions, used to also be included in the list of common phobias. However, social phobia is now considered to be a separate type of anxiety disorder called social anxiety disorder.
Signs of Specific Phobias
Specific phobias cause people to experience intense anxiety and distress during times when they think about, anticipate, or encounter a feared situation or object. Anxiety can be experienced differently by people but involves specific changes in a way a person thinks, feels, and behaves.
These changes can include:
- Changes in thinking: includes racing thoughts and “what-if” thoughts in which a person imagines or visualizes a terrible outcome. Some people also may experience confusion or disorientation or have trouble concentrating.
- Changes in emotions: includes intense stress, anxiety, panic, and sometimes irritability
- Changes in bodily sensations: includes racing heart, shortness of breath, tense, stiff or rigid muscles, rushes of nervous energy, stomach upset, and dizziness
- Changes in behavior: includes panic responses (running, screaming, etc), crying, and avoidance of any situation where the person believes there is a chance of encountering the feared object or situation
It is not uncommon for a person with a specific phobia to experience a panic attack. A panic attack is a sudden and intense onset of anxiety symptoms that usually lasts several minutes.
While people may experience different symptoms during a panic attack, some common symptoms include:
- Heart palpitations
- Chest pain
- Trouble breathing or hyperventilation
- Dizziness or loss of consciousness
- Confusion and disorientation
- Feeling a loss of control
- Fear of dying
- Fear of going crazy
Not all people with specific phobias experience panic attacks but those who do describe having very intense experiences. While panic attacks are generally not dangerous, it is not uncommon for people to mistake a panic attack for a heart attack and to seek emergency medical care. Anxiety and/or panic attacks are primary signs of specific phobias when these symptoms arise only in response to very specific triggers.
Symptoms of Specific Phobias
A phobic disorder can only be diagnosed by a licensed health or mental health professional with the appropriate credentials and training. This usually occurs during an initial appointment with a licensed counselor, psychologist, or psychiatrist, but may also occur during other visits with medical providers. All mental health conditions, including specific phobias, are diagnosed using a standardized set of criteria outlined in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders .1
Symptoms of specific phobias include:
- A persistent fear that is excessive or unreasonable that occurs when a person encounters or anticipates a specific object or situation
- Exposure to the feared object or situation leads to immediate symptoms of anxiety
- There is a recognition that the fear is excessive or that the response is disproportionate
- The phobia is avoided or endured with intense distress
- The avoidance, anticipation or distress experienced before or during the situation interferes significantly with the person’s routine, work, relationships, or social activities
- The fear is persistent and occurs for at least six months
- The anxiety and avoidance cannot be better explained by another mental health disorder (like an anxiety disorder or PTSD)
Causes and Triggers for Specific Phobias
Specific phobias, like other mental health conditions, are caused by a complex interplay of biological and environmental factors. Some risk factors are known to increase a person’s risk of developing any mental health disorder. These include having a family history of mental illness, experiencing childhood trauma, and being exposed to drugs or alcohol at a young age. Experiencing the loss or separation of a parent in childhood has also been found to increase risk of mental illness.6
In addition to risk factors that occur in childhood, other risk factors can occur at any point in a person’s life. These include experiencing high levels of stress or trauma, using substances, and having few close, supportive relationships. Also, people who are diagnosed with one kind of mental health disorder are at higher risk for developing others. In fact, one researcher notes that, “comorbidity among anxiety disorders has proven to be the rule rather than the exception”5, highlighting how common it is for a person to have more than one diagnosis. The most common comorbid condition with an anxiety disorder is Major Depressive Disorder.2
There are some risk factors that are thought to be more specific to anxiety disorders. For instance, those with a tendency to internalize stress are at higher risk for both anxiety and depression. People with shy or introverted temperaments are at higher risk for developing an anxiety disorder. People who experience high levels of negative affectivity (thoughts and emotional reactions) are also more likely to develop an anxiety disorder. Certain health conditions like thyroid problems and heart problems can also increase a person’s risk for developing an anxiety disorder.7
Specific phobias often, but not always, develop after having a frightening experience. From a social learning perspective, researchers believe that phobias are “learned” through experiences that can occur in three different ways.10
These experiences are:
- Direct learning experience: When a person has a traumatic or stressful experience and subsequently develops a phobia. For instance, a person might develop a phobia of dogs after being bitten by a dog.
- Observational learning experience: When a person observes others having strong fear reactions to an object or situation, and then develops this response themselves. For example, a person might grow up with a parent who is afraid to leave the home (agoraphobia) and later goes on to develop this same phobia.
- Informational learning experience: When a person develops a fear after learning some information, instead of having directly experienced or witnessed something. For instance, a person might develop a phobia of flying only after reading about a plane crash in the news.
Specific Phobias in Different Ages
Most children have specific irrational fears throughout their childhood, but these are not usually signs of a specific phobia disorder. Research has shown that certain fears are developmentally appropriate. For instance, infants are likely to be startled by loud noises, toddlers often fear separation from parents, school-aged children may fear monsters or bad people, and teens may fear social rejection. In general, as children age their fears become more realistic in nature and begin to reflect their growing independence from caregivers.10
Young children who experience specific phobias may not have the language to be able to describe their symptoms. For this reason, they may act out behaviorally, throwing tantrums or becoming aggressive. Children with specific phobias may refuse to participate in certain activities where they may encounter their phobia but may not be able to verbalize their reasons to their caregiver. Younger children also often do not realize that their fears are irrational (this symptom is not required for childhood diagnoses). These factors can all contribute to difficulty detecting and treating phobic disorders in children.
In teens, phobic disorders may also present behaviorally in the form of irritability, outbursts, or a refusal to participate in certain activities. Because many teens struggle with social phobias (now known as social anxiety disorder), they may become more withdrawn, isolated, or give up certain social activities. Because of the social avoidance, teens with social phobias are sometimes misdiagnosed with depression. Teens may also be reluctant to have open discussions with their caregivers or other authority figures, which can further impede detection and treatment.
While it is common for specific phobias to begin in childhood, they often are diagnosed in adulthood, peaking during midlife and later.4 Adults with phobias tend to present with more typical symptoms and tend to be more aware of their symptoms and what triggers them.
Because anxiety disorders, including specific phobias, are typified by avoidant behaviors, it is possible that an adult would not recognize their symptoms because they have carefully crafted a lifestyle or routine where they are unlikely to encounter their phobia. For this reason, it is sometimes the case that a phobia is only identified when a person’s routine or circumstances change in ways that expose them to new things or situations. Phobias might also only occur in adulthood following a particularly negative experience, like symptoms reported in those with PTSD.
Treatment of Specific Phobias
Thankfully, specific phobias, like other anxiety disorders, are highly treatable. While treatment might include therapy and/or psychiatric medication, therapy is recommended as a front-line solution. One kind of therapy called exposure therapy has proven to be especially effective in treating specific phobias.
Exposure therapy is a type of Cognitive Behavioral Therapy that involves a trained counselor helping a person become desensitized to their fear through repeated exposure. This exposure happens gradually, usually beginning with thought exposures where a person is asked to think of the feared situation and gradually moving to more anxiety-provoking exposures. The counselor also provides skills training to help the client learn relaxation and mindfulness techniques that help them tolerate these exposures.
Over time, exposure therapy has been proven to reduce anxiety and, in some cases, even resolve it entirely. While initial exposures are difficult, people generally find that over time, the exposure tasks become easier and less anxiety-inducing. Because avoidance of feared situations and triggers is a key way that phobic disorders impair people’s lives and functioning, exposure therapy can reverse this impairment, improving their ability to cope and function without using avoidance.
Cognitive Behavioral Therapy
While exposure therapy is the therapy with the most evidence supporting its efficacy for specific phobias, other types of therapy are also available. More general forms of Cognitive Behavioral Therapy, or CBT, are sometimes indicated as a treatment option. This treatment involves a trained counselor teaching a person how to redirect and restructure specific thoughts that increase their anxiety. Because specific phobias almost always include a miscalculation of risk, CBT exercises might prompt the person to challenge these thoughts and re-calculate the risk in a more reasoned way.
CBT also focuses on helping encourage specific behavior changes. Behavior changes that may be recommended for those with specific phobias include improved use of healthy coping skills, outlets or supports or a reduction of avoidant behaviors. CBT utilizes a pragmatic approach to evaluating which behaviors need to change, determined by the short- and long-term consequences of the behavior.
Other Therapy Approaches
Less commonly, other therapies are sometimes recommended for people struggling with specific phobias. One is Eye Movement Desensitization and Reprocessing, also known as EMDR. EMDR is an innovative treatment approach that uses specific eye movement or body tapping exercises to stimulate certain areas of the brain, allowing people to access traumatic memories and process through them.
Somatic Experiencing is another innovative treatment that is sometimes being used to treat anxiety disorders, including specific phobias. Somatic experiencing therapists believe that stress and trauma are held in specific areas of a person’s body. This treatment involves helping a person become more aware of their body and using specific somatic exercises to access and adjust different emotional responses.
Third wave behavior therapies like Dialectical Behavioral Therapy or Acceptance and Commitment Therapy are also gaining popularity. These treatments differ in how they are used, but both have mindfulness as a key component. Mindfulness is a practice where a person increases their present-moment awareness, using their mind to observe difficult thoughts and feelings in a more detached way. By experiencing these thoughts and feelings differently, clients also find it easier to respond in more effective ways during times when they experience symptoms.
Medications Used to Treat Specific Phobias
Medications are sometimes also used for the treatment of specific phobias, especially in cases where the feared situation or trigger is only encountered very occasionally.
These are the most prescribed types of medication for specific phobias:
These are common types of anti-anxiety medication prescribed for occasional symptoms of anxiety and are taken only when needed. Benzodiazepines are anti-anxiety medications that work to suppress certain activities in the central nervous system. These medications can be extremely effective in reducing short-term anxiety, but have some contraindications, including a high risk for abuse and dependence, and are not recommended for regular/prolonged use. People who become dependent on these medications can experience dangerous withdrawal symptoms, including a heightened risk of seizures. Common benzodiazepines, also known as “benzos” include: alprazolam (Xanax), clonazepam (Klonopin), and lorazepam (Ativan).
SSRI or SNRI Medications
These medications are typically used to treat depression, but also work on certain neurotransmitters involved in anxiety. These medications are typically prescribed to be taken daily and have fewer risk factors than Benzodiazepines and do not have a risk of abuse and dependence. Still, some people do develop side effects to these medications. Some common SSRIs and SNRIs include: sertraline (Zoloft), citalopram (Celexa), desvenlafaxine (Pristiq), and duloxetine (Cymbalta).
These medications are typically prescribed for people with blood pressure issues, and they work to block certain chemicals that are involved in stress and anxiety (like adrenaline). These medications do not typically cause a lot of undesired side effects.. They can, however, be effective in helping to alleviate and prevent anxiety resulting from specific situations, making them relevant to the treatment of specific phobias. Common beta blockers for anxiety include propranolol and atenolol.
This medication is a novel anti-anxiety medication that is sometimes prescribed for people who experience frequent anxiety. It works on specific receptors in the brain known to be involved in anxiety and is sometimes prescribed because it carries lower risks than other anti-anxiety medications.
How to Get Help for Specific Phobias
The first step to getting help for a specific phobia is often to contact your health insurance provider. Often, calling the number listed on the back of your card or using a search tool on the insurance company’s website will yield a list of in-network counselors. Typically, specific phobias are treated in outpatient (office) settings by licensed counselors or psychologists. The reason people often prefer to go through their insurance company to find a provider is that in many instances, therapy will be a covered service.
For those not using insurance or who are having trouble using their insurance company’s search tools, there are also options for finding a provider online. People can find local therapists in an online directory, using filters to narrow down to providers who have specific specialties, availabilities, or who accept certain insurances.
Those who struggle with phobic disorders that make it difficult to leave their home might consider online counseling.
Many people with anxiety disorders hesitate to get help, but those who do often experience a significant improvement in their symptoms and quality of life.
Specific Phobia Statistics
Anxiety disorders are the most common type of mental illness in the US, affecting 1 in 3 people at some point in their lives. Specific phobias are also very common in the U.S. Recent research estimates that 9.1% of adults in America had a specific phobia in the past year, and 12.5% of adults in the US will experience a specific phobia in their lifetime.7
For reasons not completely understood, some people are at higher risk for developing a specific phobia:
- Adult females are more likely to be affected than adult males (12.2% vs 5.8%)
- Adolescents are affected at higher rates than children or adults (19.3% of US teens in the past year)
- Females are more likely to experience multiple phobias (5.4%) than men (1.5%)
- Female adolescents were affected with specific phobias at higher rates than males (22.% vs 16.7%) in the past year
- Children experience the lowest rates of specific phobias, estimated at a rate of about 5%9
The types of phobias also vary depending on a person’s age and gender:
- Women and children are more likely to have animal phobias whereas adults are more likely to fear inanimate objects or situations
- People with specific phobias related to blood or injury tend to be more impaired by their disorder than people with phobias related to animals or situations3
- Blood/injury phobias occur at comparable rates in both men and women.
Living with Specific Phobias: Coping and Managing Symptoms
Specific phobias can cause people a great deal of stress and impairment. Without treatment, these disorders often get progressively worse but with treatment, symptoms usually improve. The best course of action for those struggling with specific phobias is to seek professional help. In addition to formal treatment, making certain lifestyle or routine changes can sometimes also help, including:
- Getting 7-8 hours of sleep each night
- Maintaining an active lifestyle
- Maintaining important relationships
- Regularly participating in social activities
- Developing a meditation practice
- Abstaining from drugs and alcohol
- Practicing self-compassion
- Joining a support group
Specific Phobias vs Other Anxiety Disorders vs Normal Fear
While all anxiety disorders feature symptoms like high levels of anxiety, disproportionate responses, and avoidant behavior, specific phobias are triggered only by certain objects or situations. When a person experiences anxiety in response to many triggers, other anxiety disorders like Generalized Anxiety Disorder, are sometimes suspected. However, if a person’s anxiety is very limited in scope, they may be struggling with a specific phobia.
It can also be difficult to differentiate between “normal” anxiety and a specific phobia. Most people have certain fears that are not very rational and may even have intense anxiety when they encounter these fears. The key difference between normal anxiety and a specific phobia is the extent to which the fear is impairing a person’s quality of life or ability to function. When there is a significant impairment to either, a specific phobia may be the cause.
Specific Phobias Tests & Quizzes
Specific phobias can only be diagnosed with a person who has a license and the qualifications to do so. Usually, this includes licensed counselors, social workers, therapists, and psychologists, in addition to doctors. If you or someone you care about is exhibiting symptoms of a specific phobia or other anxiety disorder, the only way to confirm a diagnosis is through an appointment with one of these providers.
Still, many people with symptoms of anxiety disorders may want to find more information on specific phobias. For those interested in additional reading, resources, and screening tools, consider these reputable websites:
- Anxiety and Depression Association: a free screening tool for specific phobias
- American Psychiatric Association: a symptom severity scale for those diagnosed with specific phobias
To learn more about specific phobias, consider visiting: