Specific Phobias: Signs, Symptoms, & Treatments

What Are 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.

Types of Specific Phobias

Phobias fall into five distinct categories, with each category containing several subtypes. The five categories of specific phobias are:¹

1. Natural/Environmental Type: includes phobias of water, storms, natural disasters, etc.
2. Blood-Injection-Injury Type: includes phobias of cuts, blood, getting injections or IVs
3. Animal Type: includes zoophobia (fear of animals) and phobias of insects, spiders, snakes, or dogs
4. Situational Type: includes phobias of flying, elevators, driving, being in closed spaces
5. Other Miscellaneous Type: includes all other phobias which do not fit in another category (ie: fear of eyes, fear of clowns, fear of choking, fear of people, etc.)

Specific Phobias vs. Other Anxiety Disorders

While all types of 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.

Specific Phobias Vs. Normal Fear Responses

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.

What Are the Most Common Phobias?

While there are many different kinds of phobias, some are much more common than others. These include situations or things that people are more likely to encounter on a somewhat regular basis, as well as fears that are more likely to become problematic enough for a person to seek professional help.

Some of the more common phobias include:

• Agoraphobia: A fear of public spaces
• Claustrophobia: A fear of small, enclosed spaces
• Dentophobia: A fear of dentists
• Entomophobia: A fear of insects
• Arachnophobia: A fear of spiders
• Melissophobia: A fear of bees
• 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
• Hemophobia: A fear of blood
• Mysophobia: A fear of germs and contamination
• Scopophobia: A fear of being stared at
• Chronophobia: A fear of time
• Astraphobia: A fear of thunder and lightning
• Megalophobia: A fear of large objects
• Chromophobia: A fear of colors
• Obesophobia: A fear of gaining weight

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.

Phobia Symptoms

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.²

Symptoms of specific phobias include:²

• 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, anticipatory anxiety, 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 a different anxiety disorder or PTSD)

Specific Phobias & Panic Attacks

It is not uncommon for a person with a specific phobia to experience a panic attack in the moment. 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, and disorientation.

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.

Outward 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, while 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

Specific Phobia Examples

While phobias may present in similar ways by exhibiting fear, there are specific examples of what phobias can look like. Some examples include:

• Astraphobia (fear of storms): In this fear, someone may obsessively watch the weather and become anxious and fearful when there are reports of a storm. They may begin preparing excessively, have panic attacks and be unable to calm themselves down.
• Acrophobia (fear of heights): In this fear, someone can be triggered by a varying degree of heights. It can occur when going up on a ladder as well as being at the top of the roller coaster. They may be unable to take another step for fear of falling and feel their entire body become paralyzed from the fear.
• Melissophobia (fear of bees): This fear can trigger severe emotional and physical symptoms of anxiety and fear such as shaking, crying and anticipatory pain. Simply the photos of bees can also trigger intense responses.
• Agoraphobia (fear of crowds): This fear is linked with the feeling of being trapped and can be brought on by being in large crowds, using public transportation or standing in line at a grocery store. The fear limits people in where they are able to go comfortably.
• Mysophobia (fear of germs): In this fear, someone may have obsessive behaviors such as frequent cleaning, washing hands and living area. They will also avoid public places for reasons related to potentially picking up germs, so they will avoid non-sterile environments.
• Bathophobia: In this fear of depths, such as caves, wells, and deep waters. Someone with bathophobia may avoid exploring nature for fear of encountering geographical depths.
• Haphephobia: Haphephobia is the fear of being touched by others. Someone with this phobia may avoid situations where touch is likely, such as family gatherings or team sports.

Causes of 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 anxiety, 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.³

Are Phobias Genetic?

Phobias and other anxiety disorders do have a genetic component. Some anxiety disorders run in families and others can be influenced by a family history of other anxieties. Phobias tend to have a hereditary factor as well as environmental influences.

Risk Factors for Developing a Phobia

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.¹

The learned experiences that may lead to a phobia are:

1. 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.
2. 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.
3. 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.

Complications of Living With a Phobia

Phobias can limit life experiences and quality of life. These phobias can get in the way of meaningful relationships and keep people stuck in situations they don’t want to be in.

There are many complicated of living with phobias, including:

• Worsened symptoms of anxiety and fear related to the phobia
• Development of additional mental health conditions and symptoms
• Mood disorders
• Alcohol or substance misuse to cope with fears
• Increase in suicidal thoughts
• Lack of social support system
• Poor cognition
• Development of delusional thoughts

How to Get Over Phobias

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, but there are things you can do to help yourself get over phobias, too.

In addition to formal treatment, here are 10 ways to cope with specific phobias:

1. Getting 7-8 hours of sleep each night: Sleep helps to regulate mood, stress and anxiety.
2. Maintaining an active lifestyle: Exercise regulates stress hormones and other brain chemicals that affect mood and anxiety, as well as providing a physical outlet for anxiety.
3. Maintaining important relationships: Relationships are important for all aspects of mental health, and can help provide support to people struggling with a phobic disorder.
4. Developing a meditation practice: Meditation can help reduce stress and anxiety, improve mood, and help people feel more calm.
5. Abstaining from drugs and alcohol: Drugs and alcohol interfere with the natural brain chemistry, often those related to anxiety and other emotions.
6. Practicing self-compassion: Self-compassion is the practice of self-kindness, and helps people be more patient with themselves, more confident in facing fears, and less critical when they have a set-back.
7. Joining a support group: Talking with others who have struggled with anxiety or phobias can provide a lot of comfort, as well as practical advice on what has worked for others.
8. Reducing avoidance: While avoiding feared situations tends to provide instant relief, it tends to worsen phobias in the long run. Facing fears has the opposite effect, helping people develop more confidence in their ability to overcome their fear.
9. Researching online: Learning more about what you are afraid of can sometimes help you feel better able to confront it.
10. Thinking positively: Imagining yourself facing your fear and overcoming it and visualizing this can actually help you develop more courage and confidence, giving you the boost you need to face your fear.

Can Phobias Be Prevented?

Many phobias are unable to be prevented, however phobias can be managed and treated when they are first discovered. Children specifically can learn new ways to manage their symptoms from behavioral observation better than adults, so the earlier it is discovered, the better the outlook.

How Are Specific Phobias Diagnosed?

Diagnosis of phobias are dependent on the individual and situation they are in. Many people are aware of what their fears are and try to find ways to manage on their own. They don’t necessarily see the formal diagnosis as a requirement and have already accepted this is a problem for them. For others, it can come out in therapy or other situations which highlight an oddity of why someone may be behaving the way they are, such as someone acting fearful at a party. They may not understand that what they have is a phobia versus a personality trait, and need to seek treatment from a therapist and psychiatrist to get a formal diagnosis and understanding of their symptoms. Regardless, a mental health professional is the one who makes all diagnoses related to phobias.

Treatment of Specific Phobias

Thankfully, specific phobias 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

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.

Other Types of Phobia Therapy

Other types of counseling are sometimes recommended instead of or in addition to exposure therapy for those trying to overcome a phobia. CBT for anxiety is often used to help people struggling with anxiety disorders, including phobias. This kind of therapy involves helping people become better able to notice, interrupt and change anxiety-provoking thoughts. Other times, third wave theories like acceptance and commitment therapy (ACT) are used to help people become more accepting of their anxiety, and to learn to use mindfulness to help respond more effectively when anxious.

Medication for 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. Often, PRN medications, or medications prescribed to only be taken “as needed,” are prescribed to people with a specific phobia. The most common type of PRN medications used are benzodiazepines, but beta blockers are sometimes also used, and both help to regulate the nervous system. Occasionally, people with specific phobias may be prescribed a daily SSRI medication, especially if they struggle with depression or another more chronic mental health problem.

How to Get Help for Specific Phobias

People who are looking for help with a specific phobia often start out by finding a licensed therapist who can provide individual therapy. By using an therapist directory people are able to narrow their search to people who specialize in certain kinds of therapy like exposure therapy or CBT, and also to find a therapist who is in-network with their insurance.

In addition to seeking counseling, some people who seek help for phobias also talk with a doctor or psychiatrist about options for medication, which is generally only recommended in addition to therapy. Occasionally, a primary care doctor will be open to prescribing medication to people struggling with a specific phobia or other mental health issue.

How Specific Phobias Present 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.¹

Specific Phobias in Young Children

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 (although this symptom is not required for childhood diagnoses). These factors can all contribute to difficulty detecting and treating phobic disorders in children.

Specific Phobias in Teens

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 this 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.

Specific Phobias in Adults

While it is common for specific phobias to begin in childhood, they often are diagnosed in adulthood, peaking during midlife and later.⁶ 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.

Specific Phobia Statistics

Anxiety disorders are the most common type of mental illness in the US, affecting one in three 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:^5,7,8

• 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%

Final Thoughts on Specific Phobias

People who struggle with specific phobias might believe that they will always have their fear, but often it is possible to overcome a phobia. People who seek the help of a therapist or counselor might have an easier time doing this, and will learn tried-and-true techniques to help them. In some cases, it is possible to overcome a phobia in just a few sessions when using research-backed treatments like exposure therapy.