Fear is a natural human emotion that everyone experiences from time to time. However, when fear becomes extreme or irrational, it can be debilitating and disrupt normal life. The clinical terms for extreme or irrational fear are phobia and panic disorder.
What is a Phobia?
A phobia is an extreme, irrational fear of something that poses little or no real danger. People with phobias experience intense anxiety when exposed to the source of their fear. The level of fear is so severe that it interferes with normal functioning. There are three main types of phobias:
- Specific phobias – Fear of a single specific object or situation, such as spiders, heights, or flying.
- Social phobia – Extreme fear of social settings and situations due to fear of embarrassment or judgment.
- Agoraphobia – Fear of situations where escape would be difficult or help unavailable if one experienced panic symptoms.
Phobias are the most common anxiety disorders. Specific phobias, such as fear of snakes, affect up to 9% of adults. Social phobia affects up to 13% of people. Agoraphobia affects about 1.7% of adults in a given year.
Common Phobias
Some of the most common specific phobias include:
- Arachnophobia – Fear of spiders
- Ophidiophobia – Fear of snakes
- Acrophobia – Fear of heights
- Cynophobia – Fear of dogs
- Astraphobia – Fear of thunder and lightning
- Trypophobia – Fear of holes
- Claustrophobia – Fear of confined spaces
- Dentophobia – Fear of dentists/dental procedures
- Aerophobia – Fear of flying
- Carcinophobia – Fear of cancer
Social phobia and agoraphobia are also common. People with social phobia have an intense fear of social situations and being scrutinized or humiliated. Agoraphobia involves fear of situations where escape would be difficult if one experienced panic symptoms like dizziness or nausea.
What Causes Phobias?
Phobias are complex conditions caused by a combination of genetic and environmental factors. Potential causes include:
- Genetics – Specific phobias can run in families, suggesting a genetic component.
- Brain chemistry – Neurotransmitter imbalances may play a role.
- Unconscious associations – Some phobias may be rooted in unconscious associations formed in childhood.
- Traumatic experiences – Experiencing trauma related to the feared object can trigger phobias.
- Learning – Observing phobic behavior in others can lead to developing a phobia.
The exact causes are unknown, but it likely involves a complex interplay between genetics, brain chemistry, past experiences, and psychological factors. Certain personality types also seem predisposed to phobias.
Phobia Symptoms
The main symptom of phobias is an intense, irrational fear reaction when exposed to the feared object or situation. Common phobia symptoms include:
- Racing heart rate, palpitations
- Trembling, shaking
- Shortness of breath, hyperventilation
- Sweating, flushing skin
- Tightness or pain in chest
- Nausea, stomach distress
- Feeling dizzy or faint
- Feelings of unreality or detachment
- Fear of losing control or “going crazy”
- Fear of dying
The physical symptoms are the body’s fight-or-flight response kicking in. The psychological symptoms reflect the extreme anxiety produced by phobias. The person recognizes the fear is irrational but cannot control it.
People with phobias typically experience severe distress when encountering the phobic object/situation and go to great lengths to avoid it. Avoidance behavior interferes with normal functioning. For example, someone with agoraphobia may avoid leaving home and become increasingly housebound.
Phobia vs. Panic Disorder
Phobias and panic disorders both involve extreme fear and anxiety. However, there are some key differences:
| Phobia | Panic Disorder |
|---|---|
| Focused on specific object/situation | Not focused on specific trigger |
| Trigger is present | Panic attacks can occur “out of the blue” |
| Avoids the trigger | Avoids situations due to anticipatory anxiety about panic attack |
| Fear is somewhat proportional to the trigger | Panic attacks are seemingly “out of proportion” to trigger |
With phobias, fear is focused on the specific phobic object or situation and occurs when triggered. Panic attacks can arise without an obvious trigger and the fear response seems disproportionate to any potential “cause.”
Treating Phobias
Effective phobia treatments include psychotherapy, medications, and gradual exposure to the feared situation. Common treatments include:
Cognitive-behavioral therapy (CBT)
CBT helps identify irrational fearful thoughts/beliefs and replace them with more realistic, adaptive ones. Gradual exposure is used to desensitize the person to the feared trigger.
Exposure therapy
This involves gradually and repeatedly exposing the person to the trigger in a controlled, safe way. It allows them to learn the feared outcome doesn’t happen which can help extinguish the fear response.
Anti-anxiety medications
Medications such as antidepressants and benzodiazepines can help reduce phobia symptoms and support other therapy.
Virtual reality exposure therapy
Using virtual reality simulations of the feared situation can help treat phobias. It provides exposure in a safe, controlled environment.
Treatment aims to teach coping strategies for managing fear, change thinking patterns, safely face fears and build confidence. With evidence-based treatment, most people with phobias can achieve significant improvement.
What is Panic Disorder?
Like phobias, panic disorder also involves extreme fear and anxiety. But while phobias focus on specific fears, panic disorder involves seemingly spontaneous, inexplicable panic attacks and persistent anxiety of having another attack.
Panic Attack Symptoms
Panic attacks involve sudden, intense episodes of anxiety, fear and physical symptoms that peak within minutes. Symptoms include:
- Racing heart rate, palpitations
- Sweating, chills
- Trembling, shaking
- Shortness of breath
- Feelings of choking
- Chest pain
- Nausea, abdominal distress
- Dizziness, lightheadedness
- Numbness or tingling
- Detachment from reality or fear of losing control
- Fear of dying
Attacks reach peak intensity within 10 minutes and usually resolve within 30 minutes. People having an attack feel an urgent need to escape and intense fear they are losing control, going crazy or having a heart attack.
Panic Disorder Symptoms
In panic disorder, the person experiences recurrent, unexpected panic attacks followed by persistent worry about future attacks. Associated symptoms include:
- Chronic anxiety about having another attack
- Avoidance of potential panic triggers
- Distress due to inability to predict or control attacks
People with panic disorder often restrict their lives in an effort to avoid triggers. For example, someone may stop driving or confine themselves at home due to fear of having an attack.
Causes of Panic Disorder
Panic disorder likely arises from a complex combination of factors like:
- Genetics -panic disorder can run in families.
- Brain chemistry – Neurotransmitter imbalances and hypersensitive fear pathways in the brain may play a role.
- Stress – Significant life stress often precedes panic disorder.
- Medical conditions – Conditions like hyperthyroidism can trigger panic attacks.
- Drug use – Stimulant drugs can trigger panic attacks.
- Major life transitions – Events like starting college or new jobs can trigger attacks in predisposed people.
The exact mechanisms behind spontaneous panic attacks is unclear. However, once someone experiences an attack, fear of having another one can lead to chronic anxiety and panic disorder.
Treating Panic Disorder
Effective panic disorder treatments include therapy, medications, relaxation techniques and facing fears. Common treatments include:
Cognitive behavioral therapy (CBT)
CBT helps identify and change fearful thoughts and beliefs that lead to avoidance behavior. Exposure therapy and relaxation techniques are often included.
Exposure therapy
Facing feared situations in a gradual, controlled way can help overcome avoidance and reduce anxiety about having an attack.
Anti-anxiety medications
Medications like SSRIs and benzodiazepines can help relieve anxiety, panic symptoms, and depression associated with panic disorder.
Relaxation techniques
Relaxation training like deep breathing, meditation, yoga, and mindfulness can help relieve anxiety and panic symptoms.
With proper treatment, most people with panic disorder experience significant improvement. Attacks become less frequent and intense over time. The anxiety about having another attack also diminishes.
Conclusion
In summary, extreme, irrational fear is known as phobia and panic disorder in clinical terms. Phobias involve focused fears about specific triggers like objects or situations. Panic disorder involves seemingly spontaneous panic attacks and worry about future attacks striking unexpectedly. While distressing, both phobias and panic disorder are treatable conditions and various effective therapies exist. With professional help, most people can overcome extreme anxiety and return to healthy, normal functioning.