The word “phobia” is often used frequently to describe a general fear, in the same way “bipolar” gets thrown around to describe someone’s mood swing or “OCD” is used to reference someone’s dedication to cleaning. Like bipolar or obsessive-compulsive disorders, however, phobias are actually serious, diagnosable, and more intense than the frivolous use of the label in everyday culture implies. If you have a particularly strong fear, you might have a phobia and not even realise it — so here’s how to tell the difference between the two.
What is a phobia?
This is how Johns Hopkins Medicine defines a phobia:
“A phobia is an uncontrollable, irrational, and lasting fear of a certain object, situation, or activity. This fear can be so overwhelming that a person may go to great lengths to avoid the source of this fear. One response can be a panic attack. This is a sudden, intense fear that lasts for several minutes. It happens when there is no real danger.”
For what it’s worth, the “related” topics suggested by Johns Hopkins on the side of that page include OCD and generalized anxiety disorder. This is a mental health concern, not just a simple fear or discomfort. The last part of the definition — “it happens when there is no real danger” — is key: Just because you would feel intense fear if you were, say, being chased by an aggressive dog, doesn’t necessarily mean you have a phobia of dogs. If a photo of a dog causes a panic attack or other intense reaction, even when there is absolutely no dog around and you are not facing any dog-chase threat, it could be a phobia. If you alter your daily activities to avoid dogs, even knowing that you’d likely encounter leashed and well-trained ones, it could be a phobia.
About 15 per cent of Aussies have at least one phobia, and those can range from mild to severe. While they can develop in early childhood, they’re typically first seen between the ages of 15 and 20. There’s been a lot of study done here and researchers believe genetic and environmental factors can contribute to the start of a phobia. Some have been linked to “a very bad first encounter” with the trigger, but experts aren’t sure if that’s necessary for a phobia to begin.
What are the most common phobias?
There are three main categories of phobias: Specific phobias, social phobias, and agoraphobia. Specific phobias are the ones you’re likely familiar with, as they relate to a specific thing or situation. People with these phobias are aware that their fear is extreme, but they may not get diagnosed if the trigger is easy to avoid.
Someone with a specific phobia of heights, for instance, may simply be able to avoid skyscrapers or bridges — but when that avoidance impedes their ability to take a certain job, travel somewhere, or get a particular apartment, it’s clearly a problem. Common specific phobias include flying, dogs, closed-in places, tunnels, heights, and insects or spiders. Again, while any of these could potentially be dangerous, phobias are characterised by intense fear and reaction when there is no danger.
Social phobia, on the other hand, is an anxiety disorder in which someone has significant discomfort around their fear of being embarrassed, humiliated, or scorned by other people, either in social or performance situations. Largely, social phobia includes public speaking, meeting people, eating in public, and the like, and Johns Hopkins is clear that the extreme anxiety leading up to these events is what differentiates social phobia from standard shyness.
Finally, agoraphobia is the fear of having a panic attack someplace from which there is no escape. The anxiety associated with agoraphobia can, in turn, cause panic attacks. Examples of agoraphobia include tremendous fear when alone outside the home, at home alone, being in a crowd, being in an elevator, being on a bridge, or in similar situations.
Treatment for phobias
Phobias are not only diagnosable but can even be treatable. One in-depth study review in The Lancet pointed out that the developmental course of a phobia is fear of avoidance to diagnosis, so interrupting the progress could reduce a phobia’s prevalence. Plus, having a phobia is strongly predictive of the onset of other anxiety, mood, and substance use disorders, so early treatment is pretty critical, not only to improve someone’s quality of life outright but to attempt to nip other potential issues in the bud.
The issue with treatment, of course, is that by phobias’ definition, they’re distressing or downright impairing, as the review points out. As a result, people with phobias may be hesitant to seek out treatment at all. Affected individuals become adept at avoidance; only about 10% to 25% ever seek treatment.
The treatment of choice for specific phobias is exposure therapy, which involves in-vivo or imaging approaches to the trigger or stimuli, done in a professional environment. Cognitive-behavioural therapy and breathing exercises in conjunction with exposure therapy are recommended for specific phobias, while CBT and medicine are recommended for people with social phobia and agoraphobia.
The first step is, of course, getting a diagnosis. An initial diagnosis does not mean you’ll automatically be tossed into exposure therapy, so don’t let the fear of having to confront your trigger stop you from reaching out to a professional. Once you’re diagnosed, you can work on a step-by-step treatment plan that you’re comfortable with. A mental health professional won’t do anything to panic you with no warning, but every day you delay getting a diagnosis and treatment is another day you could encounter your stimuli in real life, so consider getting help if any of the above symptoms apply to you.