Phobias are the most common psychological disorder among American women and the second most common disorder among men older than 25. About 75 percent of people who seek treatment find relief.

We all have things we’re afraid of—spiders, snakes, and heights are common fears. Even so, most people with ordinary fears of ordinary things can function quite well at home and work and in public.

However, people with phobias— persistent irrational fears of specific objects or situations—aren’t so fortunate.

“People with phobias often suffer from disrupted daily routines, impaired workplace productivity, reduced self-esteem, and strained personal relationships,” says Stephen Whiteside, Ph.D., director of the Anxiety Disorders Program at the Mayo Clinic in Rochester, Minn.

What is the difference between a fear and a phobia?

For a phobia to be diagnosed, it has to cause the person significant distress or impairment. For example, if you’re fearful of speaking in public, you may not want to give a presentation, but if asked to, you can get through it. If you have a phobia of speaking in public, however, you’ll avoid doing so at all costs and may have symptoms of panic if you try to deliver a speech.

Common phobias include:

• Specific phobias. These involve fears of objects or places, such as a fear of enclosed spaces; spiders, snakes, dogs, or mice; heights; flying; water; storms; dentists; tunnels; bridges; and the like.
• Social phobia. This phobia involves a combination of excessive self-consciousness, a fear of public scrutiny or humiliation in common social situations, and a fear of negative evaluation by others.
• Agoraphobia. This is a fear of being outside or in a public place and having a panic attack.

Symptoms
A person with a phobia may experience these symptoms when confronted with the object or situation that’s feared:

• Persistent irrational fear, dread, and panic
• Physical symptoms, such as shaking, sweating, and trouble breathing
• An overwhelming desire to avoid the thing that may result in taking unusual measures to stay away from it; for example, someone afraid of tunnels may drive miles out of their way to avoid passing through one
• An impaired ability to function normally because of the fear

Help’s Available
If you believe you have a phobia that’s negatively affecting your life, ask your doctor or a mental health professional for an evaluation.

“To treat phobias you have to break the cycle of fear,” says Whiteside. “For this reason, treatment usually starts with behavior modification and possibly medication, if needed.”

Effective therapies include:

• Exposure or desensitization therapy that focuses on changing your response to the feared thing by gradually exposing you to it. For example, if you’re afraid of dogs, you might begin by spending time with a golden retriever puppy, followed by an adult retriever, and then a more aggressive breed, such as a German Shepherd.
• Cognitive behavior therapy involves exposure exercises as well as learning ways to view and cope differently with what you fear. There’s special emphasis on learning to develop a sense of mastery of your thoughts.
• Medications that might be prescribed include beta-blockers, antidepressants, and sedatives.
• Self-care steps include visualization of yourself facing your fears, and making positive statements to yourself, such as “I will be OK.”

Barbara Floria spoke with Stephen Whiteside, Ph.D., director of the Anxiety Disorders Program at the Mayo Clinic in Rochester, Minn. For more information, visit www.mayoclinic.com and search for “phobias.”

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