Many people experience specific phobias, intense, irrational fears of
certain things or situations—dogs, closed-in places, heights, escalators, tunnels,
highway driving, water, flying, and injuries involving blood are a few of the more common
ones.
Phobias aren't just extreme fear; they are irrational fear. You may be
able to ski the world's tallest mountains with ease but panic going above the 10th floor
of an office building. Adults with phobias realize their fears are irrational, but often
facing, or even thinking about facing, the feared object or situation brings on a panic
attack or severe anxiety.
Specific phobias strike more than 1 in 10 people. No one knows just what
causes them, though they seem to run in families and are a little more prevalent in women.
Phobias usually first appear in adolescence or adulthood. They start
suddenly and tend to be more persistent than childhood phobias; only about 20 percent of
adult phobias vanish on their own. When children have specific phobias—for example, a
fear of animals—those fears usually disappear over time, though they may continue
into adulthood. No one knows why they hang on in some people and disappear in others.
If the object of the fear is easy to avoid, people with phobias may not
feel the need to seek treatment. Sometimes, though, they may make important career or
personal decisions to avoid a phobic situation.
When phobias interfere with a person's life, treatment can help.
Successful treatment usually involves a kind of cognitive-behavioral therapy called
desensitization or exposure therapy, in which patients are gradually exposed to what
frightens them until the fear begins to fade. Three-fourths of patients benefit
significantly from this type of treatment. Relaxation and breathing exercises also help
reduce anxiety symptoms.
There is currently no proven drug treatment for specific phobias, but
sometimes certain medications may be prescribed to help reduce anxiety symptoms before
someone faces a phobic situation.
Social phobia is an intense fear of becoming humiliated in social
situations, specifically of embarrassing yourself in front of other people. It often runs
in families and may be accompanied by depression or alcoholism. Social phobia often begins
around early adolescence or even younger."
If you suffer from social phobia, you tend to think that other people are
very competent in public and that you are not. Small mistakes you make may seem to you
much more exaggerated than they really are. Blushing itself may seem painfully
embarrassing, and you feel as though all eyes are focused on you. You may be afraid of
being with people other than those closest to you. Or your fear may be more specific, such
as feeling anxious about giving a speech, talking to a boss or other authority figure, or
dating.
The most common social phobia is a fear of public speaking. Sometimes
social phobia involves a general fear of social situations such as parties. More rarely it
may involve a fear of using a public restroom, eating out, talking on the phone, or
writing in the presence of other people, such as when signing a check.
Although this disorder is often thought of as shyness, the two are not the
same. Shy people can be very uneasy around others, but they don't experience the extreme
anxiety in anticipating a social situation, and they don't necessarily avoid circumstances
that make them feel self-conscious. In contrast, people with social phobia aren't
necessarily shy at all. They can be completely at ease with people most of the time, but
particular situations, such as walking down an aisle in public or making a speech, can
give them intense anxiety. Social phobia disrupts normal life, interfering with career or
social relationships. For example, a worker can turn down a job promotion because he can't
give public presentations. The dread of a social event can begin weeks in advance, and
symptoms can be quite debilitating.
People with social phobia are aware that their feelings are irrational.
Still, they experience a great deal of dread before facing the feared situation, and they
may go out of their way to avoid it. Even if they manage to confront what they fear, they
usually feel very anxious beforehand and are intensely uncomfortable throughout.
Afterwards, the unpleasant feelings may linger, as they worry about how they may have been
judged or what others may have thought or observed about them.
About 80 percent of people who suffer from social phobia find relief from
their symptoms when treated with cognitive-behavioral therapy or medications or a
combination of the two. Therapy may involve learning to view social events differently;
being exposed to a seemingly threatening social situation in such a way that it becomes
easier to face; and learning anxiety-reducing techniques, social skills, and relaxation
techniques.
The medications that have proven effective include selective serotonin
reuptake inhibitors, MAO inhibitors and high-potency benzodiazepines. People with a
specific form of social phobia called performance phobia have been helped by drugs called
beta-blockers. For example, musicians or others with this anxiety may be prescribed a
beta-blocker for use on the day of a performance.
modified from information provided by the National Institute of Mental
Health
