Phobias

What are phobias?

A phobia is when something causes you to feel fear or anxiety that’s so severe it consistently and overwhelmingly disrupts your life. Phobias are a type of anxiety disorder, and there’s one diagnosis for almost all of them: specific phobia. Only one phobia, agoraphobia, is a specific diagnosis.

When you aren’t in a situation that directly involves your phobia, you can recognize that the fear is much more severe than it should be. But knowing that doesn’t change how you feel. If you encounter something that triggers your phobia, you’ll feel overwhelming fear or anxiety. You might be able to keep functioning, but doing so will be extremely difficult.

How many different phobias are there?

Because phobias, including the feelings of fear or anxiety they cause, affect everyone differently, there’s no set number of fears. However, experts group fears into five main categories:

The most common phobias

Some of the most common phobias, by category, include:

Animals

• Arachnophobia (Fear of Spiders).
• Cynophobia (Fear of Dogs).
• Entomophobia (Fear of Insects).
• Ophidiophobia (Fear of Snakes).

Natural environment

• Acrophobia (Fear of Heights).
• Agoraphobia (Fear of Public Spaces).
• Aquaphobia (Fear of Water).
• Astraphobia (Fear of Thunder and Lightning).

Blood, medical procedures or injuries

• Algophobia (Fear of Pain).
• Dentophobia (Fear of Dentists).
• Hemophobia (Fear of Blood).
• Trypanophobia (Fear of Needles).

Situations

• Aerophobia (Fear of Flying).
• Amaxophobia (Fear of Driving).
• Claustrophobia (Fear of Enclosed Spaces).
• Nyctophobia (Fear of the Dark).

Other

• Coulrophobia (Fear of Clowns).
• Emetophobia (Fear of vomiting).
• Pyrophobia (Fear of Fire).
• Trypophobia (Fear of Clusters or Groups of Holes).

Agoraphobia

Agoraphobia is a separate diagnosis because it can have many potential triggers. A diagnosis of agoraphobia requires that you experience multiple types of triggers. The five all relate to being in public areas or spaces.

How common are phobias?

While it’s common for people to describe having a strong fear of something — like snakes or heights — that’s not the same as a phobia. In reality, phobias aren’t very common.

Specific phobia

The rates for specific phobia can vary by age. However, most people develop them before age 10.

• Overall: Only about 8% to 12% of people in the U.S. meet the criteria for specific phobia. Everywhere else in the world, it’s between 2% and 6%.
• Children: Worldwide, between 3% and 9% of children meet the requirements for specific phobia. Among teenagers (between 13 and 17 years) in the U.S., about 16% have it.
• Older adults (65 and older): Specific phobia rates tend to decrease as people age. Estimates range between 3% and 5% for people 65 and older.

Women and people assigned female at birth (AFAB) are twice as likely to have specific phobia than men and people assigned male at birth (AMAB).

What are the symptoms of phobias?

Specific phobia and agoraphobia have the same possible symptoms but can happen in different ways or settings. Phobias can cause you to experience physical, mental and behavioral symptoms when you’re exposed to the feared object or situation and/or when thinking about it.

Mental symptoms are effects that impact how you think and feel. They include:

• Intense or overwhelming fear.
• Panic or feeling the need to escape.
• Feeling like you’re in immediate danger.
• Feelings of disconnection from your own body (depersonalization) or the world around you (derealization).

Physical symptoms are effects that directly affect your body. They include:

• Heart rate and activity changes.
• Sweating, feeling hot or chills.
• Shaking or trembling.
• Nausea, upset stomach or stomachache.
• Tightness or pain in your chest.
• Trouble breathing or feeling smothered.
• Feeling dizzy or lightheaded.
• Fainting.
• Pallor (blood rushing out of your face).
• Narrowed vision (also known as tunnel vision).

Behavioral symptoms are ways you change (or don’t change) your lifestyle, routine or habits. They include:

• Going out of your way to avoid triggers. Example: Avoiding regular medical or dental care because you’re afraid of needles, dentists, etc.
• Deliberately changing your life to avoid triggers. Example: Moving out of a coastal area because of a fear of hurricanes.
• Avoiding life changes — especially positive ones — so you don’t encounter triggers. Example: Avoiding buying a house or taking a job somewhere with a view of a river, lake or ocean because of a fear of water, swimming or drowning.

Phobia symptoms in children

Children can also develop specific phobia, and they may show different symptoms, including:

• Crying.
• Tantrums or emotional outbursts.
• Freezing (holding still).
• Clinging or being inseparable from someone they feel is safe.

What causes phobias?

Phobias are when your brain takes fear and anxiety to extreme degrees. Under ordinary circumstances, these emotions can be protective and helpful. They’re your brain’s way of warning you that something is wrong and you might be (or currently are) in danger. But experts don’t fully understand why these emotions can turn into phobias. However, several factors and processes may contribute to having a phobia. These include:

• Traumatic experiences. These can be experiences that happen to you or that you see happen to someone else.
• Genetics. Certain types of phobias are more likely to happen in people who have a relative with that type of phobia. The types with higher rates in family members are animal, blood/medical procedure/injury and situational phobias.
• Informational transmission. Some phobias may happen because of things you learn about or things you see or hear repeatedly.
• Learned fears. People can learn about the phobias or fears of others and may develop a phobia as a result. This may be a factor in why people with overprotective parents may be more likely to have specific phobia.

What are the complications of phobias?

Phobias can have long-term effects on your mental and physical health, especially when you frequently encounter triggers or have especially severe effects. People with specific phobia and agoraphobia have a higher risk of certain mental health conditions. While phobias may not cause those conditions, phobias usually start before the other conditions and can contribute to them.

Mental health conditions that are more likely in people with specific phobia or agoraphobia include:

• Anxiety disorders.
• Bipolar disorder.
• Depressive disorders.
• Personality disorders (especially dependent personality disorder).
• Substance use disorders.
• Somatic symptom disorders.

Physical health conditions that commonly happen along with phobias or that may get worse because of phobia symptoms include:

• Heart disease.
• Chronic obstructive pulmonary disease (COPD).
• Parkinson’s disease.
• Balance and dizziness symptoms, which can also cause falls and fall-related injuries.
• Degenerative brain disorders and dementia symptoms.

How are phobias diagnosed?

A mental health provider, usually a psychologist or psychiatrist, can diagnose specific phobia or agoraphobia by talking to you and asking questions. Diagnosing these conditions doesn’t require lab, imaging or diagnostic testing. The questions they ask may follow specific questionnaires designed to help diagnose a phobia. The questions they ask can include, but aren’t limited to:

• Phobia triggers that you know about.
• What symptoms you experience and how severe they are.
• Your current lifestyle and routine and if phobia symptoms affect it.
• When the symptoms started.
• If you have a history of a traumatic event or other possible factors that could cause or contribute to a phobia.

Your provider will ask these questions because diagnosing specific phobia or agoraphobia requires that your symptoms meet certain criteria.

Specific phobia criteria

• You experience strong fear or anxiety about a specific object or situation.
• Encountering a phobia trigger causes immediate fear, anxiety or both.
• You actively avoid phobia triggers, or experience intense fear, anxiety or both, when you encounter triggers you can’t avoid.
• The fear or anxiety you experience is much more severe than the trigger should cause.
• You experience fear or anxiety from triggers or work to avoid them for at least six months.
• The fear, anxiety or avoiding phobia triggers disrupts part of your life, including work, social relationships, etc.
• The symptoms you experience aren’t better explained by another condition (such as post-traumatic stress disorder (PTSD) or panic disorder).

How are phobias treated, and can they be cured?

Treating phobias can involve mental health therapy (the formal term is “psychotherapy”), medications or a combination of the two. The treatments can depend on the type of phobia you experience, how severe the symptoms are, and factors related to your lifestyle, routine and preferences. A healthcare provider can tell you more about the possible treatments that can help you and which they recommend.

Psychotherapy

One of the main ways to treat a phobia is by helping you adjust your thinking and behaviors surrounding your fear. Mental health therapy (psychotherapy) is one of the most useful ways to do this. Cognitive behavioral therapy (CBT) is a common type of therapy that helps with this. Over time, therapy can help you better cope with the fear and anxiety you experience.

Exposure therapy

Another treatment approach is exposure therapy. That can happen in two main ways:

• Systematic desensitization (graded exposure). This involves gradually exposing you to parts of triggers slowly. Over time, your provider will help you work through parts of your fears from least to most troubling. It also helps you practice adjusting your thinking and behaviors to manage feelings of fear and anxiety.
• Flooding. This technique is similar to desensitization, but it involves exposing you to the phobia triggers themselves, not in small bits over time. That helps you adjust to triggers and control your anxiety. Though less common, this technique can sometimes help people with phobias (but most providers recommend using it cautiously).

Exposure therapy can happen in two ways:

• In vivo. From Latin, and in this context means, “in real life.” Exposing yourself to your fear in real life is one way that you can work through it.
• Imaginal. This is where your provider has you imagine your fear and helps you process and work through the fear by thinking about it. For some phobias, this is the only way to use exposure therapy, especially phobias that would be dangerous to be around in real life.

Medications

In some cases, certain medications can also help you with phobia symptoms. These are usually depression medications or anxiety medications. Many types of medications can help with phobia symptoms, so your healthcare provider is the best person to explain your options and which they recommend. They can also explain the possible side effects, complications and other details you should know about these drugs.

Are phobias preventable?

Phobias happen unpredictably, and they can vary widely from one person to another. That’s partly because fear is something that each person experiences differently. Because of that, there’s no way to prevent phobias from developing. There’s also no known way to reduce your risk of developing them.

What can I expect if I have a phobia?

Phobias can majorly impact your mental health and well-being, especially if they involve something you encounter often. About 75% of people with specific phobia also have more than one type of phobia, which can make this condition very disruptive.

Over time, untreated phobias can cause some people to limit their lives severely.

How long do phobias last?

Over time, specific phobia can fade. However, this is less likely to happen without treatment. Phobias that start in childhood may fade quickly. But childhood phobias that last into adulthood can last for years or even decades.

What’s the outlook for phobias?

The outlook for specific phobia is best with treatment, especially early on. Without treatment, these conditions can greatly impact your mental health and how you live your life.

Early treatment for phobia symptoms can make a major difference, even if you don’t have an official phobia diagnosis because you haven’t had symptoms for at least six months. This is true no matter what your age or what phobia you have.

How do I take care of myself if I have a phobia?

The most important things you can do if you think you have a phobia include:

• Seek help. You should seek help as soon as you notice phobia symptoms disrupting your life. Getting help sooner can make a big difference in your recovery.
• Follow treatment guidance. If your healthcare provider prescribes medication or recommends regular mental health visits, following them can make your treatment more effective and help you faster.
• Don’t underestimate the value of lifestyle changes. Staying active, eating a healthy diet, getting enough sleep, avoiding alcohol and nonmedical use of drugs, and managing your stress and mental health can all help you as you work on managing or overcoming a phobia.

When should I go to the ER?

Phobias can increase your risk of anxiety, depression and other mental health conditions. Those conditions can, in turn, increase your risk of self-harm or suicide.

You should get immediate help if you have thoughts about harming yourself or others, or if you suspect someone you know is in danger of harming themselves. Resources that can help you include:

• National Suicide and Crisis Lifeline (United States). This line can help you if you have suicidal thoughts or impulses, and you can also call even when you’re not in crisis. To call this line, dial 988. You can also receive help via text message. To do so, text HELLO to 741741.
• 911 (or your local emergency services number). You should call 911 (or the local emergency services number) if you feel like you are (or someone you know is) in immediate danger of self-harm or suicide. Operators and dispatchers for 911 lines can often help people in immediate danger because of a severe mental crisis and send first responders to assist.

A note from Cleveland Clinic

You might feel that having a phobia is a major flaw or a sign of weakness, but it isn’t. Phobias are widespread and can affect everyone, regardless of age or background. Just as there’s nothing wrong with seeking treatment for a broken bone or an ear infection, there’s nothing wrong with seeing a mental health professional for help with a phobia.

If you have or think you might have a phobia, talk to a mental health provider. With treatment, you can find ways to manage — or even overcome — your fears. That way, you won’t have to worry about what you might encounter the next time you go out your door.