All people have fears or situations they would rather avoid. It is part of everyday life. Some people are frightened by job interviews. Others are uncomfortable to be home alone at night. Most people manage to control their fears and go about their normal activities.

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But for some people, anxieties and fears are overwhelming and persistent. Normal coping mechanisms don't work, and the need to avoid the objects or situations that cause anxiety can be so intense that they drastically interfere with daily life. Sometimes people may make important career or personal decisions to avoid a phobic situation. Others may refuse to go to the doctor for fear of having blood drawn.

Phobias aren’t just extreme fear, they are irrational fear. Adults with phobias realise 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.

Phobias often begin in childhood or adolescence, but many adults find that their lives are impaired by phobic symptoms. Many phobias are more common in women, but some (e.g. fear of blood) are more common in men.

What causes phobias?
Scientists are learning more about the particular brain regions that are involved in phobic fears. Phobias are thought to be caused by a combination of biological factors and life events, much in the way other disorders (such as diabetes or heart disease) are influenced by a person's genes and lifestyle.

Categories of phobias
Phobias are divided into three broad categories: specific phobia (which used to be called simple or single phobia), social phobia/social anxiety disorder, and agoraphobia depending on what triggers the fear and how the individual reacts to the dreaded object or situation.

Specific phobia:
A specific phobia is the intense, irrational fear of specific objects or situations that cause terror. Specific phobias can be classified into subtypes, namely Animal Type, Natural Environment Type (eg storms, heights or water), Blood-Injection-Injury Type (eg seeing blood or an injury), Situational Type (eg public transportation or enclosed places) or Other Type (if fear is cued by other stimuli).

Agoraphobia:
Agoraphobia, which often accompanies panic disorder, is a fear of being in any situation that might provoke a panic attack, or from which escape might be difficult if one occurred.

Social Anxiety Disorder (Social Phobia):
Social anxiety disorder (social phobia) is an intense fear of becoming humiliated in social situations; in other words, of embarrassing yourself in front of others. If you suffer from social anxiety disorder, you tend to think other people are very competent in public and that you are not. Small mistakes you make may appear much more serious to you than they really are. Blushing may seem painfully embarrassing, and you feel as though all eyes are focused on you.

Social anxiety disorder should not be confused with shyness. Shy people can be very uneasy around others, but they don't experience 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 anxiety disorder aren't necessarily shy. They can be completely at ease with people most of the time, but particular situations such as making a speech can give them intense anxiety.

Treatment
If the object of fear is easy to avoid, people with phobias may not feel the need to seek treatment. When phobias interfere with a person's life, treatment can help. Successful treatment usually involves Cognitive Behavioural techniques such as desensitisation or exposure therapy, in which patients are gradually exposed to what frightens them until the fear begins to fade. Three-quarters of patients benefit significantly from this type of treatment. Relaxation and breathing exercises also help reduce anxiety symptoms.

Sometimes certain medications may be prescribed to help reduce anxiety symptoms before someone faces a phobic situation.

For more information contact the Mental Health Information Centre at (021) 938 9229.

(Ilse Pauw, Health24)

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