In this article
Fear is a normal part of life, and we encounter many things that can be dangerous, painful or frightening, such as fire, physical attacks, treacherous weather conditions or ferocious animals. This type of anxiety is very useful as it warns us when danger threatens.
Fear releases adrenaline and other chemicals into the blood and this speeds up our heart rate, sharpens our senses and heightens our physical powers. This prepares us for what is known as ‘fight or flight’ – either to fight for our lives, or run for them.
It becomes an ‘anxiety disorder’ when someone experiences uncomfortably high levels of ‘fight or flight’ arousal in situations where you would not normally expect to feel this level of fear. A phobia develops when the mind has learnt to associate a certain situation or object with the ‘fight or flight’ fear response.
Fear is described as ‘phobic’ when the object or situation is ‘illogically’ feared beyond its ability to harm, when we cannot rationalise it or put it into perspective, when it involves avoidance of the fearful object or situation or when it cuts out choices, interferes with our daily living and reduces our quality of life.
The NHS estimate that 10 million people in the UK have phobias and that phobias are the most common type of anxiety disorder. But what is a phobia? A phobia has been defined as “an overwhelming and debilitating fear of an object, place, situation, feeling or animal” and they are either categorised as Simple Phobias, also known as Specific Phobias, or as Complex Phobias.
Simple aka Specific Phobias
Simple aka specific phobias are fears about specific objects, animals, situations or activities. Exposure to the object or situation brings about an immediate reaction, causing the person to endure intense anxiety (nervousness) or to avoid the object or situation entirely.
Some common examples include:
- Acrophobia – Fear of heights – According to the most recent survey from market researchers YouGov, heights are the UK’s biggest fear; it is the most common phobia. Nearly a quarter of the population is reportedly “very afraid” of being up high, while a further 35% are “a little afraid”.
- Arachnophobia – Fear of spiders – One of the most common phobias, as around 18% of us admit to being petrified of spiders and daddy-long-legs; some people cannot even look at the eight-legged creatures on TV.
- Aviophobia or Aerophobia – Fear of flying – YouGov found that around 24% of British people have some form of anxiety about getting on a plane. Some people worry about something going wrong with the plane, whilst others suffer from anxiety about an internal loss of control and the sensation of flight.
- Bathmophobia – Fear of stairs or steep slopes – Reportedly Donald Trump suffered from this phobia. It is quite similar to climacophobia, or the fear of climbing stairs, except in its specific focus.
- Claustrophobia – Is the irrational fear of confined spaces. It’s estimated around 10% of the UK population are affected by claustrophobia during their lifetime. People affected by claustrophobia will often go out of their way to avoid confined spaces, such as lifts, tunnels and tube trains, but avoiding these places may reinforce the fear.
- Coulrophobia – Fear of clowns – Another common fear, 12% of the population suffer from a genuine phobia of clowns.
- Dentophobia – Fear of dentists – Very common, the British Dental Association (BDA) quote that as many as 25% of the UK population suffer from this.
- Nyctophobia – Fear of the dark – It is hard to find reliable statistics about nyctophobia in adults, however, around 17% of adults sleep with the light on and 10% of adults are too fearful to even get out of bed to use the bathroom with the lights out. YouGov’s data suggests that people in their late 20s and 30s are most likely to leave a light on.
- Ornithophobia – Fear of birds – This can take many forms. Some people fear only birds of prey, while others are afraid of garden birds or household pets like budgies or parakeets; some may even fear all representations of birds, including photos.
- Technophobia – Fear of technology – Whilst experts believe that we all suffer at least a small amount of nervousness when confronted with new technology, there is very little data in scientific literature about tech-related phobias and anxieties; however, some individuals are fearful of technology or of particular gadgets for various reasons.
- Tokophobia – Fear of childbirth and pregnancy – Although rare, women who have this phobia have a pathological fear of giving birth, and will often avoid becoming pregnant and giving birth altogether. Women with a severe fear of childbirth often have depression or anxiety too.
- Trypanophobia – Is an extreme fear of medical procedures involving injections or hypodermic needles and is suffered by 10% of the UK population. It tends to be more common in children and may lessen as people grow older and gain more experience having medical procedures and injections involving needles.
Simple aka specific phobias can start during early childhood, often between the ages of four and eight, and usually disappear on their own as the child gets older. Fear can be learnt from others; a child whose parents react with fear and anxiety to certain objects or situations is also likely to respond to those objects with fear. For some people, these phobias do not cause too many problems in adulthood.
Simple aka specific phobias in adults generally start suddenly and are more lasting than childhood phobias. Only about 20% of simple aka specific phobias in adults go away on their own (without treatment). Simple aka specific phobias affect different people in different ways; some people only react with mild anxiety when confronted with the object of their fear, while others experience severe anxiety or can even have a severe panic attack.
Symptoms of simple aka specific phobias may include:
- Excessive or irrational fear of a specific object or situation.
- Avoiding the object or situation or enduring it with great distress.
- Anticipatory anxiety, which involves becoming nervous ahead of time about being in certain situations or coming into contact with the object of your phobia; for example, a person with a fear of dogs may become anxious about going for a walk because they may see a dog along the way.
- Physical symptoms of anxiety or a panic attack. The symptoms of panic are:
– Pounding heart.
– Nausea or diarrhoea.
– Trembling or shaking.
– Numbness or tingling.
– Problems with breathing (shortness of breath).
– Feeling dizzy or lightheaded.
– Feeling like you are choking.
Children with a simple aka specific phobia may express their anxiety by crying, clinging to a parent, or throwing a tantrum.
Although many simple aka specific phobias cannot be prevented, early intervention and treatment following a traumatic experience, such as an animal attack, may prevent the person from developing a severe anxiety disorder.
Complex phobias tend to be more disabling than simple aka specific phobias because they are often associated with a deep-rooted fear or anxiety about a particular circumstance or situation. Whilst the exact causes of a complex phobia may be unknown, they may be triggered by traumatic experiences like being trapped in a lift, being chased by an animal or seeing traumatic incidents which then result in the development of a phobia.
Common examples of complex phobias are:
Agoraphobia – The NHS describe agoraphobia as “a fear of being in situations where escape might be difficult or that help would not be available if things go wrong”. People assume agoraphobia is simply a fear of open spaces, but it’s actually a more complex condition.
Someone with agoraphobia may be scared of:
- Travelling on public transport.
- Leaving home.
- Being in wide open spaces.
- Being in crowded places.
- Standing in long lines.
- Being in a confined space.
- Being at home alone.
Agoraphobia is twice as common in women as men. It usually starts between the ages of 18 and 35 and affects between 1.5% and 3.5% of the general population.
Social Phobia – Is a fear of social situations. The National Institute for Health and Care Excellence (NICE) have estimated that women are twice as likely to suffer social anxiety, and that in England 6.8% of all women were diagnosed with anxiety disorders compared to 4.9% of all men.
Examples of social phobias include:
- Talking in groups.
- Starting conversations.
- Speaking on the phone.
- Meeting new people.
- Speaking to authority figures, such as talking to doctors.
- Eating and drinking in front of others.
- Regular trips out, to the shops.
- Using public toilets.
- Public speaking (glossophobia).
Glossophobia – Fear of public speaking – 20% of people in the UK fear talking to a room full of people, and YouGov’s stats reveal women are over twice as likely to be “very afraid” of public speaking compared to men.
Usually social anxiety starts in childhood or adolescence. The median age of onset is in the early to mid-teens. Most people develop the condition before they reach their 20s. Some people identify their social anxiety developing in association with a particular event, for example moving to a new school or being bullied or teased.
Are Phobias linked with mental health?
Often phobias pose little real danger but they do provoke anxiety and avoidance in the people who suffer from them. People with a phobia either try to avoid the thing that triggers the fear, or they endure it with great anxiety and distress. This can trigger panic attacks.
Some of the psychotic disorders, such as schizophrenia and delusional disorder, can cause fears that resemble phobias or another anxiety disorder in many ways. However, those with psychotic disorders typically believe that their fears are well-founded and based in reality.
Adults with phobias or another anxiety disorder usually recognise that their fears are irrational. They understand that the feared object or situation is basically harmless and that their fears are out of proportion to the genuine level of risk. However, a phobia can have a very real impact on a person’s daily functioning and quality of life.
People may suffer from:
- Life-limiting and severe anxiety – Depending on what your phobia is, you might find it a real struggle to run errands, go out with friends, or even make it to work every day.
- Isolation – This can affect your relationships with family and friends, which could contribute to you becoming reclusive and depressed.
- Helplessness – Helplessness may appear when you realise that your phobia has affected several or even all aspects of your life, like your job, social life and general happiness.
Help available to deal with Phobias
Obtaining a diagnosis of a phobia can often be straightforward; speak to your GP or you can contact:
One risk if phobias are left untreated is the worsening of symptoms and the development of another mental health problem/s. Many phobias can be resolved naturally without the need for formal treatment, however, even if this is the case there is a risk of relapse. Living in a world of fear can be lonely, demanding, emotional and tiring if left untreated.
The main treatment types for dealing with phobias are:
- Self-help techniques – Such as lifestyle changes; attending a self-help group.
- Exposure therapy – To overcome your fear. Exposure therapy focuses on changing your response to the object or situation that you fear. Gradual, repeated exposure to the source of your specific phobia and the related thoughts, feelings and sensations may help you learn to manage your anxiety.
- Talking treatments – Such as cognitive behavioural therapy (CBT) which is a talking therapy that can help you manage your problems by changing the way you think and behave. CBT emphasises learning to develop a sense of mastery and confidence with your thoughts and feelings rather than feeling overwhelmed by them.
- Medication – This is not usually recommended for treating phobias because talking therapies are normally more effective and do not have any side effects. However, medication is sometimes prescribed on a short-term basis to treat the effects of phobias, such as anxiety. There are three types of medication recommended for treating anxiety:
There can be high success rates in treatment for phobias so speak to you GP or NHS 111.
As a parent, there are many things you can do to help your child cope with their fears so that they do not develop into phobias.
- Talk openly about their fears – Let your child know that everyone has scary thoughts and feelings sometimes, but some do more than others. Do not trivialise the problem or demean your child for being afraid. Instead, talk to your child about their thoughts and feelings and let your child know that you are there to listen and to help.
- Do not reinforce simple aka specific phobias – Take advantage of opportunities to help children overcome their fears. If your child is afraid of the neighbour’s friendly dog, for example, do not go out of your way to avoid the animal. Instead, help your child cope when meeting the dog and show them ways to be brave. For example, waiting and offering support while your child steps a little closer to the dog and then returns to you for safety. Over time, encourage your child to keep closing the gap so that eventually they can be close to the dog without fear.
- Model positive behaviour – Because children learn by seeing, you can demonstrate how to respond when confronted by something your child fears or that you fear. You can first demonstrate fear and then show them how to work through the fear. For example, you may hate spiders; rather than running away, show them how to extract the spider and put it outside safely.
If your child’s fears seem to be excessive, persistent and interfere with daily life, talk with your doctor for advice on whether professional diagnosis and treatment are required.