Phobias occur in several forms. A specific phobia is a fear of a particular object or situation. Social phobia is a fear of being painfully embarrassed in a social setting. And 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.

Specific Phobias

        Iím scared to death of flying, and I never do it anymore. Itís an awful feeling when that airplane door closes and I feel trapped. My heart pounds and I sweat bullets. If somebody starts talking to me, I get very stiff and preoccupied. When the airplane starts to ascend, it just reinforces that feeling that I canít get out. I picture myself losing control, freaking out, climbing the walls, but of course I never do. Iím not afraid of crashing or hitting turbulence. Itís just that feeling of being trapped. Whenever Iíve thought about changing jobs, Iíve had to think, ďWould I be under pressure to fly?Ē These days I only go places where I can drive or take a train. My friends always point out that I couldnít get off a train traveling at high speeds either, so why donít trains bother me? I just tell them it isnít a rational fear.

        Many people experience specific phobias, intense, irrational fears of certain things or situations Ė dogs, closed-in places, heights, escalators, tunnels, highway driving, water, flying, and injuries involving blood are a few of the more common ones. Phobias arenít just extreme fear; they are irrational fear. You may be able to ski the worldís tallest mountains with east but panic going above the 10th floor in an office building. Adults with phobias realize their fears ae 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, thought 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 Ė for example, a fear of animals Ė 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 personís 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

        I couldnít go on dates or to parties. For a while, I couldnít even go to class. My sophomore year of college I had to come home for a semester. My fear would happen in any social situation. I would be anxious before I even left the house, and it would escalate as I got closer to class, a party, or whatever. I would feel sick to my stomach Ė it almost felt like I had the flue. My heart would pound, my palms would get sweaty, and I would get this feeling of being removed from myself and from everybody else.

        When I would walk into a room full of people, Iíd turn red and it would feel like everybodyís eyes were on me. I was too embarrassed to stand off in a corner by myself, but I couldnít think of anything to say to anybody. I felt so clumsy; I couldnít wait to get out.

        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.

        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 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 certain antidepressants. 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 m ay be prescribed a beta-blocker for use on the day of a performance.

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