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A Guide to Phobias Rebrand A Guide to Phobias A phobia is strong fear or dread of a thing or event which is out of proportion to the reality of the situation. The most effective treatment is cognitive behaviour therapy (CBT). Antidepressant medication also helps in many cases. ©EMIS 2010, as distributed on http://www.patient.co.uk/health/ Phobias.htm Used with permission. A Guide to Phobias What are the symptoms of phobia? There are different types of phobia If you come near to, or in contact with, Social phobia the feared situation you become anxious Social phobia is possibly the most or distressed. In addition you may also common phobia. With social phobia you have one or more unpleasant physical become very anxious about what other symptoms. people may think of you, or how they may judge you. For example: a fast heart rate, palpitations, feeling sick, shaking Therefore, you fear meeting people, or (tremor), sweating, dry mouth, chest pain, ‘performing’ in front of other people, a ‘knot in the stomach’, fast breathing. especially strangers. You fear that you will The physical symptoms are partly caused act in an embarrassing or humiliating way, by the brain which sends lots of and that other people will think that you messages down nerves to various parts are stupid, inadequate, weak, foolish, of the body when you are anxious. In crazy, etc. You avoid such situations as addition, you release ‘stress’ hormones much as possible. (such as adrenaline) into the bloodstream when you are anxious. These can also Agoraphobia act on the heart, muscles and other parts This too is common. Many people think of the body to cause symptoms. that agoraphobia means a fear of public places and open spaces. But this is just You may even become anxious by just part of it. If you have agoraphobia you thinking of the feared situation. You end tend to have a number of fears of various up avoiding the feared situation as much places and situations. For example, you as possible, which can restrict your life may have a fear of: and cause suffering. • entering shops, crowds, and public places. • travelling in trains, buses, or planes. • being on a bridge or in a lift. • being in a cinema, restaurant, etc, where there is no easy exit. A Guide to Phobias But they all stem from one underlying What is the treatment for phobias? fear. That is, a fear of being in a place where help will not be available, or where • Cognitive-behaviour therapy (CBT) you feel it may be difficult to escape to a CBT helps you to change certain ways safe place (usually to your home). that you think, feel and behave. It is a useful treatment for various mental health When you are in a feared place you problems, including phobias. become anxious and distressed, and have an intense desire to get out. Cognitive therapy is based on the idea Therefore, to avoid this anxiety many that certain ways of thinking can trigger, people with agoraphobia stay inside their or ‘fuel’, certain mental health problems home for most or all of the time. such as anxiety, depression and phobias. Other specific phobias The therapist helps you to understand There are many other phobias of a your current thought patterns. In specific thing or situation. For example: particular, to identify any harmful, claustrophobia (fear of confined spaces unhelpful, and ‘false’ ideas or attitudes or of being trapped); fear of certain which you have that can make you animals; fear of injections or needles; fear anxious. The aim is then to change your of vomiting; fear of being alone; fear of ways of thinking to avoid these ideas. choking; fear of the dentist; fear of flying; Also, to help your thought patterns to be But there are many others, some quite more realistic and helpful. rare. • Behaviour therapy Behaviour therapy aims to change any behaviours which are harmful or not helpful. For example, with phobias your response to the feared object (anxiety and avoidance) is not helpful. A Guide to Phobias The therapist helps you to change this. CBT is usually done in weekly sessions of Various techniques are used, depending about 50 minutes each, for several on the condition and circumstances. weeks. For example, for agoraphobia the You have to take an active part, and are therapist will usually help you to face up given ‘homework’ between sessions. For to feared situations, a little bit at a time. example, you may be asked to keep a diary of your thoughts which occur when A first step may be to go for a very short you become anxious. walk from your home with the therapist who gives support and advice. Over Note: unlike other forms of talking time, a longer walk may be possible, and treatments (psychotherapy), CBT does then a walk to the shops, then a trip on a not ‘look into the events of the past’. CBT bus, etc. aims to deal with your current thought processes and/or behaviours, and helps The therapist may teach you how to to change them where appropriate. control anxiety when you face up to the feared situations and places. CBT usually works well to treat most phobias, but does not suit everyone. For example, by using deep breathing However, it is not available on the NHS exercises. This technique of behaviour in all areas. therapy is called ‘exposure therapy’ where you are exposed more and more to feared situations, and learn how to cope. • Cognitive-behaviour therapy Cognitive-behaviour therapy (CBT) is a mixture of the two where you may benefit from changing both thoughts and behaviours. A Guide to Phobias Antidepressant medicines • Note: after first starting an These are commonly used to treat antidepressant, in some people anxiety depression, but they also help to reduce symptoms become worse for a few days the symptoms of phobias (particularly before they start to improve. agoraphobia and social phobia), even if you are not depressed. They work by A combination of cognitive-behaviour interfering with brain chemicals therapy and an SSRI antidepressant may (neurotransmitters) such as serotonin work better in some cases than either which may be involved in causing anxiety treatment alone. symptoms. Benzodiazepines such as diazepam • Antidepressants do not work straight These medicines are sometimes called away. It takes 2-4 weeks before their ‘minor tranquillisers’. They work well to effect builds up. A common problem is ease symptoms of anxiety. that some people stop the medicine after a week or so as they feel that it is doing The problem is, they are addictive and no good. can lose their effect if you take them for You need to give it time. more than a few weeks. They may also make you drowsy. • Antidepressants are not tranquillisers, and are not usually addictive. Therefore, they are not a useful long-term treatment of phobias. However, a short • There are several types of course, or even a single dose, may be antidepressants, each with various useful for a phobia which occurs rarely. ‘pros and cons’. For example, they differ in their possible side-effects. For example, if you have a fear of flying in a plane, a short course just before a However, SSRI antidepressants flight may help. (selective serotonin reuptake inhibitors) are the ones most commonly used for anxiety and phobic disorders. A Guide to Phobias Further help information and advice Dental Anxiety & Phobia Association 104 Harley Street, London W1G 7JD National Phobics Society Zion Community Resource Centre Telephone 020 7935 8092 339 Stretford Road, Hulme www.healthyteeth.com Manchester M15 4ZY Gut Reaction Telephone 0870 122 2325 www.gut-reaction.freeserve.co.uk www.phobics-society.org.uk Gut Reaction was formed in 1994 by a NO PANIC (National Organisation life-long sufferer of emetophobia, a fear For Phobias, Anxiety, Neuroses, of vomiting. Information & Care) 93 Brands Farm Way, Randlay Needlephobia.co.uk Telford, Shropshire TF3 2JQ www.needlephobia.co.uk Helpline 0808 808 0545 Needlephobia’s correct name is www.nopanic.org.uk “Belonephobia”. It can be defined as a fear of sharp objects such as pins or Triumph Over Phobia (TOP UK) needles. PO Box 3760, Bath BA2 3WY This website, run by Smith & Nephew, Telephone 0845 600 9601 includes information for the general www.triumphoverphobia.com public and professionals affected by this issue with regard to healthcare. Runs a national network of structured, self-help groups for adults (16+) suffering British Association for Behavioural from phobias. and Cognitive Psychotherapies www.babcp.com Their website has lots of information on CBT, and a ‘Find a Therapist’ facility. Inspire Mental Health works with and for people with mental illness to ensure they live healthy, productive lives and are supported to achieve their full potential within all aspects of their lives. We provide a range of supported accommodation including floating support that supports over 400 people per year. Day opportunities and recovery focused services are provided to over 1000 people per year and our advocacy services touch the lives of thousands every year. We also provide a range of community support services for people over 60 leaving hospital or who have become socially isolated to help them reintegrate into society. We provide support to people with Personality Disorders, who self-harm and who are in prison. We also provide support to young mothers struggling with parenting and their mental wellbeing. Inspire Inspire Central Office Dundalk Office Lombard House Clontygora Drive 10-20 Lombard Street Muirhevnamor Belfast Dundalk BT1 1RD Co.Louth Email NI/UK: [email protected] Ireland: [email protected] Telephone Central Office: (00
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