Phobia – Causes, Symptoms & Treatment


Phobias are a common problem. About 7% of people suffer from a mild phobia, but less than 1% of the population has a severe phobia.

What is a phobia?

An exaggerated fear of a specific situation or thing is called a phobia . There are three types of phobias. Agoraphobia is a fear of public places or crowds of people. Social phobia is a general fear of other people.

With a specific phobia, the fear is related to specific things, such as spiders or diseases. Those affected are usually aware that their behavior is senseless. However, they cannot defend themselves against their own behavior because the fear is compulsive and cannot be controlled.


There are three groups of explanatory models for the causes of phobias . The learning theory approach assumes that fear is “learned”. Fear is felt in an originally neutral situation. Because those affected avoid these and similar fearful situations in the future, fear is intensified and those affected get caught in a vicious circle from which they can no longer get out without help.

The neurobiological approach assumes that phobias have a biological cause. It is assumed that phobics have a more unstable autonomic nervous system, which can be irritated more quickly and, as a result, fears develop more quickly.

The depth-psychological approach assumes that the normal solution to conflicts by finding compromises in phobics fails in certain situations and that this creates fear.

Symptoms, Ailments & Signs

A phobia manifests itself with typical vegetative symptoms and can also spread to the psyche. It can trigger symptoms due to a specific trigger (such as arachnophobia or claustrophobia) or lead to a permanent state of anxiety. This depends on what form of anxiety disorder is present.

Anxiety disorders with non-everyday triggers (airplanes, clowns, or the like) do not lead to long-lasting anxiety attacks. Phobias related to the omnipresent, on the other hand, can.

The vegetative symptoms include profuse sweating, tachycardia , nausea , urge to defecate , urinary urgency and tremors . Overall, the flight instinct is activated and those affected want to get out of the situation quickly. The longer they are confronted with the trigger of their fear, the more the symptoms intensify. They also include a fainting spell in some cases .

On the psychological level, the fear of losing control dominates. In addition, there is occasionally the feeling of being beside oneself (depersonalization) or fear of an (negative) changing environment. A phobia can lead to strong avoidance behavior in those affected. He then does everything in his power not to encounter the trigger of his fear. The avoidance behavior has varying degrees of impairment, but often leads to negative moods .

Diagnosis & History

In order to make a reliable diagnosis of a phobia , other mental and also some physical illnesses must first be ruled out. These include depression , schizophrenia , bipolar disorder , and obsessive-compulsive disorder.

Physically, hyperthyroidism or heart disease should be ruled out as a cause. Special questionnaires help with the diagnosis. A distinction is made between external and self-assessment forms. Agoraphobia usually occurs in situations and places where people fear they will not be able to escape.

Agoraphobia is a type of claustrophobia and means an ever-increasing restriction of freedom of movement, which can ultimately make a normal life impossible. Agoraphobia is often accompanied by panic disorders .

People with social phobia fear failing in the presence of other people. The fears sometimes have a serious impact on social life and go far beyond normal shyness. A social phobia is often accompanied by other psychological problems such as depression, other phobias or addictions. Men are less likely to be affected by social phobias than women.

The fears associated with specific phobias only appear in certain situations or with certain objects. Typical situations for specific phobias can be confined spaces, air travel, tunnels, freeway driving or dental treatments (see fear of the dentist ). Typical objects that trigger specific phobias are animals such as spiders, snakes or mice, blood, syringes and injuries.

People with a specific phobia know full well that their fear is actually unfounded. However, they cannot control this and therefore come to terms with their phobia by avoiding the situation or object that triggers the fear. A specific phobia only becomes clinically significant when it severely restricts or impairs everyday life.


Phobias often coexist with other phobias and other anxiety disorders. Many sufferers have more than one specific phobia, such as fear of dogs (canophobia) and spiders (arachnophobia).

A possible complication is agoraphobia, in which sufferers become increasingly withdrawn and avoid situations in which they could expose themselves. Agoraphobia can lead to complete social isolation: Some agoraphobics hardly leave their homes.

All types of phobias also often appear together with depressive disorders. To regulate fear, some phobics resort to medication, alcohol, tobacco, or drugs. Others engage in self-harm behaviors or develop abnormal eating habits. Phobias and other anxiety disorders can also promote physical illnesses.

Increased stress levels increase the risk of cardiovascular disease. Phobic people who are afraid of doctors, needles or blood often avoid medical examinations. This can lead to further complications: people with dental phobia often only go to the dentist when they are in severe pain. As a result, not only do they suffer physically longer and more severely than necessary, but the condition of the teeth, as a rule, also deteriorates.

When should you go to the doctor?

People who suffer from strong fears that go far beyond a natural feeling of fear should consult a doctor or therapist. If you experience stress in various situations, if the number of anxiety triggers increases or if you can no longer fulfill everyday obligations, you need to see a doctor. Restrictions in lifestyle, social isolation and personality changes indicate a need for treatment.

A doctor’s visit is advisable so that a treatment plan can be drawn up and a gradual improvement in health can take place. A limited quality of life, reduced well-being and a loss of zest for life are signs of a mental disorder. Sweating, tachycardia, insecurities or physical freeze in a fear-inducing situation should be discussed with a therapist. In case of hyperventilation, tearfulness and inner restlessness, a doctor should be consulted. Avoidance behavior is typical of a phobia.

The way of life is continuously restricted and the inner malaise increases. The disease is characterized by a steady increase in symptoms over several years. Professional activities can often no longer be fulfilled and participation in leisure activities hardly takes place. If the person concerned can no longer leave their own home, they need help. If interpersonal conflicts increase or autonomic dysfunctions occur, a doctor should be consulted.

Treatment & Therapy

Most phobias are treated with behavioral therapy. In some cases, additional treatment with medication is necessary. Systematic desensitization and flooding therapy are particularly effective. Systematic desensitization first ensures that the patient is completely relaxed . This is followed by a step-by-step introduction to the fear trigger.

This procedure ensures that the phobic gradually loses his fear and, after successful therapy, can face the fear trigger without fleeing from it. Flooding therapy “floods” the patient with the fear trigger. During therapy, the phobic learns, with the support of the therapist, that if he endures and perseveres in the frightening situation, his greatest fear will eventually subside.

After such an experience, the trigger of the phobia has almost no power over the person affected. Medications are sometimes used to treat social phobias in particular. These are mostly antidepressants . But sedatives and beta- blockers are also used.

Outlook & Forecast

A phobia in adulthood rarely goes away completely. The disease accompanies those affected for years. If the person concerned is aware of their fears and has learned how to deal with the phobia appropriately through behavioral therapy, the prognosis is usually favorable. However, the outlook depends on the severity of the disease and cannot be generalized.

In the case of a mildly pronounced phobia, the (treated) patient can lead a largely symptom-free life. Severe anxiety disorders will continue to affect the sufferer even after treatment is complete. They usually become chronic. In the case of severe social phobia, the person affected is often unable to return to his or her place of work. The consequences are a job change or even disability. This course can also cause depression . Further psychotherapy becomes necessary. Secondary diseases always have a negative effect on the prognosis.

The patient can do his part himself by applying the advice of his psychotherapist in everyday life. He has become aware of which situations trigger anxiety in him and for what reason. An agoraphobic will deliberately avoid vacancies. Such behavior is not a sign of weakness, but of a conscious approach to the disease.


Those who do not flee from fearful situations or experiences and do not switch to active behavior to avoid them can protect themselves in the best possible way against the outbreak of a phobia . In addition, if you suspect it, you should consult a doctor or psychologist in good time in order to nip the phobia in the bud right from the start.


The phobia is a mental illness in which the success of treatment is ideally supported by consistent aftercare. It is important, as is usually learned in behavioral therapy, not to avoid contact with objects or situations that trigger fear. It is important for those affected to learn again and again after the treatment that these things are harmless and not associated with any danger.

The more often this is practiced, the more stable the success of the therapy with regard to the respective phobia. Visiting a self-help group can be valuable support in this context, since discussions can lead to a good exchange of experiences and helpful tips. In the case of illnesses that are associated with anxiety, relaxation methods are often an effective element that can be effectively integrated into the aftercare by those affected.

There are several methods here. For example, progressive muscle relaxation according to Jacobsen and autogenic training are possible. In addition, yoga often rebalances and heals through a combination of physical exercises (asanas), breathing exercises (pranayama), meditation and relaxation. Confidence in your own body comes back and mind and soul can regenerate. Walks and endurance training also strengthen the normal body awareness of those affected and complement the aftercare in a meaningful way.

You can do that yourself

The quality of life of a person affected by a phobia depends on its type. For example, if the phobia relates to animals such as spiders or cats, and activities such as driving a car or train or flying, life can be shaped relatively well by avoiding these avoids things. However, other phobias can significantly affect everyday life.

If the person concerned is afraid of large crowds, small rooms and certain noises, they have to limit themselves when it comes to choosing a place to live and a job. The people you deal with on a daily basis should be made aware of the illness so that there are no embarrassing incidents and help can be given immediately. If a situation emerges in which the phobia comes to light, the person affected should not hesitate to inform those around them that they must get out of it immediately.

In any case, it is helpful to talk to a doctor or therapist about a phobia in order to get it under control or at least to be able to live with it. Those affected must learn that the situations they are afraid of are not dangerous. They can only do that if they put themselves in these situations. A therapist, in milder cases also a close friend or relative, can accompany this so that the person concerned does not overwhelm himself.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.