Phobias

Overview


A phobia is an irrational fear ignited in a person once they are presented with a certain situation or phenomenon. It is very common for many people to have fears in which they simply try to avoid due to the anxiety it may cause; however, phobias are much more extreme. A phobia becomes diagnosed when the fear completely disrupts a person’s life, and it may cause them to lose the ability to function under normal stimuli. Phobias are typically categorized as either simple (specific) or complex. Phobias are not exclusive to any race, gender, or social class, and they tend to develop in early youth. Some phobias are easier to avoid than others, but the effects of phobias tend to be similar in most cases. (phobia, 2013)



Symptoms


  • The main symptom of phobia is extreme and immediate anxiety. The sufferer of phobias will feel this immense stress, even though they are fully conscious that their fear is illogical and misrepresented. They often know that the object of fear is not a danger to their well-being, and they realize that others are not affected by the object. Despite this, they still find their reaction uncontrollable, and they feel powerless to the phobia. (Marks, Horder, 1987)

  • They try to avoid the situation or object at all possible costs. Sometimes they may isolate themselves in their own homes according to what the phobia may be. The thought of the possibility of encountering the object can sometimes cause enough anxiety that they cannot function properly in situations outside of the home. In turn, this sometimes causes them to withdrawal from outside activities and relationships.

  • There are physiological symptoms of a phobia as well. Like basic anxiety, the person’s heart rate increases, they may begin to sweat, and their breathing becomes irregular. Sometimes these indications of stress can occur when the person thinks about the phobia, and they do not actually have to be presented with the phobia. (Nordqvist, 2013)



Diagnosis


There is no specific test to diagnose phobias. Instead, there can be patient evaluations on each individual to determine if the fear is in fact a phobia. Typically, if the symptoms shown above are displayed and match the specific DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders) criteria, then the person can be diagnosed as having a phobia. (Mandal)
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Arachnophobia, the fear of spiders, is a simple phobia because the fear is exclusive to only spiders and no other situation or object. http://www.psmag.com/blogs/the-101/fear-44096/


Simple

  • Simple, or specific, phobias are the fear of a certain object or situation. For example, phobias of spiders and heights are very common, and they are unambiguous in that they only refer to the fear of that particular situation or object. To diagnose these fears as phobias, again, there must be a marked increase in anxiety when exposed to the object or situation. Normal functioning also ceases, and the response to the stimuli is not linked to any other mental disorder. This fear must be persistent, lasting at least six months time. (Mandal)

Complex

  • With complex phobias, the diagnosis guidelines are much more specific to each phobia. (Mandal) For example, someone diagnosed with social phobia is afraid of humiliation and judgment from others. These concepts cover a broad range of actions, such as speaking in front of others or even being in groups. Since the person is not afraid of one particular object or situation and many things can cause them anxiety, these complex phobias have a much more complicated diagnosis.


Misdiagnosis


The way the body reacts because of a phobia may not be so clear initially. Since the body is acting in a natural way that is not uncommon in many other disorders, phobias can very easily be misdiagnosed. For example, agoraphobia (a complex phobia that includes the fear of public spaces) can be misdiagnosed since many of its symptoms are shared with other health and psychology related problems. They experience dizziness and irregular heartbeat, which can be attributed to issues with the ear or heart. Unless asked more in depth questions, in this case if the person experiences these problems while in public, the diagnosis of a phobia can go undetected. (Marks,1987) If this problem goes on undetected, it can lead to detrimental problems later on in life, especially during the college years when a person has more responsibility of independence and typically a further distanced support system.


Distinction between fear, anxiety, and depression


Fears

  • Phobias differ from fears since fears are not as persistent. It is true that a fear is the stem of a phobia; however, phobias are much more extreme. Fears can trigger the same reactions as a phobia can, but they are mostly situational. Some people may have a fear of spiders. People with a fear will usually only become afraid if they see or are in the presence of the spider. Those with a phobia become anxious when even thinking about a spider and will rearrange their life so they have no possibility of even coming in contact with a spider. (Swanson, 1986)

Anxiety

  • Anxiety is clearly related to phobias, but they are not one in the same. Anxiety is one of the feelings or reactions that occur when the phobia is stimulated, but anxiety in itself can occur from other situations or objects in which the person feels stress towards (anxiety, 2013). Phobias occur when that anxiety is directed towards a specific phenomenon, and the anxiety is typically exclusive to just that. Anxiety in anxiety disorders that are not the root of phobias can be triggered from many other situations that do not relate to a specific fear.

Depression

  • Many times, phobias can lead to depression. The person who is experiencing the phobia knows that they are living an abnormal life compared to those who do not possess a phobia. They are isolated from others, and they cannot go about life functions without constant fear and stress, which makes them feel sad and depressed. It is also shown that antidepressants can be used to help with treating phobias. (Harris, 1981) This shows that phobias are clearly related to depression in the medicinal sense, but there is much more going on in phobias than just depression.


Demographics

  • Phobias are very common, especially in the United States. It is projected that of 2,000 people, 100 of them have possible phobias. (Marks, Horder, 1987)

  • Women tend to report their phobias more often than men do. They also seem more typical within women and those without a college education. (Swanson, 105)

  • It is uncommon for a phobia to develop in later adulthood. They usually begin in childhood, specifically anywhere between four and eight years of age. The typical on-set age is 7 years old. (Specific Phobia)


Causes of Phobia Development

amygdala-prefrontal-cortex.jpg
http://mybrainnotes.com/memory-brain-stress.html

Neurobiology


  • Multiple parts of the brain handle and store the information relating to fear. Often times, when a potentially dangerous or frightful situation is experienced, the reactions to those situations are stored and later recalled so that the body responds in similar ways. The two areas of the brain that work together in this process are the prefrontal cortex, specifically the medial prefrontal cortex, and the amygdala. The prefrontal cortex is the area responsible for the storage of memories and experiences, and the amygdala is what responds to fear. So, in phobias, the prefrontal cortex is feeding information about situations that have happened before to the amygdala. If the cortex interpreted that certain object or situation as something to fear, then the amygdala will respond accordingly. Essentially, those two parts are overreacting, causing the person with the phobia to know that the fear is irrational and having no means of controlling it. (Travis, 2004)

Learned

  • Phobias can be learned from a parent. Since children are easily influenced and their parents are their largest resource for how to act, phobias can be passed down through set examples. If a parent shows fear towards an object, perhaps a spider, then the child will learn from their parent how to behave towards that object. This object will be stored in the brain as something to be feared, and phobias can develop later on because of this. Researchers stress that phobias are learned and not biologically or genetically inherited. (Nordqvist, 2013)

Trauma

  • Often times, phobias stem from a traumatic event that occurred in one’s lifetime, prominently their early youth. When a child experiences something unpleasant, the brain will store it in a way that the unpleasant emotions will occur if the situation is repeated. This can be considered classical conditioning of sorts. For example, one famous case of phobia was the “Little Albert” experiment. A young baby was shown a white mouse or rodent while at the same time a loud noise was produced to startle the baby. Since the loud noise was unpleasant to the child and the white rodent was present, the child associated the two as one in the same. Thus, the child became fearful of the rodent because the brain stored it as a fear-inducing object. This goes to show that the fear developed due to trauma misinterpreted by the brain. (Travis, 2004)
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Picture from the "Little Albert" experiment. http://psychology-4-everyone.blogspot.com/2012/02/infamous-case-of-baby-albert-1920.html

Evolutionary

  • It is also believed that fears are evolutionary. Some natural instincts were ingrained in our early prehistoric ancestors, and they have somehow trickled down to show up again in humans even now. One example of this is snakes and spiders. In prehistoric times, many of those organisms were a leading cause of death among humans. According to the evolutionary theory, this fear is so deep-rooted that it is even natural to us even though these fears are not nearly as large of threats as they once were. This is supposedly why humans today become fearful if they see organisms such as snakes or spiders, even if they're in a situation that cannot be seen as harmful, such as seeing them in an enclosed chamber at the zoo. (Harris, Pashler, 1995)


College Aged Students

As noted before, phobias begin developing in early youth. If they go untreated, then they only worsen with age. Some phobias are very common within college-aged students, and they can severely hamper a person's life in many aspects--socially, academically, emotionally, etc.

Social Phobia
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Someone with social phobia may feel like they are constantly being judged by others. http://www.redorbit.com/news/health/1112734517/social-anxiety-disorder-or-shyness-111912/

  • Social phobia reaches far beyond the shyness or the fear of public speaking. Those with social phobia are immensely terrified of public scrutiny. They cannot even drink or eat without fear they are being judged. They find humiliation in most situations, and this causes them to avoid social interactions. 23% of young adults fit the criteria for both simple and social phobia, and nearly half of those exclusively fit the criteria for social phobia. (de Boer, 1997)

  • This phobia can, at times, be considered a handicap. Those with social phobia cannot interact properly because they are hindered by the fear, and this is especially hard for students attending college. They may feel like the have to isolate themselves due to the fear of social situations, and this may lead to depression in knowing that they are living abnormally from others their age.

School Phobia

  • School phobia is a phobia that typically is prevalent in elementary-aged school students. This is a condition in which the child refuses to go to school for a variety of reasons. A large contributor is the fear of leaving their mothers or other caretakers, and this phobia is sometimes considered a type of separation anxiety. There are other factors as well, such as bullying from other students or the thought of inability to live up to expectations. (School Phobia, 1960) If left untreated, these fears may foster even worse fears of schooling in later years. Some college-aged students may even refuse to attend or enroll in college when the time for it arrives.



Treatments


It is true that there are many ways to treat one diagnosis in any sort of psychological disorder, and there is never one perfect way to care for disorders. Phobias may have different roots within each person, and these roots will not typically have a cookie-cutter treatment.

Exposure

  • Exposure treatment is exactly as it sounds. It is exposing the person with the phobia to their fear. The length of time varies by the progress shown in the patient. By exposing the patient to the fear without any risk factors, the body and mind reprocess the situation as not potentially dangerous. Once the mind becomes used to and desensitized to the stimuli and can recognize its lack of danger, the person with the phobia can overcome the fear. (Watson, Gaind, Marks, 1971).

Medicinal

  • There have been some significant results when medicine was used as a treatment option for phobias. One drug, phenelzine, had shown phenomenal results in one woman who had suffered with social phobia for a larger part of her life and many others as well. (Bower, 1988) This shows that the brain is literally altered in some disorders, and it takes certain chemicals to fight off these symptoms. Sometimes a disorder must be treated at the source: the brain.

Hypnosis

  • It is believed that hypnosis can be used to treat phobias. The practice is considered to be therapeutic and can be an effective way to alter behavior. (Hypnosis, 1976) There have not been many conclusive results on this topic, but it is clear that some physicians view this as a treatment option.



Activity


One activity that could demonstrate how someone with a phobia would feel or react in situations would begin with putting a heart monitor on a group of individuals (it would not matter how many). The individuals would be asked how many of them had arachnophobia (the fear of spiders), and a few would most likely raise their hands. Then, a live, caged spider would be presented in the front of the room. Again, a few would likely to be shocked, and their heart would race, causing the monitors to beep. The spider would be left in the room, and the participants would be given another activity to do. After a few minutes, the activity would be stopped and those who had an abnormal heartbeat would be documented. The researchers or whoever was conducting the activity would then explain how, if they truly had a phobia, their heart rate would not return to normal. As long as the spider was in the room, or even as long as there was a possibility the spider would return to the room, those with a true phobia would not rest. This would give people clearer insight on how phobias truly affect their life and can hinder them from daily performances.



Relevance

As shown in this wiki, phobias are not uncommon, even with college aged students. I find them super interesting, which is one reason why I chose this topic to research. Also, I personally feel like I have a phobia. The main purpose for me in writing this topic was to understand my own phobia a bit more. I also feel that other college-aged students with a phobia could also read this, and it might give them a little more insight on some of the monsters in their closet.
For me, I’ve always been extremely scared of human veins, especially when they are protruding. I remember once when I was younger a student in my class had a vein that he could pop fairly far out of his arm. When he showed me this, I lost my eyesight for at least a full minute out of pure terror. Another time, I was rubbing my eye when I felt a vein move under my finger. I became very dizzy until I finally threw up. I'm aware of every vein in my body that protrudes, and I avoid touching or looking at those areas. I’ve never had my blood drawn or had any sort of IV put into one of my veins because I am terrified of the thought. I would probably do anything in my power to get out of it. At points, I've been scared of riding in cars for fear of getting into an accident and waking up in the hospital with an IV in my arm. I know this is totally irrational and somewhat insane, but I truly cannot control it. I’m not sure if this exactly classifies as a phobia, since it doesn't disrupt my life as much as some phobias affect others. However, I definitely wish it is something I can eventually overcome.
Although my fear is one I think to be uncommon, fears and phobias in themselves are not. Phobias affect many people, and if they are extreme enough, they can cause people to live unhealthy and abnormal lives. I have discussed different types of phobias with my friends and their experiences with them. Just the other night, one friend of mine could not go near her room and ultimately spent the night in mine because she said hers smelled like the dentist, a gigantic fear of hers. Although this instance was minor, phobias can alter lives.
College is time when students are supposed to grow and mature into their own independent selves, but phobias can severely hinder that for some, which is why they are extremely relevant. In one article I read, I saw that some people who suffer from phobias self-medicate, mostly with alcohol. For college-aged students, in a time that alcohol is readily available and socially acceptable, this form of coping can lead to other health and mental problems. In my mind, even simply knowing that a phobia is something common and something that can be treated is helpful. We, as humans, often blame ourselves for our problems, which can then lead to even more problems. By knowing that phobias develop in ways that are hard to avoid, those with the phobias may realize that they are something that can also be overcome. Even if they don't directly affect a person, I believe it is really important to simply be aware of phobias. Knowing about phobias will lead to understanding, and understanding can never hurt, especially if a friend is the one in need of that understanding.





Sources


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de Boer, J. A. "Social Phobia: Epidemiology, Recognition, and Treatment." BMJ: British Medical Journal 315 (1997): 796-800. Print.

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Harris, E. (1981). Antidepressants: Old Drugs, New Uses. The American Journal of Nursing, 81, 1308-1309.

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Marks, I. (1991). Phobias And Related Anxiety Disorder: Treatment With Behavioural Exposure Can Be Quick, Inexpensive, And Effective. BMJ: British Medical Journal, 302, 1037-1038.

Nordqvist, C. (2013, September 25). What Is A Phobia? What Causes Phobia?. Medical News Today. Retrieved December 2, 2013, from http://www.medicalnewstoday.com/articles/249347.php

phobia. (2013). In Encyclopaedia Britannica. Retrieved from http://www.britannica.com/EBchecked/topic/457032/phobia

Specific Phobia Among Adults. (n.d.). NIMH RSS. Retrieved November 28, 2013, from http://www.nimh.nih.gov/statistics/1SPEC_ADULT.shtml

Swanson, G. E. (1986). Phobias and Related Symptoms: Some Social Sources. Sociological Forum, 1(1), 103-130.

Travis, J. (2004). Fear Not. Science News, 165, 42-44.

Watson, J., Gaind, R., & Marks, I. (1971). Prolanged Exposure: A Rapid Treatment For Phobias. The British Medical Journal, 1, 13-15.