Health A-Z

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Harvard Medical School

Phobia

What Is It?

A phobia is a persistent, excessive, unrealistic fear of an object, person, animal, activity or situation. It is a type of anxiety disorder. A person with a phobia either tries to avoid the thing that triggers the fear, or endures it with great anxiety and distress.

Some phobias are very specific and limited. For example, a person may fear only spiders (arachnophobia) or cats (galeophobia). In this case, the person lives relatively free of anxiety by avoiding the thing he or she fears. Some phobias cause trouble in a wider variety of places or situations. For example, symptoms of acrophobia (fear of heights) can be triggered by looking out the window of an office building or by driving over a high bridge. The fear of confined spaces (claustrophobia) can be triggered by riding in an elevator or by using a small restroom. People with these phobias may need to alter their lives drastically. In extreme cases, the phobia may dictate the person's employment, job location, driving route, recreational and social activities, or home environment.

There are three major types of phobia:

• Specific phobia (simple phobia) – With this most common form of phobia, people may fear specific animals (such as dogs, cats, spiders, snakes), people (such as clowns, dentists, doctors), environments (such as dark places, thunderstorms, high places) or situations (such as flying in a plane, riding on a train, being in a confined space). These conditions are at least partly genetic (inherited) and seem to run in families.

• Social phobia (social anxiety disorder) – People with social phobia fear social situations where they may be humiliated, embarrassed or judged by others. They become particularly anxious when unfamiliar people are involved. The fear may be limited to performance, such as giving a lecture, concert or business presentation. Or it may be more generalized, so that the phobic person avoids many social situations, such as eating in public or using a public restroom. Social phobia seems to run in families. People who have been shy or solitary as children, or who have a history of unhappy or negative social experiences in childhood, seem more likely to develop this disorder.

• Agoraphobia – Agoraphobia is a fear of being in public places where it would be difficult or embarrassing to make a sudden exit. A person with agoraphobia may avoid going to a movie or a concert, or traveling on a bus or a train. In many cases, he or she also has repeated, unexpected panic attacks (intense fear and a set of uncomfortable physical symptoms trembling, heart palpitations and sweating).

Childhood phobias occur most commonly between the ages of 5 and 9, and tend to last a short while. Most longer-lasting phobias begin later in life, especially in people in their 20s. Adult phobias tend to last for many years, and they are less likely to go away on their own. Without proper treatment, phobia can increase an adult's risk of other types of psychiatric illness, especially other anxiety disorders, depression and substance abuse.