A phobia is an extreme form of worry, anxiety or fear triggered by a specific situation (e.g. going outside or heights) or object (e.g. spiders), even when these things do not represent any obvious danger.  For example, a person may understand that it is safe to be on a balcony in a high-rise block of flats, but feel terrified to go out on it. Similarly, they might know that a spider isn’t poisonous or that it cannot bite, but this still doesn’t reduce the intense anxiety.

We all have fears about particular objects or situations in life and this is absolutely normal. However, a fear becomes a phobia if it lasts for more than six months, and has a significant, distressing impact on how a person lives their day-to-day life.

What are the signs?

Phobia symptoms involve experiencing intense worry, fear and anxiety when faced with the situation or object that a person is afraid of. If a phobia is severe, simply thinking about the object of your phobia can trigger these symptoms.

Physical symptoms of a phobia include:

  • Pounding heart, palpitations or accelerated heart rate.
  • Feeling unsteady, dizzy, lightheaded or faint.
  • Feeling as though you are choking.
  • Chest pain or tightness in the chest.
  • Sweating.
  • Hot and/or cold flushes.
  • Shortness of breath. 
  • Nausea.
  • Vomiting or diarrhoea.
  • Numbness or tingling sensations.
  • Trembling or shaking.

Additional symptoms include:

  • Feeling out of touch with reality or from your body.
  • Worrying about fainting.
  • Worrying about losing control.
  • Worrying about dying.

If these symptoms are very intense, they can sometimes trigger a panic attack (for more information, see the section on panic).

When are phobias a problem?

This can differ between people depending on their personality, their coping skills, the severity of the symptoms, the support they have around them and the demands of life. It also depends on how frequently a person is confronted by the thing they fear. Symptom severity in itself does not necessarily indicate how much of a problem the phobia may be in a person’s life. What matters is whether it is a problem for you. 

Experiencing this type of fear is very unpleasant and can be extremely frightening. It may make you feel stressed, out of control and overwhelmed. It may also lead to feelings of embarrassment, anxiety or depression. As a result, many people with phobias avoid situations where they might have to face their fear. While this is an effective strategy to start with, avoiding your fears often causes them to become worse, and can start to have a significant impact on how you live your life.

What helps with phobias?

Research shows that there are a number of effective approaches to treating phobias which are often based on talking therapy or on medication or a combination of the two. Cognitive Behavioural Therapy has a strong evidence base for its effectiveness at alleviating the symptoms of anxiety and the long term effects of this treatment often far exceed those of medication. The NHS website, which is based on the National Institute for Clinical Excellence (NICE) guidelines, recommends talking therapy such as CBT for mild to moderate symptoms of worry and anxiety but suggests that medication may be considered for more severe symptoms.

However, everyone is an individual and although CBT can be extremely effective for phobias, sometimes a different therapeutic approach or a therapy tailored to the individual and their needs is more appropriate. EMDR for example can be very effective for phobias.The assessment stage of any therapeutic intervention provides an opportunity to develop an in depth understanding of your difficulties on which a tailored individual therapy can be developed specifically for you.