5 different types of phobia

Phobia is defined as an unrealistic, persistent, and intense fear of situations or objects. It is a type of anxiety disorder. A person with a phobia experiences intense fear and panic or dread even when the subject of their phobia poses no danger at all.

While some people may know their reaction is unhealthy, they can’t control how they behave or what they feel and think when exposed to specific stimuli. That’s what also makes phobia different than fear. Most people are afraid of something or experience fear in some situations, but they don’t necessarily have a phobia. 

1. Fears related to animals

Fears related to animals are quite common. The term zoophobia is used to describe the fear of animals. Some people are afraid of all animals, whereas others are scared of specific types of animals. This phobia belongs to a group of specific phobias. In fact, it is the most common type of specific phobia, Cleveland Clinic reports. Most people understand their fear of animals is irrational and that the specific animal poses little to no threat to them, but they can’t help or control their reaction. 

The most common types of fears related to animals are arachnophobia (fear of spiders) and ophidiophobia (fear of snakes). Other examples of fears related to animals include cynophobia (fear of dogs), musophobia (fear of rats and mice), and entomophobia (fear of insects). 

The exact cause of fears related to animals is unclear, like in many other types of phobia. Factors that may contribute to the development of animal phobias include traumatic experiences with animals e.g., being attacked or bitten by a dog, having family members afraid of those animals, and genetics. Some people are naturally more anxious than others. 

The main symptom of animal phobias is the intense fear of a specific animal or more of them. The presence of the animal or even exposure to it via photos and videos can induce such a reaction. Sometimes even thinking about that animal can cause fear. In most cases, the level of fear is out of proportion to reality. As mentioned above, a person feels intense fear even if that specific animal doesn’t jeopardize their safety.

Someone with animal phobias may avoid going to zoos because they want to avoid seeing a specific animal e.g., a snake. Or they may refuse to visit friends or family with pets such as dogs, hamsters, and others. 

Intense fear can produce a wide range of symptoms, including chest pain or tightness, heart palpitations, nausea and/or vomiting, lightheadedness, dyspnea (shortness of breath), sweating, and trembling. In children, reactions may include uncontrollable crying and temper tantrums.

Severe, irrational fear of animals is a good sign to see a healthcare professional. In order to diagnose the problem, a healthcare provider may ask questions regarding anxiety in certain situations. They may ask whether a patient experiences extreme avoidance of thinking about interacting with specific animals, feelings of panic that are out of proportion to the actual threat an animal presents, and symptoms that may interfere with daily routine. Also, a healthcare professional may want to know if fear or distress related to animals lasts six months or longer. 

Once a patient receives a diagnosis, the doctor recommends the most suitable treatment approach. Treatment of fears related to animals involves a combination of therapies. The main objective of the treatment is to improve a patient’s quality of life. Exposure therapy and cognitive behavioral therapy (CBT) are the most common psychotherapy approaches for the treatment of animal-related phobias. 

Exposure therapy is the first-line treatment, and its purpose is to help patients manage fear by gradually exposing them to the source of their fear. For example, the therapy may start with looking at photos or videos featuring the specific animal, thinking about them, and progressing to the actual encounter when a patient is ready. The therapist doses exposure, thus making it easier for a patient to control their reaction, reduce anxiety, and lower fear levels.

On the other hand, CBT revolves around patients talking about the symptoms of their phobia. The therapist helps a patient identify irrational thoughts or beliefs, thus leading to negative emotions and uncontrollable reactions. A patient learns to replace fearful and irrational thoughts with rational alternatives. Sometimes a patient may do a combination of exposure therapy and CBT. This is up to a therapist and what they feel is most suitable for the severity of someone’s phobia.

Medications aren’t a common approach in the treatment of this condition. At this point, there is no approved medication that targets phobia specifically, but a healthcare provider may prescribe anti-anxiety medications to reduce the severity of symptoms. 

2. Fears related to the natural environment

Fears related to the natural environment are among external specific phobias of conditions in the environment. The term external phobia refers to phobias that relate to places, objects, situations, and environments occurring outside a person’s body.

The most common fears related to the natural environment include acrophobia (fear of heights), nyctophobia (fear of the night/dark), heliophobia (fear of the sun), hydrophobia (fear of water), astraphobia (fear of thunder and lightning), and anemophobia or ancraophobia (fear of wind and air). 

The cause of fears related to the natural environment isn’t entirely known. A traumatic experience in childhood is one of the main culprits. For example, scary storms that cause damage can leave a child frightened and pave the way to astraphobia. Someone can develop a fear related to the natural environment if their sibling or parent also has it. For instance, a child whose older sibling is scared of heights may also be more likely to develop this type of phobia as well.

Symptoms of fears associated with the natural environment are similar to those of other phobias. The most prominent sign is the overwhelming fear when exposed to the subject of phobia or even just by thinking about it. A person with acrophobia experiences intense fear when watching a video of someone looking down from a tall building, for example. People with these phobias also experience other symptoms of anxiety, such as chest tightness, shortness of breath, dizziness, diarrhea, sweating, tremors, heart racing, and nausea and vomiting.

In order to diagnose the condition, a healthcare provider may ask questions about symptoms and situations that trigger them. They may also want to know if symptoms last at least six months or if panic and fear interfere with a person’s life even when they realize that they are safe. Additionally, a healthcare provider will ask questions regarding avoidance of the subject of phobia and immediate dread or distress caused by it.

It’s important to bear in mind not everyone afraid of thunder has astraphobia, for example. Some natural environments may cause unease among people. A good example is heights as well. But, people whose fear, panic, and distress aren’t proportional to reality may be diagnosed with the specific phobia. That happens because the level of threat presented by some environments isn’t as severe to induce such a reaction i.e., the threat may be irrational. 

Treatments of fears related to the natural environment depend on their severity. A healthcare provider may recommend exposure therapy, cognitive behavioral therapy, and anti-anxiety medications all of which are treatment approaches for animal-related phobias too. A healthcare professional may also recommend dialectical behavioral therapy (DBT) and stress management techniques.

Dialectical behavior therapy is a type of CBT that helps people who experience their emotions intensely. The purpose of DBT isn’t to ignore irrational thoughts about the subject of phobia. Instead, patients learn to acknowledge and accept them while developing healthier coping mechanisms. A healthcare provider may combine DBT with meditation to reduce anxiety levels. 

When it comes to stress management techniques, their main objective is to reduce anxiety symptoms. A good example is deep breathing. By focusing on taking deep breaths instead of paying attention to the subject of phobia, patients can notice their anxiety levels are going down.

3. Fears related to blood, injury, or medical Issues

Also known as blood-injury type phobia, it is a condition wherein a person is likely to have a strong reaction to the anticipation of the injury, the sight of blood, or being exposed to the injection or other medical issues. This kind of fear is also referred to as a body-based phobia.

The most common examples are hemopobia (fear of blood), trypanophobia (fear of needles/injections), traumatophobia (fear of injury), and iatrophobia (fear of doctors and medical tests/procedures).

Blood-injury type of phobia is different than other forms of specific phobia. A paper from Behavioral Neurology explains that exposure to blood, needles, or anticipation of physical injury can induce a vasovagal reaction i.e., a person may faint. Other phobias usually don’t trigger that reaction. As one of the most common types of phobia, fears related to blood, injury, or medical issues affect 3% to 4% of the general population. Exposure to phobic cues may cause tachycardia (fast heart rate) followed by bradycardia (slow heart rate), hypotension (low blood pressure), shock, vertigo, syncope (fainting), diaphoresis (excessive sweating), nausea, and rarely asystole (heart stops beating) and death.

These phobias are usually caused by experiencing direct trauma in childhood or adolescence. For example, a child or teen may sustain an injury that involves a lot of blood and develop a phobia because of it. Or they may be directly exposed to someone else’s blood. Similar is the scenario for fears of injuries and injections. 

However, it’s useful to mention that some people may develop these phobias due to indirect or vicarious trauma. Someone else’s traumatic experience may lead to the development of a phobia.

Symptoms of fears related to blood, injury, or medical issues include fainting, panicking, shortness of breath, sweating, confusion, dizziness, nausea, and desire to escape the situation. Avoidance is also a common symptom. A person with these phobias may even avoid watching medical shows, for example.

Most people are uneasy about blood, needless, and other medical-related things. Not everyone has a phobia, though. People who have an irrational response to the exposure, fear, and experience of fainting may have this specific phobia type. To diagnose the problem, a healthcare provider will ask a patient about symptoms and their duration. They may also look into the patient’s family health history and personal health. The doctor may use the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), to make a diagnosis if a patient meets all criteria mentioned in this manual published by the American Psychiatric Association.

Treatment for this phobia is necessary because it may interfere with a person’s daily life. Hemophobia may lead to avoidance of doctor’s appointments, which can jeopardize a person’s health. The most common treatment approaches are exposure therapy, cognitive behavioral therapy, anti-anxiety medications, relaxation techniques, and applied tension. The latter is helpful for patients who faint when exposed to blood. The main goal is to tense muscles in the arms, torso, and legs at timed intervals until the face becomes flushed when exposed to the trigger. In one older research, subjects who tried this technique were able to watch a 30-minute video of surgery without fainting.

4. Fears related to specific situations

Also known as situational phobia, this kind of phobia causes overwhelming fear and worry due to exposure to specific situations. The best examples include aerophobia (fear of airplanes/flying), elevatophobia (fear of elevators), amaxophobia (fear of driving), claustrophobia (fear of enclosed spaces), gephyrophobia (fear of tunnels), dentophobia (fear of going to the dentist), and many others.

The causes of fears related to specific situations aren’t fully understood. Similar to other types of phobia, causes usually include experiencing a traumatic event as a child, having a triggering effect after childhood, or exposure to a parent’s or sibling’s phobia in childhood. For example, a person may develop claustrophobia after getting stuck in an elevator in childhood or due to an uncomfortable experience that happened later.

Scientists also believe that, in presence of fear, neurochemicals can overstimulate the amygdala, which is the integrative center for emotions, emotional behavior, and motivation. This part of the brain also forms the core of a neural system for processing threatening and fearful stimuli.

Symptoms of fears related to specific situations are similar to those of panic attacks and anxiety. They involve intense and irrational fear of a subject of phobia, sweating, shaking, ringing in the ears, shortness of breath, flushing, upset stomach, dry mouth, dizziness, feelings of dread, and others. The level of fear in someone with these phobias isn’t proportionate to the threat projected by the subject of that phobia. For example, someone with claustrophobia may feel like they can’t breathe in an elevator or some other small space, but the reality is that they can. 

If a person has claustrophobia, aerophobia, or another situational phobia, they know it’s a problem. Most people understand their reactions to these situations symbolize the presence of a problem and they know their fear is irrational. But, they can’t control their reactions. For that reason, they need to see a healthcare provider, who will hand out a questionnaire for a patient to complete. The purpose of the questionnaire is to make a distinction between fear and phobia, but also to see whether a patient’s symptoms meet the criteria from DSM-5 to be classified as a phobia.

If the symptoms have been present for at least six months and a person tries to avoid a certain situation as much as they can, they are likely to be diagnosed with some form of situational phobia.

Two main treatments for these phobias are exposure therapy and cognitive behavioral therapy. Sometimes, a doctor may prescribe medications such as anti-anxiety drugs and antidepressants to manage the severity of symptoms.

5. Fear of choking, loud noises, drowning

Pseudodysphagia (fear of choking), ligyrophobia or phonophobia (fear of loud noises), and thalassophobia (fear of drowning/deep water) are among “other phobias,” i.e. fears that don’t fall into the four abovementioned categories. People can develop a phobia of many different things, including foods, objects, and even characters. 

Like with all specific phobias, the exact cause isn’t fully understood. Trauma, especially in childhood, may play a prominent role here. For instance, a child may start choking on something and develops trauma as a response to this traumatic experience. A person is also more likely to develop these phobias if their parents or siblings also have them. In some cases, genetics may be involved. Some people have a genetic predisposition to anxiety, which can influence their reactions to exposure to certain situations.

The most prominent symptom is intense fear or panic when exposed to the subject of phobia. In this case, a person may feel overwhelming panic or severe fear when exposed to loud noises or deep water, or they may be scared of eating some foods or taking pills because they don’t want to choke. 

Other symptoms include fear of losing control or dying heart palpitations, hyperventilating, sweating, dry mouth, shaking, chest pain, nausea, stomach cramps, and weakness.

The healthcare provider diagnoses these fears by asking a patient questions about their symptoms and triggers. They may also discuss a patient’s medical, psychological, and social history. In order to determine whether someone’s fear is a phobia, the healthcare provider will use DSM-5.

When left untreated, these fears can significantly limit a person’s life. The most common treatment approaches are exposure therapy, CBT, and medications such as those to manage anxiety. Relaxation techniques are also helpful in the management of these phobias. They help patients cope with negative stimuli in a healthier manner. The best effects occur when relaxation techniques are combined with other treatment approaches. For some people, regular therapy sessions are all they need to get better.

What kinds of phobias are most common?

The most common kinds of phobias are listed below.

• Arachnophobia: fear of spiders and other arachnids. The fear response is triggered by the sight of a spider, even by an image or video. People with arachnophobia tend to avoid places or situations where they may become exposed to spiders. They may react with intense fear even though most spiders are harmless. It could be that our ancestors lacked knowledge on how to take care of spider bites and that we developed a predisposition to fear these creatures.
• Acrophobia: fear of heights. It leads to anxiety attacks and avoidance of high places. Someone with this phobia may go to great lengths just to avoid high places such as bridges, towers, tall buildings, balconies, and others.
• Mysophobia: fear of germs and dirt. It can lead people to engage in compulsive hand-washing, extreme cleaning, and avoidance of situations and things they perceive dirty. In some cases, mysophobia is related to obsessive-compulsive disorder (OCD).
• Agoraphobia: fear of being alone in situations when escape could be difficult. This phobia is complex and may include different cases, such as fear of open spaces, crowded areas, and situations that may cause a panic attack. People end up avoiding these triggering events. Some patients refuse to leave their homes entirely.
• Ophidiophobia: fear of snakes. It is one of the most common phobia examples mainly because snakes can be dangerous. Since many snakes are poisonous, our ancestors had probably avoided places or situations where these reptiles could be involved. They could have passed down their genes to the next generations. For some people, even watching a video or photo of a snake can trigger phobia symptoms.

How is phobia diagnosis done?

Phobia diagnosis is done through clinical interviews and diagnostic guidelines, Mayo Clinic explains. The healthcare provider asks questions about symptoms as well as the psychiatric and medical history of a patient. To make an accurate diagnosis, a healthcare provider will use diagnostic criteria from DSM-5. 

Criteria that patients need to meet for phobia diagnosis include suffering persistent, excessive, or unreasonable fear, experiencing anxiety symptoms when exposed to the stimulus, and fear that is out of proportion to the actual danger. Other criteria include a phobic situation or object that is actively avoided, the disturbance isn’t better explained by symptoms of other mental health disorders, and symptoms such as fear, anxiety, and avoidance are present for at least six months. Doctors also make sure the patient is aware their fear is irrational but they are unable to control their reactions.

What phobia treatments are available?

Available phobia treatments are listed below.

• Cognitive behavioral therapy
• Anti-anxiety medication
• Other medications 

1. Cognitive behavioral therapy

Cognitive behavioral therapy is a type of talk therapy that helps patients manage their mental health problems or improve psychological health by changing their thinking patterns. This type of therapy is based on the notion that negative or irrational beliefs lead to negative emotions and behaviors. Focusing on those thoughts or beliefs can increase anxiety symptoms in persons with phobia. But, by identifying them and using skills and coping mechanisms learned during CBT sessions, patients can reduce their anxiety and fear when exposed to the subject of their phobia. 

The effectiveness of cognitive behavioral therapy is scientifically proven. For example, a paper from the Industrial Psychiatry Journal focused on CBT for social phobia and found that this therapy helped a patient. Seventeen sessions were necessary in this case.

There is no specific number of CBT sessions that works for every patient with a phobia, but in most cases, between four and 20 appointments are necessary. It’s useful to mention CBT sessions may involve a component of exposure. Basically, a therapist helps the patient overcome their fear with incremental steps. 

During cognitive behavioral therapy sessions, patients develop coping mechanisms that allow them to respond to fear and anxiety adequately. But that’s not the only thing they do. They also learn other skills that improve their functioning. The exact skills may depend on the type of phobia. For example, a person with social phobia may learn communication skills. Patients also get homework to do in between sessions. The homework consists of practicing skills learned during the appointment. It is strongly advised to do homework because it helps patients continue managing their phobia even when the treatment comes to an end. 

2. Antianxiety medication

Anti-anxiety medications are prescribed to reduce symptoms of anxiety and panic in patients with phobia. A doctor may prescribe benzodiazepines that promote relaxation by lowering anxiety. Since sedatives like this one can be addictive, they are used with caution. 

Patients need to adhere to the dosage and frequency recommended by the doctor. It’s important to keep in mind the doctor may not prescribe anti-anxiety patients to persons with a history of substance use disorders. 

Evidence shows the effects of anti-anxiety medications begin shortly after oral use.

Keep in mind that medications are never the sole treatment for phobia. They are always an adjunct to the therapy approaches. Doctors only prescribe medications when patients need more support in the management of their symptoms. 

3. Other medications

Besides anti-anxiety medications, a healthcare provider may prescribe other classes of drugs to patients with phobias. These medications include beta-blockers and antidepressants. Beta-blockers work by blocking the stimulating effects of adrenaline. These adrenaline effects include rapid heart rate, pounding heart, elevated blood pressure, and shaking voices and limbs, all of which are caused by anxiety. 

On the other hand, antidepressants such as SSRIs (selective serotonin reuptake inhibitors) act on levels of serotonin in the brain. These medications can decrease anxiety symptoms. They may be prescribed to patients with social phobia. 

Like anti-anxiety medications, beta-blockers and antidepressants are only adjunct therapies.