Hello, people… welcome back to the blog! Last week, we finished a two part series on N-acetyl cysteine, the latest and greatest amino acid supplement that’s showing major promise in helping to treat some heavy hitting psych disorders, especially bipolar depression. This week, I want to talk about a very intriguing topic… phobias.
What is a phobia? A phobia is an irrational fear of something that’s unlikely to cause you any harm. I want to highlight the most important point here: irrational fear. Irrational, without rationale. What does that mean exactly? It generally means not thinking, but sometimes it means thinking, but without logic. So a phobia is when you’re afraid of something, often without even thinking about it, sometimes despite thinking about it- which just causes more anxiety btw- and the thing that you’re afraid of is usually nothing to be afraid of in the first place. But despite that fact, the fear can be intense. The word phobia comes from the Greek word phobos, which means fear or horror. Generally, the name of the phobia is a telling label, one basically made up as the need arises, typically by combining a Greek (or sometimes Latin) prefix that describes the phobia, along with the -phobia suffix. For example, the fear of water is named by combining hydro (water) and phobia (fear), so you end up with hydrophobia.
When someone has a phobia, they experience very intense fear of a certain object, thought, or situation. This fear is more extreme than fear in the normal everyday sense, and it develops when a person has an exaggerated or irrational perception of danger about a particular thing. But where’s the line? Being a little wary of spiders isn’t the same as being arachnophobic, right? And btw phobias aren’t always entirely irrational… some spiders ARE dangerous- they can kill you- so they should be avoided. But a phobia will assume that ALL spiders- even a teeny tiny harmless house spider- is a real threat. That’s how phobias are a little different than regular fears, because they cause significant distress, potentially enough to interfere with life at home, work, and/ or school. You’re afraid of serial killers, I’m afraid of serial killers, I imagine everyone is afraid of serial killers. Actually, are serial killers afraid of serial killers? Hmmm… don’t know. Anyway, is this a phobia? Not for most folks, but it sure is for some. What’s the difference? It has to do with interference. Why and how does that phobia, that thing, interfere with your life? Because people with phobias actively avoid the phobic object or situation- that’s another difference- they’ll do nearly anything to avoid it- or else they’ll just white knuckle through it with super intense fear and anxiety. Are you so afraid of serial killers that you avoid going to a nearly deserted truck stop diner at midnight, or so afraid of them that you refuse to leave your house… ever? If you’re the latter, you might have foniasophobia, fear of dying at the hands of a serial killer.
Ultimately, phobias are a type of anxiety disorder. Anxiety disorders are very, very common- I see them all day long- and they’re estimated to affect more than 30 percent of U.S. adults at some point in their lives. Specific phobias affect fewer people, with an estimated 12.5 percent of American adults experiencing one at some time in their lives. You can have a phobia without having a true anxiety disorder, and you can have an anxiety disorder without having a phobia, though I can’t think off the top of my head of a patient with a generalized anxiety disorder that hasn’t told me about a specific phobia, though I’m sure there are some.
In the shrink bible, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, aka the DSM-5, it outlines several of the most common phobias, and they typically fall within five general categories:
-Fears related to animals, like spiders, dogs, and insects
-Fears related to the natural environment, like heights, the dark, and thunder
-Fears related to blood, injury, or medical issues, like injections, blood draws, and medical catastrophes, like falls and broken bones
-Fears related to specific situations, like flying, riding in an elevator, being on an escalator, and driving over bridges
-Fears of other more random things like loud noises or choking
The thing is, these categories encompass an infinite number of specific objects and situations. A person can conceivably be afraid of anything they can physically do, think about, or feel. And let me tell you, I’ve heard some doozies. Some people are genuinely afraid of some weird stuff! Not even making fun… most of the time, they’ll even tell you it’s weird too. One of my patients that I’ve treated forever has a wind phobia, anemophobia, or sometimes called ancraophobia. Whatever it’s called, she hates wind… anything more than a light breeze is like nails on a chalkboard for her. What’s really wild is that this very specific, and fairly rare phobia appears to be genetic for her- it runs in her family- and she never even knew that until they all “hurricaned” together several years ago. She, her father, who evidently never really admitted it, and her aunt on her father’s side… all three of them were climbing the walls together during the hurricane. And apparently she always hated wind. As a kid, she would get up in the middle of the night… even if, maybe even especially, when it was storming… and hello, windy… and climb up on a barstool to take down her mom’s windchimes! Every one of them, and evidently she had a lot. Why? Because they drove her looney, listening to the wind blow them around… ding!! Ching ching bing!!! Ding ding da ding!!! She told me that they all made different noises, varying tones, high and low, and she said that every one of them just reminded her how bloody windy it was. For her mom, that sound was relaxing, but for her… not so much! Now, was she actually worried that the wind would blow her away, like Dorothy, off to Oz? Nope. She always knew that wouldn’t happen. She knew she was perfectly safe in her concrete block constructed house, but nonetheless, the wind made her beyond anxious. That, my friends, is a phobia. Totally irrational. And she’d tell you so herself.
Phobias come in all shapes and sizes, and because there really are an infinite number of objects and situations, the list of specific phobias is very, very long. Did you know that there’s even such a thing as a fear of fears? Phobophobia. How about that? And it’s actually more common than you might imagine. That’s one of the problems with fear, it often begets itself. If you have a panic attack because you go sailing in a 28 foot sloop in 12 foot seas, you may end up with not just a phobia about sailing, but a phobia of water and waves. And because the impact of the fear was so intense that it produced physical symptoms of a panic attack, you can even wind up with a phobia of having a panic attack. Yep, and you can be so afraid of having a panic attack that you can cause yourself to have one. Kid you not.
While there are potentially hundreds, maybe even thousands of different types of phobias, there are some that affect the population at much higher rates than others. Here are a few of the most commonly diagnosed phobias, along with some interesting points on each.
The fear of spiders, or arachnids, is possibly the most well-known of all phobias, and it’s estimated that arachnophobia affects roughly 1 in 3 women and 1 in 4 men.
Ophidiophobia is the fear of snakes. Interestingly, both ophidiophobia and arachnophobia are thought to be rooted in human evolution, meaning we evolved to fear these critters. It was a matter of survival, so humand learned it generation over generation, to the point it stuck in our DNA. Pretty amazing, no?
This is the fear of heights, which affects over 20 million people. Acrophobia can affect a person in a variety of situations, including air travel, crossing bridges, and even travelling up an escalator. It can be extremely limiting, because this fear in particular is frequently associated with anxiety attacks as well as avoidance of the phobia trigger, and this often prevents people with acrophobia from participating in activities that most of us take for granted.
This is the fear of dogs, and unfortunately, often stems from a personal traumatic experience in the patient’s past, maybe a bite or an attack. I’m a dog lover, and have never had a negative experience with a dog, so while I can’t understand it from an experiential standpoint, I have great empathy for people that are so afraid of dogs for whatever reason that they miss out on the love and companionship they can provide. Cynophobia is an interesting one to me, because it is one of the most commonly treated phobias. In fact, 36 percent of all patients who seek phobia treatment actually do so for cynophobia, which gives you an idea of how much it impacts their lives.
Social phobia involves fear centered around social situations and interactions. Among the most common symptoms of social phobia is fear of public speaking, but it can center on any number of situations, like starting conversations, speaking on the phone, meeting new people, speaking to authority figures, and even eating and drinking in front of others. Social phobia typically first appears during puberty, and it can be lifelong if not properly treated.
Agoraphobia is the fear of entering open or crowded places, of leaving one’s home, or of being in places or situations that trigger a feeling of helplessness, or where a quick escape would be difficult, such as being on public transportation, like an airplane. Agoraphobia is its own unique diagnosis, and is often associated with panic disorder and panic attacks; roughly one-third of patients with an existing panic disorder will also go on to develop agoraphobia as a comorbidity. Statistically, it’s more prevalent in women than men, with two-thirds of patients being female.
Speaking of being on airplanes, aerophobia is the fear of flying, and it affects an estimated 8 million people. Given today’s world of travel and transportation, this one can be particularly difficult to avoid, but it can be addressed with various techniques, like exposure therapy. More on that next week.
That’s a good place to stop. Next week, more on freaky phobias; among other things, we’ll talk about how to rid yourself of them. Because while you might assume that once a person gets to the other side of their phobia and knows they lived through it, that it would go away all by itself… you’d be wrong most of the time. Wah wah waaaah. We’re going to talk about just why the hell that is.
I hope you enjoyed this blog and found it to be interesting and educational. Please feel free to share it with family and friends. Be sure to check out my YouTube channel with all of my videos, and I’d appreciate it if you would like, subscribe, leave comments, and share those vids! As always, my book Tales from the Couch has more educational topics and patient stories, and is available in office and on Amazon.
Thank you and be well people!