Specific phobia: symptoms, causes and treatment of intense, focused fears

Many people are afraid of things. NHS inform explains that a fear only becomes a phobia when it is out of proportion and you begin to organise your life around avoiding it, with an overwhelming need to avoid all contact with the source of anxiety. Coming into contact with it, or sometimes just thinking about it, causes anxiety or panic.

The NHS describes phobias as an anxiety condition usually caused by a particular object or situation. NHS inform divides them into simple phobias, which are fears about specific objects, animals, situations or activities, and complex phobias such as agoraphobia and social phobia, which are often associated with a deeper fear or anxiety about a circumstance and can have a bigger impact on life. A specific phobia belongs to the first group.

How much a specific phobia matters depends on how often you meet the trigger. NHS inform notes that if the cause is an object or animal that you do not see regularly, it is unlikely to affect everyday life, but if you encounter it often, you may find it very difficult to lead a normal life.

The NHS groups common phobias into those triggered only on contact with the object or situation and those with a bigger impact on daily life.

The NHS lists the symptoms of a phobia, which are those of intense anxiety and can include panic attacks, which NHS inform describes as very frightening and sudden.

• Severe anxiety and worry.

• Feeling dizzy and lightheaded.

• A noticeable or unusual heartbeat (palpitations) and tightness in the chest.

• Feeling sick or being sick, or diarrhoea.

• Trembling or shaking.

• A strong or intense fear that you may faint, lose control or die.

The NHS says it is not always clear why some phobias start, but many can be linked to a frightening event or stressful situation, and they usually develop in childhood, adolescence or young adulthood. You may be more likely to have a phobia if you had a frightening childhood experience, such as being chased by a dog, have family or friends with a phobia, which can be learned from others, or have had your panic or fear met with negative reactions. Being a woman and having a family history of anxiety disorders are also listed.

NHS inform adds that if family members share a phobia, it is likely they learnt it from another family member as children.

The NHS says to see a GP if you think you have a phobia and the symptoms are affecting your life. NHS inform notes that most people with a phobia know they have one, and that many live with it without formal diagnosis by avoiding the trigger. If it is interfering with day-to-day life, speaking to a GP may lead to referral to a specialist such as a psychologist.

The NHS also says you can refer yourself to an NHS talking therapies service. It suggests practical things to try: breathing exercises, talking to someone you trust, joining a self-help group, being careful about looking up triggering images online, checking whether zoos and airlines run sessions for people with phobias, and avoiding caffeine after 3pm because it can worsen anxiety.

NHS inform says treating simple phobias involves gradually becoming exposed to what causes your fear, known as desensitisation or self-exposure therapy. No single programme works for everyone. You might get help from a specialist such as a psychologist or use your own self-help strategy, and NHS inform provides CBT-based self-help guides.

Treatment for complex phobias often takes longer and might involve counselling, psychotherapy and cognitive behavioural therapy. The NHS lists talking therapies such as CBT, hypnotherapy and medicines such as antidepressants, beta blockers and sedatives, but NHS inform says medication is not usually used to treat phobias. Exposure should be gradual and planned, ideally guided by a trained therapist, so that each step is manageable.

NHS inform says almost all phobias can be successfully treated and cured. Progress depends on the type of phobia, how long it has been present and how consistently exposure and coping skills are practised. Setbacks are common and do not mean treatment has failed.

NHS talking therapies services accept self-referral and offer CBT-based approaches for anxiety, with referral to specialist psychological services for complex or severe problems.

Some people choose private therapy for faster access or for a particular approach. Check that the therapist is registered with a recognised professional body and ask what the plan and number of sessions will be.