Phobias: Treatments and Medications

Phobias are a common anxiety disorder. However, they are also commonly lefty undiagnosed and untreated. Many people who suffer from one phobia or another may shrug off their fears as normal; some, on the other hand, may recognize how irrational their fears are, but they still choose to do nothing about it. In any case, people who have a phobia usually adapt to their phobias. They take preventive measures to avoid the object of their fears. They will do anything that will let them avoid putting themselves in situations where they will be forced to confront the objects of their fears.

Unfortunately, ignoring phobias won’t make them go away. Phobias may eventually incapacitate a person. Someone with a phobia may soon be unable to perform the requisite activities of daily living or soon be unable to function normally. For instance, someone who has an extreme fear of being in public and crowded places may simply remain at home, cutting himself off from others and choosing not to go anywhere. If this happens, he will be unable to go to work, buy his own groceries or do all sorts of things that require him to go out and be in public and crowded places. When his stock of food runs out, he will probably choose going hungry over going into the store and facing the crowd.

It is obvious then that those who have phobias often form unhealthy habits or adaptation measures to deal with their phobias when, in fact, phobias are treatable medical conditions. Those who are suffering from a phobia just need to admit their condition and seek medical help. Only then can they be given treatment that will make them able to manage their response to that object or situation that they fear.

The Diagnosis of Phobias

Are you intensely and irrationally afraid of something? Are you so afraid that you have let your fear hinder your performance of your usual activities of daily living or your normal functions? If so, you are probably suffering from a phobia. You must therefore seek medical attention as soon as possible before your fear escalates and before your fear brings you more harm.

Medical professionals use various methods for diagnosing phobias. They perform physical assessments, carry out various laboratory tests and conduct interviews to assess the existence of phobias in a subject. Typically, these medical professionals ask the subject to discuss their fears and the reasons for their fears. These medical professionals then make their judgment based on the degree of irrationality and intensity of the fears disclosed and the reasons given for such fears.

Medications to Treat Phobia

Medical professionals also use medications to help alleviate the symptoms of phobias – that is, the body’s physiological responses to the feared objects. Medications are usually administered in combination with behavioral therapy.

The following are some of the common medications used to treat the symptoms of phobias:

Beta-blockers. This medication works by blocking the sympathetic nervous system and stimulate the adrenal glands into producing epinephrine. In other words, the beta blockers prevent the increase in heart rate, respiratory rate, blood pressure, and voice and hand tremors – all of which are the body’s common response or reactions to fear. The beta-blockers therefore control the body’s reaction to fear or anxiety.

The side effects of using this type of medication are drowsiness, weakness, nausea, vomiting, feeling of coldness at the extremities, and leg pain.

The use of beta-blockers requires a prescription from a doctor. Beta-blockers are not meant to be used for long periods. They are also administered only in cases of simple phobias like the phobia of public speaking.

Anti-depressants. Anti-depressants are mainly used for alleviating depression but they are also used in treating patients with anxiety disorders like phobias.

Anti-depressants can be classified into several categories. The two major categories, however, are Selective Serotonin Reuptake Inhibitors (SSRI) and the Monoamine Oxidase Inhibitors (MAOI).

Selective Serotonin Reuptake Inhibitors block the reuptake of serotonin but they do not block the reuptake of dopamine and norepinephrine. By blocking the reuptake of serotonin, serotonin levels are normalized (in cases where the inadequacy of serotonin in the synapse is causing the depression, phobias or panic attacks). Some of the commonly used SSRIs are Zoloft, Prozac, Paxil, Celexa, Lexapro, and Luvox.

Monoamine Oxidase Inhibitors, on the other hand, are medications that inhibit the enzymes (the monoamine oxidase) that break down the monoamine neurotransmitters – norepinephrine, dopamine and serotonin. Since the neurotransmitters are not broken down, the amount of such neurotransmitters increase and symptoms of depression and anxiety are alleviated in result. Marplan, Nardil and Parnate are some examples of MAOIs. Side effects include agitation, insomnia, restlessness, orthostatic hypertension and anti-cholinergic effects.

A point to remember when using anti-depressants is to avoid drinking alcoholic beverages. Dietary restrictions are especially crucial if a patient is taking MAOIs. Moreover, SSRIs and MAOIs should not be combined – it’s either one or the other – because of serious side effects. Anti-depressants work should work within 2-4 weeks. If no improvement has been observed, then the patient will be slowly weaned off the drug and eventually given a new medication.

Sedatives. Sedatives, also known as anxiolytics, are used to treat anxiety and sleeping disorders. This medication helps reduce feelings of anxiety. Sedatives include Ativan, Valium, Xanax, Librium and Paxipam. Patients who are taking sedatives should remember that this medication is highly addictive; it should therefore be taken in moderation and only if it is necessary. It is also contraindicated if a patient has a history of alcohol and drug abuse.

Nonpharmacologic Treatments for Phobia

Behavioral therapy is a common treatment method for phobias and anxiety disorders. One form of behavioral therapy is Desensitization or exposure therapy.

Desensitization. Desensitization is one of the most common therapeutic methods for curing patients of their phobias. In this procedure, those with phobias are repeatedly exposed to the objects of their fears to evoke the emotional, psychological and physiological responses associated with the exposure to such objects. It is hoped that due to repeated exposure, patients will become inured or used to confronting the objects of their fears that they will finally be able to deal with their fears and no longer be controlled by them.

Naturally, desensitization procedures are done systematically and performed in controlled environments so that the patient will not be harmed (or will not harm himself) in the process of confronting the object of his fears. Typically, desensitization is done gradually.

A hydrophobic patient, for instance, will be repeatedly asked to imagine being in water and will be asked to talk about his feelings and fears. He will also be shown images of his or her object of fear. These exposures will go hand in hand with relaxation techniques so that the patient will not experience exhaustion in the process. After extensive and repeated sessions like those described above, an encounter with the object of fear will be arranged. The hydrophobic patient will be taken to pools and bodies of water. Later, the patient will be asked to test his reaction to the object of fear. The hydrophobic patient will be asked to immerse his feet in water. Later on, he will be asked to submerge his whole body into the water. Then, he will be taught how to swim until such time that repeated exposure makes the patient immune to the object of fear.

Desensitization is a long and complicated method. It requires patience on the part of the patient and great timing and skill on the part of the therapist.

Cognitive behavioral therapy. This is typically done simultaneously with other methods of behavioral therapy. In this specific method, the patient is encouraged to talk about his fears and the reasons underlying his fears.

The therapist will then help the patient understand his negative thoughts about the objects of his fears. He will coach the patient about coping with his fears and the symptoms of his phobia. In the long run, it is hoped that the patient will be able to develop an adequate and effective coping mechanism so that he will no longer be controlled by his fear.

Other therapeutic methods for treating phobias are hypnotherapy, which is similar to systematic desensitization although this time it is done while the subject is under hypnosis; group exposure therapy, which uses modeling and desensitization with three or more members; virtual exposure therapy, which refers to the use of 3-D images that simulate the feared environment; and stress/ relaxation techniques, including focused imagery, diversion techniques and deep breathing.