As its name suggests, a specific phobia is an unrealistic or extreme fear of a specific situation, object, or setting that might make the average person only slightly uncomfortable or that most people would consider to carry only a slight risk of danger. For instance, the fear may be of a medical or dental office, heights, flying, elevators, germs, or seeing an insect or other animal.
Specific phobias usually start in adolescence or even early adulthood, although they can rarely begin in childhood. Symptoms persist for at least six months, and may be life-long. They occur twice as often in women as in men. People with specific phobias are extremely afraid of common, everyday situations and objects, even though they know there is no real reason to be afraid and their behavior makes no sense, even to themselves. They simply feel powerless in face of their fear, and even the anticipation of fear often causes great anxiety.
Symptoms of specific phobia include immediate and extreme fear or anxiety that may result in crying, stiffening, clinging to another person, or finding ways to completely avoid the object or situation feared. The majority of people with specific phobia disorder have more than one extreme fear that interrupt their daily lives, reduce their effectiveness at work and put a strain on their personal relationships.
For a diagnosis of specific phobia disorder, the symptoms must not be due to separation anxiety, social anxiety, agoraphobia, post-traumatic stress disorder, or obsessive-compulsive disorder. At least one study found, however, that specific phobia disorder in young people may be an early predictor of a wide range of other mental health problems, including anxiety disorders, depressive disorders, pain disorders, eating disorders, and attempted suicide.
While the cause is unknown, certain factors and personality traits are thought to increase the risk of developing specific phobia disorder. If you have a parent or sibling with a specific phobia, or if you have frequent negative thoughts, worries, and tendencies to avoid or fear the unknown, you may be at higher risk. Having lost a parent, having overprotective parents, suffering sexual or physical abuse, or having a traumatic event related to your specific fear can also put you at higher risk of developing a specific phobia.
Cognitive-behavioral therapy (CBT) is the therapy of choice for treating specific phobia disorder. CBT interventions help change the thinking and behaviors that cause distress in specific situations. Exposure treatment is usually included with CBT. Exposure therapy generally involves gradual real or virtual (computerized) exposure to the object or situation feared, sometimes paired with relaxation exercises. Medications are sometimes used to reduce anxiety, especially if the situation feared is necessary or unavoidable.
Lieb R, Miche M, Gloster AT, Beesdo-Baum K, et al. Impact of Specific Phobia on the Risk of Mental Disorders: A 10-year prospective longitudinal community study of adolescents and young adults. Depression and Anxiety. July 2016;33:667-675.
McCabe RE and Swinson R. Psychotherapy for Specific Phobia in Adults. UpToDate. Last Updated: 11/06/15. Accessed July 5, 2017.
Anxiety and Depression Association of America. Specific Phobias. Accessed September 27, 2017.
Society of Clinical Psychology: Exposure Therapies for Specific Phobias. Accessed July 5, 2017.
Last reviewed 03/05/2018