Phobias

The phobia typically results in a rapid onset of fear and is present

for more than six months. The affected person goes to great
lengths to avoid the situation or object, to a degree greater than the
actual danger posed. If the feared object or situation cannot be
avoided, the affected person experiences significant distress. With
blood or injury phobia, fainting may occur. Agoraphobia is often
associated with panic attacks. Usually a person has phobias to a
number of objects or situations.
Specific phobias affect about 6–8% of people in the Western world
and 2–4% of people in Asia, Africa, and Latin America in a given
year.[1] Social phobia affects about 7% of people in the United
States and 0.5–2.5% of people in the rest of the
world.] Agoraphobia affects about 1.7% of people. Women are
affected about twice as often as me. Typically onset is around the
age of 10 to 17. Rates become lower as people get older. People
with phobias are at a higher risk of suicide.
If a person has a phobia, he would probably realize that his fear is
irrational, yet he can’t control his feelings. Just thinking about the
feared object or situation may make him anxious. And when he is
actually exposed to the thing you fear, the terror is automatic and
overwhelming. The experience is so nerve-wracking that he may go
to great lengths to avoid it—inconveniencing himself or even
changing his lifestyle.

“Normal” fears vs. phobias or “irrational” fears

It is normal and even helpful to experience fear in dangerous situations.
Fear serves a protective purpose, activating the automatic “fight-or-flight”
response. With our bodies and minds alert and ready for action, we are able
to respond quickly and protect ourselves. But with phobias the threat is non-
existent or greatly exaggerated. For example, it is only natural to be afraid of
a snarling Doberman, but it is irrational to be terrified of a friendly poodle on
a leash, as you might be if you have a dog phobia.
The difference between normal fear and a phobia

Normal fear Phobia

Feeling anxious when flying through Not going to your best friend’s
turbulence or taking off during a island wedding because you’d have
storm to fly there

Experiencing butterflies when Turning down a great job because

peering down from the top of a it’s on the 10th floor of the office
skyscraper or climbing a tall ladder building

Getting nervous when you see a pit Steering clear of the park because
bull or a Rottweiler you might see a dog

Feeling a little queasy when getting Avoiding necessary medical

a shot or when your blood is being treatments or doctor’s checkups
drawn because you’re terrified of needles

Fast facts on phobias

 Phobias are more serious than simple fear sensations and are not
limited to fears of specific triggers.

 Despite individuals being aware that their phobia is irrational, they

cannot control the fear reaction.

 Symptoms may include sweating, chest pains, and pins and needles.

 Treatment can include medication and behavioural therapy.

 19 million people in the United States have a phobia.

 The definition of a phobia is the persistent fear of a situation, activity,

or thing that causes one to want to avoid it.

 The three types of phobias are social phobia (fear of public speaking,
meeting new people or other social situations), agoraphobia (fear of
being outside), and specific phobias (fear of other items or situations).
 Although phobias often go underreported, the statistics for people who
have phobias are thought to be more than 6 million people in the
United States.
 The average age that phobias begin is about 10 years of age.
 Women tend to be twice as likely to develop a phobia compared to
men.
 There are almost as many phobias as there are situations.
 Agoraphobia often co-occurs with panic disorder.
 If not treated, a phobia may worsen to the point where the person's life
is seriously impacted by the phobia and by attempts to avoid or hide it,
resulting in problems with physical health, friends and family, failure in
school, and/or lost jobs while struggling to cope.
 Phobias tend to run in families, can be influenced by culture
and parenting style, and can be triggered by life events.
 People with phobias seem to be more likely to deal with stress by
avoiding the trigger for the stress and have trouble minimizing the
severity of the fearful situation.
 Symptoms of phobias often involve panic attacks.
 The amygdala in the brain is thought to be linked to the development of
phobias.
 The evaluation of phobias often includes questions by a health-care
professional that explore the symptoms that are occurring, a medical
interview, and a physical examination.
  The treatment of phobias often includes the use of desensitization,
cognitive behavioral therapy, and/or medications.
 The groups of medications doctors tend to choose from when treating
a phobia include selective serotonin reuptake inhibitors, beta-blockers,
and occasionally, benzodiazepines.
 Phobia sufferers sometimes cope with their fears by talking about it,
refraining from avoiding situations they find stressful, visualization, and
making positive self-statements.

Symptoms
A feeling of anxiety or panic can be produced simply by thinking about the
object of the phobia. In younger children, parents may observe that they cry,
become very clingy, or attempt to hide behind the legs of a parent or an
object. They may also throw tantrums to show their distress. They also
involve having feelings of intense fear, dread, or terror, despite
understanding that those feelings are out of proportion to any real threat

Physical symptoms of phobias often -- in addition to physical symptoms

like tremors, sweating, "mind going blank," nausea, rapid heartbeat,
trouble breathing or excessive breathing, and an overwhelming desire to
withdraw from the situation that is causing the phobic reaction. Also,
extreme measures are sometimes taken to prevent or leave the situation
and feeling “unreal” or detached from oneself. Other symptoms include:
trembling, hot flushes or chills, a choking sensation, chest pains or
tightness, dry mouth, confusion and disorientation, dizziness and headache.

Typically, the closer you are to the thing you’re afraid of, the greater your
fear will be. Your fear will also be higher if getting away is difficult.

As a consequence of these symptoms, some individuals begin to isolate

themselves, leading to severe difficulties with functioning in daily life and
with maintaining relationships.
How the brain works during a phobia
Some areas of the brain store and recall dangerous or potentially deadly
events.

If a person faces a similar event later on in life, those areas of the brain
retrieve the stressful memory, sometimes more than once. This causes the
body to experience the same reaction.

In a phobia, the areas of the brain that deal with fear and stress keep
retrieving the frightening event inappropriately.

Researchers have found that phobias are often linked to the amygdala,
which lies behind the pituitary gland in the brain. The amygdala can trigger
the release of "fight-or-flight" hormones. These put the body and mind in a
highly alert and stressed state.

Causes
It is unusual for a phobia to start after the age of 30 years, and most begin
during early childhood, the teenage years, or early adulthood. They can be
caused by a stressful experience, a frightening event, or a parent or
household member with a phobia that a child can 'learn.'

While there is no single known cause for phobias, they are thought to run in
families, be influenced by culture and how one is parented and can be
triggered by different life events. Immediate family members of phobia
sufferers are about three times more likely to also have a phobia than those
who do not have such a family history. People whose parents either were
overly protective or were distant in raising them may be at more risk of
developing phobias. Phobia sufferers tend to be more likely to manage
stress by avoiding the stressful situation and have trouble decreasing the
intensity of the fearful situation. Another possible contributor to the
development of phobias is classical conditioning. In classical conditioning,
an individual responds to something that scares them by generalizing the
fear of that specific thing or situation to more generalized things or
situations. For example, a person may respond to a real threat by one dog
to developing a phobia of all dogs.

Treatment
Phobias are highly treatable, and people who have them are nearly always
aware of their disorder. This helps diagnosis a great deal. If the phobia does
not cause severe problems, most people find that simply avoiding the
source of their fear helps them to stay in control.

As a general rule, self-help is always worth a try. The more you can do for
yourself, the more in control you’ll feel—which goes a long way when it
comes to phobias and fears. However, if your phobia is so severe that it
triggers panic attacks or uncontrollable anxiety, you may want to seek
additional support.

Therapy for phobias has a great track record. Not only does it work
extremely well, but you tend to see results very quickly—sometimes in as a
little as one to four sessions. However, support doesn’t have to come in the
guise of a professional therapist. Just having someone to hold your hand or
stand by your side as you face your fears can be extremely helpful.

Speaking to a psychologist or psychiatrist is a useful step in treating a

phobia that has already been identified. They may recommend behavioural
therapy, medications, or a combination of both. Therapy is aimed at
reducing fear and anxiety symptoms and helping people manage their
reactions to the object of their phobia.

It is recommended that specific phobias be treated with exposure

therapy where the person is introduced to the situation or object in question
until the fear resolves. Medications are not useful in this type of
phobia. Social phobia and agoraphobia are often treated with some
combination of counselling and medication. Medications used
include antidepressants, benzodiazepines, or beta-blockers.
In Desensitization or exposure therapy, the person is strategically exposed
to their feared object in order to help them overcome their fear. This can
help people with a phobia alter their response to the source of fear. For
example, a person with aerophobia, or a fear of flying on a plane, may take
the following steps under guidance:

 They will first think about flying.

 The therapist will have them look at pictures of planes.
 The person will go to an airport.
 They will escalate further by sitting in a practice simulated airplane
cabin.
 Finally, they will board a plane.

One type of exposure treatment is flooding, in which the patient is

confronted by the feared object for an extended length of time without the
opportunity to escape. The goal of this method is to help the individual face
their fear and realize that the feared object will not harm them.

Another method often used in phobia treatment is counter-conditioning. In

this method, the person is taught a new response to the feared object.
Rather than panic in the face of the feared object or situation, the person
learns relaxation techniques to replace anxiety and fear. This new behaviour
is incompatible with the previous panic response, so the phobic response
gradually diminishes. Counter-conditioning is often used with people who
are unable to handle exposure treatments.

Finally, for people with social phobia, medication like a low dose of
a benzodiazepine or potentially an antidepressant (like a selective serotonin
reuptake inhibitor, or SSRI) in combination with cognitive-behavioural
therapy can be very helpful.

Cognitive behavioural therapy (CBT) has been found to often quite

effectively decrease phobic symptoms by helping the person with the illness
change his or her way of thinking. CBT uses three techniques to accomplish
this goal:
  Didactic component: This part of treatment involves educating the
person about phobias and treatment and helps to establish positive
expectations for therapy and promote the cooperation of the individual
with a phobia.
 Cognitive component: It helps to recognize the ideas and assumptions
that influence the behaviour of the phobia sufferer, especially those
that may predispose him or her to developing the disorder.
 Behavioural component: This uses behaviour-modifying techniques to
teach the person with a phobia more effective strategies for coping
with problems.

Selective serotonin reuptake inhibitor (SSRI) medications are often used to

treat phobias, especially when desensitization and CBT are inadequately
effective. These medications enhance levels of serotonin in the brain.

Phobias are also sometimes treated using beta-blocker medications, which

decrease the physical symptoms associated with panic by blocking the
effects that adrenaline (epinephrine) has on the body. One example of a
beta-blocker is propranolol. These disorders are also sometimes treated
with drugs in a medication class called benzodiazepines or minor
tranquilizers. This class of medications causes relaxation but is used with
caution these days to treat anxiety due to the possibility of addiction and the
risk of overdose, especially if taken when alcohol is also being consumed.

Types
Formally three phobias have been described:

Social phobias also called social anxiety disorder, involve a fear of social
situations. Such phobias include an extreme and pervasive fear of public
humiliation and being singled out or judged by others in a social situation. In
some cases, this fear may centre on a very particular type of social situation
such as public speaking. In other instances, people may fear to perform any
task in front of other people for fear that they will be somehow publicly
embarrassed.

People suffering from social phobia may:

1. view small mistakes as more exaggerated than they really are

2. find blushing as painfully embarrassing
3. feel that all eyes are on them
4. fear speaking in public, dating, or talking with persons in authority
5. fear using public restrooms or eating out
6. fear talking on the phone or writing in front of others
7. being excessively self-conscious
8. afraid of humiliation

Agoraphobia or the complication of panic attacks involves a fear of being

trapped in an inescapable place or situation. As a result, the phobic
individual may begin to avoid such situations. In some cases, this fear can
become so pervasive and overwhelming that the individual even fears to
leave their home. Example- being in a room full of people or in an elevator.
In some cases, panic attacks can become so debilitating that the person
may develop agoraphobia because they fear another panic attack. In
extreme cases, a person with agoraphobia may be afraid to leave their
house.

Specific phobias involve the fear of a particular object (such as snakes

or butterflies and moths). Such phobias typically fall into one of four different
categories: situational, animals, medical, or environmental. A few examples
of common fear objects include spiders, dogs, needles, natural disasters,
heights, and flying. These usually develop before the age of 4 to 8 years. In
some cases, it may be the result of a traumatic early experience. One
example would be claustrophobia developing over time after a younger child
has an unpleasant experience in a confined space. Specific phobias are
known as simple phobias as they can be linked to an identifiable cause that
may not frequently occur in the everyday life of an individual, such as
snakes. These are therefore not likely to affect day-to-day living in a
significant way. Phobias that start during childhood can also be caused by
witnessing the phobia of a family member. A child whose mother has
arachnophobia, for example, is much more likely to develop the same
phobia.

More examples of the four major types of specific phobias include:

1. The natural environment: Fear of lightning, water, storms, hurricanes,

tornadoes, or mudslides.
2. Animal: Fear of snakes, rodents, cats, or birds.
3. Medical: Fear of seeing blood or visiting a doctor.
4. Situational: Fear of bridges, leaving home, or driving.

Classification into Complex phobias

Specific phobias are not complex phobias as they do not affect the person’s
development. Social anxiety and agoraphobia are known as complex
phobias, as their triggers are less easily recognized. People with complex
phobias can also find it harder to avoid triggers, such as leaving the house
or being in a large crowd.

More research is needed to confirm exactly why a person develops

agoraphobia or social anxiety. Researchers currently believe complex
phobias are caused by a combination of life experiences, brain chemistry,
and genetics.
Escalaphobia
Escalaphobia is the fear of escalators and is surprisingly common.
According to the Elevator Escalator Safety Foundation, over 35,000
escalators in the United States and Canada move 245 million people per
day. Yet despite their frequent usage, escalators are scary for some people.
The fear of escalators may be mild or severe, and the reasons behind the
fear range from misunderstandings about their construction to the
perception of moving too quickly.
Escalaphobia is a common specific phobia affecting hundreds of thousands
of individuals all around the world. The word Escalaphobia comes from
Greek escalo meaning ‘to move up/escalators’ and phobos which means
‘deep aversion, dread or fear’.

Causes of fear of escalators phobia

Most cases of Escalaphobia stem from the fear of heights (or Acrophobia).
Then there are some people who do not actually fear going up the escalator
but they freeze when it is coming down. The fear of heights is evolutionary,
since mankind has always used the fear of falling as a survival mechanism.
While most of us enjoy some height to some extent, an escalaphobia does
not like the extreme heights associated with most escalators present in
airports, stadiums, malls etc.

Some past negative experience (either direct or indirect) related to

escalators is the main trigger of the phobia. A child or an adult might have
tripped or fallen down while using one. Shoelaces can easily get caught in
escalators leading to accidents, though these are extremely rare. This gives
rise to an exaggerated response each time, since the phobic’s brain simply
learns to develop the same reaction over and over.

Many movies, news reports and myths have shown escalators in bad light.
Some departmental stores have actually been sued by consumers due to a
child’s hand getting caught in the under-rail of the escalator. Most of these
cases have been dismissed since the issues were almost always the riders’
faults.
Escalators are usually huge and centrally placed. Their moving parts are
visible but the machinery is not. A child fearing large machines might
believe that the parts (or a monster lurking underneath) might grab people
from beneath or flatten its steps and send people flying. This fear could
continue well into one’s adulthood, making the phobic avoid escalators for
life.

Phobias can also develop as a learned response. A child might see his
parent/grandparent get frightened due to an escalator as a result of which
s/he associates escalators as being dangerous.

Certain medical conditions could also lead to this phobia. These include
vertigo, lack of balance, lack of depth perception, visual or hearing problems
or other sensory issues.

Apart from fear of heights (Acrophobia), other pre-existing phobias and

anxiety disorders could also trigger the fear of escalators. These include:
the fear of climbing (Climacophobia), the fear of stairs (bathmophobia) or
the fear of feeling dizzy or experiencing vertigo (illyngophobia).

Escalator Myths Debunked

Big, heavy machines are a mystery to many people. Escalators are

generally located right out in the open, where it seems that all the moving
parts are visible. Yet the escalator's movement does not seem to make
sense at first glance. Numerous myths have developed over more than a
century of use, many of which make escalators seem more dangerous than
they are.

According to the Elevator Escalator Safety Foundation, some people believe

that escalators move more quickly than normal walking speed, contain parts
that can reach out and grab people, or even that the steps could somehow
flatten out and send the riders flying. The Foundation assures readers that
none of these myths are true, yet legends persist.

Adding to the confusion is the fact that it is entirely possible to be injured on

an escalator. Popular urban legend website Snopes.com verified dozens of
incidents in which children's shoes got stuck in moving parts of an escalator,
leading to serious injuries. Years ago, my grandmother sat on the jury for a
case in which a mother sued a department store when her child's arm was
caught underneath the moving handrail of the store's escalator.

Yet virtually all of these accidents are attributable to rider error. In the case
my grandmother heard, numerous witnesses stated that the child was
playing on the escalator while the mother shopped and, at the time of the
accident, he was not following escalator safety procedures.

Symptoms of Escalaphobia
Like other phobias, the fear of escalators also gives rise to a plethora of
mental and physical symptoms which include:

 Shivering, shaking or trembling

 Feeling nauseated, dizzy
 Experiencing shortness of breath, heart palpitations etc
 Feeling like running away
 Avoiding escalators at any cost, and crying or screaming when forced to
ride one
 Having full blown panic attack

Phobias Related to Escalaphobia

The fear of escalators is often, though not always, related to

another phobia. Bathmophobia, or the fear of stairs and slopes, often
encompasses escalators as well. Bathmophobia sufferers are afraid of
simply being in the presence of a slope or a set of stairs, even if they are not
expected to climb or descend. The constantly moving metal steps of an
escalator could be even more terrifying. Climacophobia, or the fear of
climbing, may also be to blame. Those with climacophobia are perfectly
comfortable being around stairs and slopes but become fearful when
expected to actually use them. Acrophobia, the fear of heights,
and illyngophobia, the fear of vertigo, are also possible culprits.

Escalator Safety

Like any machine, it is possible for an escalator to malfunction. No activity,

including riding an escalator, is entirely risk-free. However, the Elevator
Escalator Safety Foundation maintains a list of safety rules that, when
properly followed, minimize the potential risks to nearly zero. The rules
include always facing forward and using the handrail, supervising small
children, wearing securely attached footwear, and not transporting rolling
carts or strollers on escalators.

For many people, simply familiarizing themselves with escalator safety

procedures is enough to combat the fear. Learn how escalators work, how
best to prevent accidents, and what to do should an emergency occur. Be
sure to teach your children how to safely use escalators as well.

Treatment for overcoming the fear of escalators

Once you are aware of the underlying cause of the fear of escalators, you’d
be in a better position to overcome it for good. If, for example, an underlying
medical condition is causing your phobia, then treating it could solve the
problem. People with lack of sense of balance or perception of depth can
hold someone’s hand while riding the escalator. An eye care professional
can also prescribe visual aids to overcome eye problems that might be
causing the Escalaphobia. Looking up straight ahead or to the side railings
while going up/down can help reduce dizziness. Phobics can also take extra
precautions like wearing the right clothing or footwear to minimize risks of
getting entangled in the escalator.

In all such cases, it is especially important to gradually desensitize oneself

to the fear. Facing the dreaded object slowly and in a controlled
environment can greatly help in overcoming Escalaphobia.

In extreme cases, a professional psychotherapist can also help one

overcome anxiety associated with escalators. Some examples of such
therapy are hypnotherapy, cognitive behaviour therapy, NLP etc. Finally,
one must also read up all one can about statistics related to escalators. This
can help put the phobic in a better position to overcome Escalaphobia by
helping him understand for a fact that escalators are generally safe when
used right.
Impacts
All phobias can limit your daily activities and may cause severe anxiety and
depression. If not treated, a phobia can worsen to the point in which the
person's quality of life is seriously impaired, both by the phobia itself and/or
by attempts to avoid or hide it. For example, a fear of flying can result in the
sufferer being unable to travel. Some people have problems with their
relationships, have failed in school, and/or been unable to maintain
employment as the result of a severe phobia. While there may be periods of
spontaneous improvement, a phobia does not usually go away unless the
individual gets treatments that are specifically designed to address this
condition. Alcoholics can be up to 10 times more likely to develop a phobia
than non-alcoholic, and phobic individuals may be twice as likely to suffer
from alcoholism or another addiction as those who have never been phobic.
It has even been found that phobic anxiety can be life-threatening for some
people, increasing the risk of suffering from heart disease in both men and
women.

Life-Limiting and Severe Anxiety

One of the main criteria for diagnosing a phobia is that it is life-limiting in

nature. Depending on what your phobia is, you might find it a real struggle
to run errands, go out with friends, or even make it to work every day. In
other words, a specific phobia can significantly impair your education, your
career, and your overall quality of life.

A person with escalaphobia may deny going out with friends because of the
fear of going to a mall with escalators in it.

Isolation

Limitations associated with phobias can make you experience social

isolation. You may wonder why you are not like everybody else. This can
affect your relationships with family and friends, which can contribute to you
becoming reclusive and depressed.

There are times where people have to stay downstairs in certain place just
because of escalators. They feel scared to climb on them and decide to stay
alone where they are.
Embarrassment

Phobias can create awkward and embarrassing situations.

For example, a person refuses to go to the first floor of the building. It

seems embarrassing to stand there and watch other going up. Sometimes
even parents get frustrated and tend to say that ‘How stupid you are.’

Feeling Out of Control

Perhaps one of the worst emotional components of a phobia is the out of

control feeling. You may understand that your phobia is irrational and/or
excessive, but no matter how hard you try, you cannot get it under control.

You are not alone if you spend time thinking about what your life would be
like if you could simply live daily without the dread of coming into contact
with that specific object or situation.

Sometimes people make up their mind that they will overcome their fear but
they tend to fail because as soon as they see the moving stairs they cannot
build up the courage to take a step on it.

Helplessness

Helplessness may appear when you realize that your phobia has affected
several or even all aspects of your life, like your job, social life, and general
happiness. You may feel that there is nothing you can do to heal. You may
assume that you will always have your phobia. You may wish things were
different, but feel that they never will be.

Anxiety

Phobias can cause severe anxiety and the emotional and physical
responses that accompany anxiety.

A person who is told that he has to go to the mall the next day, would stay
awake the whole night and think that how would he manage if there are only
escalators there. He would keep thinking of the next day as a dreadful time.