The Truth About Phobias

Weddings are generally joyous occasions, but not so for Marissa Wolicki, 25, of Toronto, Canada, who reluctantly attended one recently with her boyfriend.

"All of a sudden, the room started to spin. I started to feel really nauseated. My heart went pound-pound-pound-pound. I grabbed my boyfriend's hand and said we had to go. He said, 'We can't go. We're in the middle of a wedding!' He started getting mad at me. People who don't have these attacks don't understand. My legs started to shake. I had a fear of fainting and embarrassing everyone -- a fear I was going to die."

For Wolicki, this was another in a series of attacks brought on by a social phobia, a form of anxiety disorder marked by irrational fears so terrifying they can sometimes lead a person to avoid everyday situations. How many people suffer from phobias? About 8% of American adults, according to the American Psychiatric Association.

"Phobias are real," says Jerilyn Ross, who is a licensed clinical social worker, president of the Anxiety Disorders Association of America, and director of the Ross Center for Anxiety and Related Disorders Inc. in Washington, D.C. "People should not feel ashamed. For some reason, their bodies do this. Phobias are serious -- and can be treated."

When Panic Attacks

Ross is familiar with phobias from two vantage points: as a medical expert and as a patient. She overcame a serious phobia of being trapped in tall buildings.

"The experience of phobia is so unlike what most people know as fear and anxiety. If you try to tell them there's nothing to be afraid of, that just makes the person feel more alone and distant," Ross tells WebMD. "People with phobias are always aware that their fear doesn't make any sense. But they cannot face it."

"An adult with phobia does indeed recognize the fear response is exaggerated," says Richard McNally, PhD, a Harvard psychology professor. For example, "they recognize that this is not a poisonous spider but can't help but react with disgust and aversion to any spider they see. So these people cannot go into their backyard for fear of spiders."

And if the backyard isn't safe, maybe crossing the street isn't, either. "This is where phobic people's worlds start getting smaller and smaller," Ross says.

Which is what happened to Wolicki, who has agoraphobia, a fear of open spaces. When she was in high school, she could rarely leave her house. In fact, on many days she rarely left her bed. "I thought that if I slept all day, the hours would pass faster and I would not have to experience panic attacks," she says.

Nature or Nurture?

Most people think fear has a primal source. If you're afraid of dogs, the thinking goes, a dog must have bitten you. But very few people with phobias recall these kinds of "conditioning events," says McNally. To explain this, psychologists developed the notion that we are hardwired to fear certain things. Fear of snakes, for example, helped our ancestors avoid poisonous bites. Scared but safe, they passed on their snake-fear genes.