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Understanding Phobias -- Treatment

What Are the Treatments for Phobias?

How well phobia treatment will work depends partly on the severity of the phobia. Though some phobias are never completely cured, therapy can help many people learn to function effectively. Types of therapy include: 

  • Desensitization
  • Flooding -- prolonged exposure to a fearful situation or experience
  • Graded exposures
  • Biofeedback 

Attending phobia clinics and support groups has also helped many people overcome their fears.  

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In addition, medication may help some people overcome their phobia. 

Therapies for Phobia

For specific phobias, desensitization therapy and relaxation techniques are very successful.

Here's how it works: Someone who is afraid of flying first looks at pictures of airplanes in the relaxed environment of a therapist's office. Then, they imagine the steps leading to an actual -- though still imaginary -- flight. At each step, they practice relaxing. Once the anxiety is reduced, the patient is ready for actual exposure -- that is, gradually moving closer to an actual flight experience. Relaxation techniques can help at this stage, too. The support of a trusted friend or family member also helps during this process. 

Treating social phobia usually involves gradual exposure to social situations, along with role-playing and rehearsal. Individuals are taught methods to reduce the anxiety they feel. They are also encouraged to be less critical of themselves.  

The best treatment for agoraphobia is to gradually move the phobic person into the places and situations that trigger anxiety. By taking small steps each day -- in the company of a trusted person -- a sufferer eventually learns to cope with situations that once caused intense fear.

Relaxation techniques, biofeedback, and regular deep breathing help to overcome anxiety during treatment.  

Medication for Phobia

The therapist may sometimes decide that medications will help. In the treatment of phobias, medications are used in conjunction with therapy and may not necessarily be a part of initial treatment. 

A class of antidepressants called selective serotonin reuptake inhibitors (SSRIs) such as Celexa, Paxil, Prozac, Lexapro, and Zoloft can be especially helpful in the treatment of social phobia. Other drugs, called MAO inhibitors, are also effective but require careful monitoring because of interactions with certain other medicines (such as antidepressants, decongestants, or other medicines that can raise blood pressure) or food that contain the amino acid tyrmaine such as aged meats and cheeses. Another option: Many musicians, actors, and lecturers reduce their symptoms of stage fright with drugs known as beta-blockers (mostly propranolol). These drugs temporarily relieve physical symptoms of anxiety without causing much drowsiness; at higher doses, they are typically used for high blood pressure but at low doses can block the adrenaline effects that drive the body's response to stress. Sometimes short-term treatment may also include sedative-hypnotic drugs (for example, Xanax or Valium). These drugs can relieve anxiety but may be habit-forming and cause drowsiness. Therefore, they may not be the best choice when long-term symptom control is needed, or when one has to be fully alert and perform certain tasks such as driving or operating machines. Finally, some anticonvulsant medicines such as Neurontin and Lyrica have been shown in early research studies to have value for several forms of anxiety disorder including social phobia.

Important note regarding medications: Some of these drugs can actually cause anxiety if the dose is increased too quickly or if they are stopped suddenly. It is often best to start with a low dose and slowly increase medication when treating phobias.  

Overcoming phobias takes time. By taking one small step at a time, most people with phobias can reduce their anxiety and, in many cases, move beyond it. Work with a trusted friend or therapist. 

 

 

 

WebMD Medical Reference

Reviewed by Joseph Goldberg, MD on April 12, 2014

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