Anxiety & Panic Disorders Health Center

Understanding Phobias -- Treatment

What Are the Treatments for Phobias?

How well phobia treatment will work depends partly on its severity. Though some phobias are never completely cured, therapy can help many people learn to function effectively.  Types of therapy include desensitization, flooding, graded exposures, and biofeedback. Attending phobia clinics and support groups has also helped many people overcome their issues.  

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 inspired terror.

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 effective but have more side effects. 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 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 (e.g., benzodiazepines such as Xanax or Valium). These can relieve anxiety but may be habit-forming and cause drowsiness, and therefore 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 (including driving or operating machines.)  

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 for this disorder.  

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

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. Here are some guidelines: Feel free to ask for feedback or a reality check on a feared object or situation: Is it safe? Will it hurt me?

Practice shifting your thoughts in a positive direction -- from "That dog will bite me" to "That dog is tied up and can't hurt me."