Phobias

Treating phobias

Many people with a phobia do not need treatment and find that avoiding the object of their fear is enough to control the problem.

However, with certain phobias, such as a fear of flying, avoidance may not always be possible, so you may want to get professional help and advice to find out about treatment options.

Most phobias are curable, but no single treatment is guaranteed to work for all phobias. In some cases, a combination of different treatments may be recommended. The main types of treatment are outlined below.

Talking treatments

Talking treatments are often very effective for people with phobias. There are several different types of talking therapy, including:

  • Counselling: a trained counsellor listens to your problems, such as feeling anxious in certain situations, and helps you to overcome them.
  • Psychotherapy: a psychotherapist uses an in-depth approach to find the cause of your problem and suggests ways to deal with it. 
  • Cognitive behavioural therapy: a type of counselling that explores your thoughts, feelings and behaviour in order to develop practical ways of effectively dealing with the phobia.

Speak to your GP to find out if talking treatments would be suitable for you and whether they are available on the NHS in your area.

Desensitisation

Many simple phobias can be treated using a form of behaviour therapy known as desensitisation or self-exposure therapy. It involves being gradually exposed over a period of time to the object or situation of your fear so that you start to feel less anxious about it.

Sometimes, a combination of behaviour therapy and medication may be recommended.

Medication

Medication is not usually recommended for treating phobias because talking therapies are normally successful. However, medication is sometimes prescribed for treating the effects of phobias, such as anxiety.

Three types of medication are recommended for treating anxiety. These are:

Antidepressants

Antidepressants are often prescribed to help reduce anxiety. Paroxetine (Seroxat), a selective serotonin reuptake inhibitor (SSRI), is licensed to treat social phobia. Citalopram (Cipramil) and escitalopram (Cipralex) are licensed for the treatment of panic disorder. Venlafaxine (Efexor) is licensed for generalised anxiety disorder (GAD).

Common side effects of these treatments include:

  • nausea,
  • headaches, and
  • sleep problems.

Initially, they may make your anxiety worse.

Clomipramine (Anafranil) is a type of tricyclic antidepressant (TCA) that is licensed to treat phobias. Side effects include:

  • dry mouth,
  • drowsiness,
  • blurred vision,
  • tremors (shaking),
  • palpitations (irregular heartbeat),
  • constipation, and
  • difficulty urinating.

Moclobemide (Manerix) is a type of antidepressant from the monoamine oxidase inhibitors (MAOIs) group of antidepressants. It is sometimes prescribed to treat social phobia. Moclobemide interacts with certain types of food, so if you are prescribed this medication, read the information leaflet that comes with it to find out which foods you should not eat.

Other possible side effects include:

  • sleep problems,
  • dizziness,
  • stomach problems,
  • headaches,
  • restlessness, and
  • agitation.

Antidepressants can cause withdrawal symptoms. If you are prescribed antidepressants, do not suddenly stop taking them. See your GP, who will lower your dose gradually over time.

Tranquilisers

Benzodiazepines are a group of medicines that are also known as minor tranquilisers. They are sometimes used to treat severe anxiety, but are usually only prescribed in the lowest possible dose for the shortest possible time. This is because they are associated with withdrawal and dependence problems.

Benzodiazepines are usually only prescribed for a maximum of four weeks at a time. Like antidepressants, their use should be stopped gradually. Benzodiazepines that are commonly used include:

  • diazepam (Valium),
  • alprazolam (Xanax),
  • chlordiazepoxide,
  • clorazepate (Tranzene),
  • lorazepam (Ativan), and
  • oxazepam.

Side effects of these medications include:

  • drowsiness,
  • tiredness, and
  • confusion.

Two other types of tranquilisers that are licensed to treat severe anxiety are buspirone and meprobamate. Like benzodiazepines, they are only prescribed on a short-term basis.

The side effects of meprobamate are similar to those of benzodiazepines. Side effects of buspirone include:

  • nausea,
  • dizziness,
  • headaches,
  • nervousness, and
  • light-headedness.

Beta-blockers

Beta-blockers are commonly used to treat cardiovascular conditions, such as heart problems and high blood pressure (hypertension). They are also sometimes prescribed to help reduce the symptoms of anxiety, such as palpitations (irregular heartbeat).

Beta-blockers slow down your heart rate and decrease your blood pressure. Propranolol (Inderal) is a beta-blocker that is commonly used to treat anxiety. Side effects include:

  • stomach problems,
  • cold fingers,
  • tiredness, and
  • sleep problems.

Glossary

Counselling
Counselling is guided discussion with an independent trained person to help you find your own answers to a problem or issue.
Psychotherapy
Psychotherapy is the treatment of mental and emotional health conditions using talking and listening.
Antidepressants
Antidepressant medicine is used to treat depression. Examples include fluoxetine and paroxetine.
Last updated: 11 November 2011

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