Anxiety can be generalised often with no obvious trigger (free floating) or focused in response to a specific cause. Often the cause is entirely normal and justifiable, for example an impending test, or driving a car for the first time. On other occasions the cause is less understandable, or the anxiety reaction is out of proportion. In these situations a learnt fear and avoidance response to whatever is causing the anxiety often develops (phobia).

A phobia is an intense aversion which is focused on a specific object or situation. It is associated with fear of the particular stimulus, expressed as an anxiety state in particular circumstances with a specific focus when extreme. In extreme instances it is experienced by the affected individual as a panic attack.

The 'panic' attack is actually a physiological response to danger. The body prepares to 'fight or run.' To achieve this, the blood supply is diverted from one part of the body to another, the heart rate and breathing rate increase and sweating occurs. These effects produce the conscious experiences of panic and impending threat. Panic attacks are self-limiting, although phobic individuals may feel them to be life-threatening and may even believe they are experiencing a fatal event.

The focus of the attack in phobic conditions is directed to a real object or situation which becomes associated with the individual's particular fears. A phobia may reach proportions in which the individual's freedom of action is severely curtailed. In such circumstances family members are also affected.

Amongst common phobias are agoraphobia (fear of open space) and claustrophobia (fear of enclosed space), snake phobia or spider phobia. Treatment usually consists of behavioural psychotherapeutic approaches aimed at desensitizing the individual systematically to the fear inducing object or situation. Relaxation exercises are often used. 'Exposure' activities are undertaken allowing individuals to tolerate increasingly anxiety-provoking situations while practicing their ability to remain in psychological control and not panicking.

Obsessive compulsive disorder is a situation where the individual has to perform specific actions ('compulsions') such as washing or specific repeated thoughts ('obsessions') which may show as counting rituals. These activities in very severe cases may reach such proportions, that individuals' entire lives, and those of their families, are centred upon them. Behavioural programmes including exposure therapy are again useful, particular when combined with 'response prevention' strategies, encouraging sufferers to tolerate increasingly stressful situations which predispose to the obsessive-compulsive problems while remaining calm and resisting the urges. In extreme instances modern antidepressants which have strong anti-obsessional properties are prescribed.

Inheritance patterns
There may be a familial tendency

Prenatal diagnosis
None

Medical text written October 2004 by Professor J Turk, Professor of Developmental Psychiatry and Consultant Child & Adolescent Psychiatrist, Department of Clinical Developmental Sciences, St. George's Hospital Medical School, London, UK.

NATIONAL PHOBICS SOCIETY

National Phobics Society
Zion Community Resource Centre
339 Stretford Road
Hulme
Manchester
M15 4ZY
Tel: 0870 122 2325
Fax: 0161 226 7727
e-mail: info@phobics-society.org.uk
e-mail: support@phobics-society.org.uk (dedicated e-mail support service)
Web: http://www.phobics-society.org.uk

The Society is a National Registered Charity No. 1113403, established in 1970. It offers one-to-one therapies such as counselling and cognitive behavioural therapy, both face to face and by telephone, clinical hypnotherapy and a nationwide network of self-help groups. It publishes a quarterly newsletter - Anxious Times - and has a wide range of information available, details on request. The Society has approximately 6,000 members and responds to over 50,000 enquiries a year.

Group details last updated August 2007.