Even the 15 million Americans who suffer from them admit that phobias don't make sense. Nevertheless, a phobia is no laughing matter. Phobic persons speak not of ordinary fear but of intense horror and a sense of helplessness. Even while realizing that their fear is irrational, phobic individuals feel they are on the verge of death or insanity.

Most individuals harbor one or more mild phobias, at least during childhood, but these usually fade on their own or never affect daily life. A problem exists only when a phobia causes an individual to limit essential activities or exces-sively restrict his or her life. In such instances, they can and should be treated.

Agoraphobia: The Fear of Panic

One of the best known and usually the most debilitating of all phobias, agoraphobia, is common-ly classified as a separate anxiety disorder. Literally, the term means fear of the market place or of public places, but in reality this disorder usually involves an unexplained panic attack and an ensuing dread of having another attack in public. The first attack may come in a supermarket, a shopping mall or any other location. Symptoms may include a racing heart, trembling, profuse sweating, loss of balance and an inability to think clearly. The agoraphobic often fears a heart attack; at best, he or she feels incapacitated and compelled to escape to the safety of home.

If the first attack comes in an airport subsequent attacks are likely to occur in the same or a similar place. As the agoraphobe begins to avoid certain locations or situations, the phobic response generalizes to other places and activities making the person more fearful and more constricted. Some individuals with this disorder go for months without venturing away from home.

Agoraphobia typically develops in individuals during their mid- to late-20s and results in severe family and social problems. The agoraphobe usually becomes increasingly demoralized and depressed, sometimes becoming dependent on drugs or alcohol. A few also suffer from obsessive doubts or fears--a fear of suicide, for example, or of committing an act of violence. Even though the victim knows such thoughts are senseless, he or she is unable to stop them.

Only about one of every 160 American adults has agoraphobia, but those who have it suffer a great deal. Early detection and treatment is essential. Treatment usually involves medications plus behavioral and group therapy.

Specific Phobias

What psychologists call a simple or specific phobia is an irrational fear associated with one specific kind of object, place or situation. Most of us can relate to a fear of snakes, spiders, high places or even storms, but some phobias involve harmless objects such as buttons or balloons.

Social phobias are sometimes difficult to separate from persona-lity traits such as shyness. Some individuals, however, are terrified about the prospect of speaking in public, asking someone for a date, or dining out.

Even understandable fears are usually irrational. The acrophobe, or person who is afraid of high places, might have no problem looking out the window of a plane but will freeze when trying to cross the George Washington Bridge. The hydrophobe might fear water that is coming out of a tap but not an ocean beach, or vice versa.

What Causes Phobias?

Freud proposed that phobias were displaced anxiety, usually involving ambivalent mother/father/child relationships. In 1920, John B. and Rosalie Rayner Watson pro-posed that phobias are conditioned responses. The late scientist Carl Sagan suggested that some phobias, such as fear of reptiles, may be instinctual memories from the time when dinosaurs ruled the world. A fear of poisonous snakes, of course, makes a great deal of sense.

Recent research has focused on the biological roots of the phobic response. Several studies indicate that indi-viduals with social phobias have neurological systems that overreact to criticism or rejection. Some medica-tions for depression seem to be effec-tive in overcoming this tendency. As scientists isolate the neurochemicals involved, even more effective medica-tions might be developed.

Don't Fear Treatment