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Phobic Disorder: Symptoms, Treatments And Research

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1. Introduction

Although phobic disorder is certainly common, it has been more difficult to establish the extent to which it should be considered a "serious" mental disorder from a public health perspective.

Recent studies in understanding the behavioral, molecular, and anatomical bases of fear extinction in animals and humans are leading to new knowledge about the nature of fear and new treatments for anxiety disorders that affect millions of Americans (news release from SFN). In those people who suffer from phobic disorders (specific phobia, social phobia and agoraphobia) excessive and inappropriate fear and anxiety comprise the core symptoms of the disorder. Collectively, these disorders are the most common forms of psychiatric illness, surpassing rates of mood disorders and substance abuse

A study by Michael Davis, PhD, at Emory University (SFN News Release) that determined how human brain can used to treat such disorders. He found that a receptor for a particular protein called the N-methyl-D-aspartate (NMDA) receptor in a brain region called the amygdala is critical for the extinction of conditioned fear. Many medical professional believe and it also has been proved true in many cases that combination of drugs therapy and behavioral therapy has the most successful results.

2. Phobia - Definition

The term 'Phobia' was not used on its own until 1801 and in late 19th century it slowly gained acceptance in the sense it has today. The word 'Phobia' comes from the ancient Greek word 'Phobos', meaning "flight","fear" and "terror.

Phobia is a condition, which is described as an intense, obsessive, persistent and unrealistic fear of an external object or situation or feeling. In some cases avoiding such objects or situations that cause anxiety makes difficult to lead a normal and healthy life. There are hundreds of different types of phobias with technical name for each.

3. Symptoms

The symptoms of phobias are the same as those that would occur when facing an actual threat, leading to a reaction. In addition, there are other symptoms that go beyond the more "normal" fear response. Typical symptoms include:

* Anxiety reactions such as sweating, trembling, nausea, rapid heartbeat, worry, dread, or terror

* Intense fear of the object or situation, beyond an actual threat of danger

* Intense fear of being watched or judged (social phobia)

* Uncontrollable reactions that consume the mind and body

* Avoidance of the object or situation to an extreme that it may result in isolation

* Use of alcohol or substance in attempt to control feeling of anxiety

4. Classifications and Diagnosis of Phobia

In the past many attempts have been made to categorize phobia. According to (Beck et al. 119) a recent factor analytic study of the fear of 194 psychiatric patients at the center for Cognitive Therapy found that phobic disorder fell into three major categories. There is no diagnostic laboratory test for phobias. Diagnosis is based on the patient's account of their experiences.

i. Specific Phobia:- is a unrealistic and excessive fear of a specific situation or object such as flying, spiders, heights, insects etc. Exposure to the object or situation causes an immediate anxiety response or a panic attack. The person may have distress about having the phobia.

The most common specific phobias are:

o Claustrophobia - involves fear of such enclosed spaces such as elevators, buses, subways/trains

o Blood or injury phobia involves fear of blood, needles, doctors, dentist and any other medical type situations.

ii. Social Phobia: - also known as social anxiety disorder, is an excessive and unrealistic fear of embarrassment or humiliation is social situation. Typical situations feared or avoided by these individuals are parties meeting, eating in front of others, public speaking, conversation or meeting new people and any other related situations. The person knows that the fear is excessive and irrational. The condition disrupts their ability to function at work or school and causes them to withdraw from social activities and/or relationships, or the fact that they have the phobia causes them distress. Other mental disorders, a medical condition, or the effects of a drug do not cause fear and avoidance.

iii. Agoraphobia:- is a condition where the where person fears that escape or help would not be possible in case of a panic attack. This might be driving, public transport, trains, being alone, being in crowd or shopping. The individuals suffering from this anxiety avoid social situations with great distress or anxiety about having a panic attack.

5. Treatments for Phobic Disorder

Clinicians treat phobic disorders from a range of perspectives (e.g., insight-oriented therapy and hypnosis). However, there are two main approaches (Pharmacotherapy (drug therapy) and Cognitive-Behavioral therapy (CBT) are adapted by many psychiatrists, treatments with well-recognized observed support are proved to be successful. Although a few studies have compared these approaches to other treatments (e.g., analytic psychotherapy), these alternative approaches have not been effective as compare to CBT and medication. Psychodynamic therapy (or insight oriented therapy), not as rigorously studied, also is considered an effective treatment. However a careful interview and review of the patient's goals and level of pathology is assessed to determine the treatments or combination of treatments required.

Patient prognosis often is determined by several factors, including the following:

* Severity of diagnosis

* Level of functioning prior to onset of symptoms

* Degree of motivation for treatment

* Level of support (eg, family, friends, work, school)

* Ability to comply with medication and/or psychotherapeutic regimen

A person with phobias is very anxious and tense. Learning to relax helps the individual encounter the feared object or situation in a calmer state. Deep breathing, muscle relaxation, meditation, positive affirmations and other means may



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