Phobias: Where Fear and Anxiety Collide

You’ve probably heard the following phrases: “He’s such a germophobe” or “She’s xenophobic.” As Muslims, we are familiar with the term Islamophobia. It’s a word used in everyday language. But few know the difference between what is considered prejudice, fear, or a medically classified phobia. It is important to make this distinction so that those with a phobia can get an adequate diagnosis, treatment, and relief.

The American Psychology Association (APA) Dictionary of Psychology defines fear as “a basic, intense emotion aroused by the detection of imminent threat, involving an immediate alarm reaction that mobilizes the organism by triggering a set of physiological changes.” When we feel fear, it takes only milliseconds for our sympathetic nervous system to react. Our bodies decide how we should respond to the threat, usually by choosing one of the four Fs: fight, flight, freeze, or fawn.

For example, while walking around her neighborhood, a woman is surprised when she hears a growling dog. Within seconds, her body reacts to the aggressive stimuli with an accelerated heartbeat and breathing. All her cognitive functions are reacting to and assessing the threat to gauge what will be the appropriate response.

As unpleasant and uncomfortable as it feels, fear is a necessary emotion for survival. It is one of our most basic human emotions, and it equips us with the ability to sense danger. Our lives are full of challenges to overcome, and God has designed our brains to respond to these challenges effectively.

We will certainly test you with a touch of fear and famine and loss of property, life, and crops. Give good news to those who patiently endure— (Quran 2:155)

While fear is considered a rational response to a perceived threat, a phobia is usually defined by anxiety rather than fear. Fear is an appropriate short-term response to a clear and present threat. However, anxiety is a future-oriented, long-term response focused on potential threats. The APA Dictionary of Psychology defines phobia as “a persistent and irrational fear of a specific situation, object, or activity (e.g., heights, dogs, water, blood, driving, flying), which is consequently either strenuously avoided or endured with marked distress.”

Phobias are irrational, uncontrollable, and long-lasting fears, and someone with a phobia will go to great lengths to avoid the source of their fear. Phobias are unique because when a sudden feeling of intense panic or dread overwhelms a person, there is usually no real danger. Someone who fears or dislikes spiders may simply avoid or kill them. Some may even capture the spider and place it somewhere outdoors. For a person with arachnophobia—a severe fear of spiders—these responses are nearly impossible.

According to an article for Johns Hopkins Medicine, “about [nineteen] million Americans have one or more phobias that range from mild to severe.” There are a variety of causes for why a phobia develops, which can include negative childhood experiences, learned behaviors, or past traumatic experiences. Genetics and brain chemistry may also play a role.

One should seek help for a phobia when avoidance behaviors interfere with daily life. Left untreated, a phobia can hinder a person’s personal and professional life and cause other mental health disorders like depression.

People can react to phobias in a variety of ways. Notable physical and psychological symptoms include:  

• Hot or cold flashes 
• Nausea, vomiting, or diarrhea 
• Panic attacks 
• Feeling dizzy or lightheaded 
• Fear of dying 
• Fear of fainting 
• Fear of losing control

There are four major specific phobia categories: fear of the natural environment, fear of animals, fear of medical treatment or issues, and fear related to specific situations. There are a multitude of various medically classified phobias. Below are the ten most common ones.

Thankfully, there are many treatments and therapies to help overcome any phobia. Exposure therapy is a method of changing a person’s response to an object or situation that causes fear. Gradual exposure to the source of the phobia and related thoughts can help an individual learn to manage their anxiety. So, if you have nyctophobia, or an extreme fear of the dark, a therapist will gradually acclimate you to varying levels of darkness until you become desensitized.

Cognitive behavioral therapy (CBT) also involves gradual exposure to the source of a phobia, but it equips an individual with ways to challenge how they view their fear. CBT helps change how a person thinks, as it is a mode of therapy based on the interconnectedness of thoughts, beliefs, and feelings. If you can change your thoughts about a certain fear, you can change your belief, therefore reducing or eliminating your fear.

Eye movement desensitization and reprocessing (EMDR) therapy is a technique that involves moving the eyes a particular way while a therapist helps a person process traumatic memories. Instead of focusing on the object of a phobia, the participant focuses on memories of their phobic responses. The participant then examines the source of their phobia by looking into their past experiences and potential traumatic circumstances.

To manage some symptoms of a phobia, doctors may prescribe medications. These usually include selective serotonin reuptake inhibitors (SSRIs), beta-blockers, or anti-anxiety drugs. Serotonin is a neurotransmitter, a “feel good” chemical that naturally occurs in the body. Low levels of serotonin are linked to mood disorders, and SSRIs block the absorption, or reuptake, of serotonin, increasing the amount of it in the brain. Beta-blockers are used for heart and circulatory issues. They work by slowing down certain cell activity, which slows down heart rate and lowers blood pressure. Anti-anxiety medications, or benzodiazepines, are medications that relieve anxiety and muscle spasms and reduce seizures. They slow down the central nervous system and induce a relaxed mood.

When treating phobias, doctors may choose one or a combination of the treatments listed above. If you or someone you know is undergoing the effects of a phobia, please seek out proper medical guidance and treatment. Remember that the Quran says,

Allah does not require of any soul more than what it can afford. (Quran 2:286)

Start by reaching out to your primary healthcare physician and ask for a referral to a therapist or psychologist. Suffering from a phobia can be a debilitating experience, but there is always a way forward toward managing our fears and anxieties.

Kelly Izdihar Crosby is an artist and freelance writer based in Atlanta, GA.