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Phobias

Key points about phobias

Phobias are a form of anxiety disorder, in which your anxiety gets attached to a specific object or situation.
Phobias most often start in your childhood or twenties but can develop at any age, particularly after a traumatic experience. Most phobias are more common in women.
Phobias are not harmful in themselves, but avoiding what you fear (eg, objects, animals, situations or activities) can have a negative impact on your life. This is particularly true for social phobia and agoraphobia.
Some phobias can last for many years or even your whole life unless you get help with them. But the good news is that if you get help, most people recover from or learn to manage their phobia much better.

Woman wearing black hat hides face behind her hands

(Osmosis from Elsevier, 2016) Click on the watch on YouTube link(external link) to watch.

Types of phobia

Phobias fall into three main types:

specific phobias
fear of social activities or situations, known as social phobia or anxiety
fear of being away from home or safety and fear of places where you might have a panic attack, known as agoraphobia.

Specific phobias

Specific phobias are very common. You may have a mild aversion to something that doesn't affect you very much, through to a full phobia, which will affect your day to day life. Specific fears fall into 5 categories:

fear of animals, such as dogs, snakes or spiders
fear of the natural environment
fear of blood and needles
fear of activities, such as flying
other fears, such as a fear of clowns.

For example, if you are phobic of dogs, you will feel extremely anxious anywhere near a dog and want to get away from it quickly. You will avoid dogs if at all possible. This happens even though you may realise your fear is unreasonable. Once you leave the situation you feel fine.

Or if you have a fear of blood and needles, you will avoid reading or talking about these subjects and may find it hard to visit a friend in hospital. You may avoid going to the dentist and find it really hard to agree to have an injection or blood test. The sight of blood might make you panic or faint. Away from these subjects and situations, you feel okay.

If you have a phobia of blood/needles/injections, it's a good idea to see a health professional about this. Rather than learning to relax, which can be helpful for people with other phobias, it will be more helpful for you to learn how to tense up to stop fainting at the sight of blood or injections.

Social phobia

A social phobia, known as social anxiety disorder, is a fear of being judged negatively in social situations. It’s common for most of us to have occasional moments where such situations can feel a bit daunting, but someone with social phobia experiences strong anxiety or panic in most social situations.

If you have this type of phobia, you feel anxious that you will act in a way or show anxiety symptoms that will be humiliating or embarrassing. This can lead to avoiding social situations, which affects your ability to create or maintain relationships. It can seriously affect your quality of life, employment and career goals.

Agoraphobia

Agoraphobia is a fear of situations or places that would be difficult to get away from or get help in. As a result, people with agoraphobia often experience severe panic attacks. It is a more severe and complex form of phobia. Find out more about agoraphobia.

There doesn’t seem to be one cause of phobias, but there are several factors that might play a part in them developing.

A specific incident – for example, if you experienced a lot of turbulence on a plane at a young age without adequate reassurance, you might later develop a phobia about flying.
Trauma – if you experienced abuse in a particular setting, you may develop a phobia about similar places or an object that you associate with the abuse. You can also develop a phobia from observing others going through a traumatic event.
Family environment – parents who are very worried or anxious can have an effect on the way you cope with anxiety in later life, and you may even develop the same phobia as a parent or older sibling.
Hearing about a traumatic event – if there is a lot of talk or media coverage about a threatening or traumatic event, such as a plane crash.
Genetics – some people appear to be born with a tendency to be more anxious than others, which can develop into a phobia.
Responses to panic or fear – if you have a strong reaction (a panic attack) in response to a particular situation or object, and you find this embarrassing or people around you react strongly, this can cause you to develop a more intense anxiety about being in that situation again.
Long-term stress – this can cause feelings of anxiety and depression, and reduce your ability to cope in particular situations. This can make you feel more fearful or anxious about being in those situations again, and over a long period, may lead to you developing a phobia.

You may not know or recall the specific reason your phobia developed.

Most people who experience phobias find relief from their symptoms when treated with therapy, medication and education, or a combination of these. There are many things that people develop a phobia of, so don’t worry if you have an unusual phobia – the treatment and self-help methods will work for you as well.

Education

Education can be a helpful first step towards recovering from or managing your phobia better. You can start by looking at the self-help books and websites suggested on this page. They can help you:

understand how phobias develop
find ways of describing what happens to you, including problems that you may have kept completely to yourself up to now
teach you about some of the ways of dealing with your phobia
learn about how addressing your anxiety is key to reducing your phobias
realise that you are not alone – lots of people experience phobias and most of them recover from them or at least learn to manage them much better.

Counselling or therapy

There are trained professionals who know about phobias and how to help someone who is affected by them. They can provide you with support and help for working through any distressing thoughts and feelings you have and support you to make positive changes in your life. For some people, it might be helpful to understand why your phobia developed and may involve processing earlier trauma. For others, this is not important or useful, and instead, the key is to focus on changing your thinking and behaviour.

Cognitive-behavioural therapy (CBT), a psychological therapy that largely focuses on overcoming unhelpful beliefs, can be helpful for people with specific phobias. Therapy will involve desensitisation, that is, you gradually having more exposure to the object or situation you feel anxious about. This is a very effective step in overcoming your phobia. Don’t worry – this only happens when you are ready and at a pace that is right for you.

Medication

Medication isn't usually recommended for treating phobias, because talking therapies are usually effective and don't have any side effects. However, medication is sometimes prescribed on a short-term basis to treat the effects of phobias, such as anxiety.

Examples of medications recommended for treating anxiety include:

Antidepressants: selective serotonin reuptake inhibitors (SSRIs) are most often prescribed to treat anxiety, social phobia or panic disorder. They are most effective when used alongside counselling or therapy.

Benzodiazepines: these may be used on a short-term basis to treat severe anxiety when other treatments have not been effective. Benzodiazepines are habit-forming therefore they are used at the lowest possible dose for the shortest time.

Complementary therapies

The term complementary therapy is generally used to indicate therapies and treatments that differ from conventional Western medicine and that may be used to complement and support it. In general, mindfulness, hypnotherapy, yoga, exercise, relaxation, massage, mirimiri (traditional Māori massage) and aromatherapy have all been shown to have some effect in alleviating mental distress.

The key things you can do to help yourself are to:

learn about phobias and how to manage and improve your condition
learn a relaxation technique or mindfulness
get help if you need it
join a support group
stretch yourself a small step at a time in confronting your phobia
stay connected to others
stay engaged with the rest of your life that’s not affected by your phobia
avoid alcohol and other drugs
be physically active
spend time in nature
eat a healthy diet
find a greater purpose.

Find out more about living well with phobias.

There are things you can do to care for yourself and reduce the effect your phobia has on your life.

Learn about phobias and how to manage and improve your condition

Start with the brochures, self-help books, videos, apps or online courses listed on this page. It can really help to understand how phobias develop, to find out that you’re not alone, and to learn the techniques that other people have used to recover from or manage their phobia better. This helps you to take charge of your fear, rather than your fear being in charge of you.

Learn a relaxation technique or mindfulness

Learning how to breathe deeply can reduce anxiety and feelings of panic when you encounter situations that trigger your phobia. Find out more about panic disorder.

Mindfulness is the practice of being aware of each moment of your day as it happens. Becoming more mindful helps reduce tension, stress and anxiety. It also helps you notice what supports your wellbeing. Learn a mindfulness practice.

Get help if you need it

Although there is a lot you can do to support yourself, it’s also OK to ask for help. Talking therapy can help a lot, and if you need it you can also get medication that helps. Find a counsellor or therapist(external link) and talk to your doctor about whether medication would help you.

Join a support group

Joining a support group in your area is a good way to learn from other people ideas for managing your phobia, as well as feeling as though someone else understands what you are experiencing. Ask your doctor, phone Healthline 0800 611 116 or Anxiety NZ 0800 ANXIETY (0800 269 4389) to see if there is one in your area. If you can’t go out to a group, check out the online forums and find one that works for you.

Stretch yourself

If you feel you can confront your phobia, the best strategy is to face the object or situation in small doses as often as possible. It’s very empowering to learn that you can feel the feel the fear and do it anyway!

Facing the object or situation repeatedly works to reduce your anxiety through a process of habituation – your body gets used to being in the situation without a threat happening and your anxiety naturally decreases over time. Also, a good opportunity to prove your fears wrong and see that they are generally very unlikely to happen.

If you have recovered from a phobia, it’s a good idea to keep practicing being in a situation you used to fear. For example, if you know you are quite anxious about meeting new people, don’t avoid doing this. If you take every opportunity to meet new people, your confidence will grow.

Stay connected to others

Tell your family and friends what you are experiencing. Help them to understand that telling you to just relax or ignore your fears won’t help. Tell them instead that what you need is their support and encouragement for you to slowly understand and face your anxiety, one small step at a time.

Stay engaged with your life

Your phobia doesn’t affect every aspect of your life, so make sure you keep up your activities and interests that aren’t affected by your phobia. This improves your quality of life and resources you for dealing with your phobia.

Avoid alcohol and other drugs

Alcohol and other drugs are not useful ways of relaxing to overcome your phobia. You will probably feel more anxious afterwards and you risk becoming addicted. Read more about alcohol and mental health.

Be physically active

We now know that exercise benefits your mind as well as your body. In particular, researchers have found that regular exercise can help you to manage anxiety, include panic disorder and phobias. Find out more about physical activity and mental health and the general benefits of being active.

Spend time in nature

Nature is key to unlocking your wellbeing. Researchers have found that spending time in nature improves your physical and mental wellbeing. Find out some ideas for spending time in nature.

Eat a healthy diet

Eating to ensure you have good nutrition gives you the sustained energy to help you to manage your anxiety. Learn more about healthy eating basics.

There is also some evidence that specific foods can help you to reduce your anxiety. It can help to include as part of your healthy diet foods containing magnesium (leafy greens, legumes, nuts, seeds and whole grains), zinc (oysters, liver, beef, cashews, eggs), Omega-3 fatty acid (fatty fish, such as salmon, tuna, sardines) and probiotic foods (sauerkraut, kefir), and foods rich in B vitamins (wholegrains, almonds, avocado).

Find a greater purpose

Connecting with something that has greater meaning can be a useful support when you are managing any mental health issue, including phobias. This could be through religion or spirituality, through connecting with your culture or whakapapa, through a creative project, or through volunteering or helping others in need. This can distract you from your own problems for a while and build your resilience to manage your phobias when they affect you.

Anxiety NZ Trust(external link) 24/7 anxiety helpline phone 0800 14 269 4389 Auckland
Wellington Anxiety Specialists(external link) Wellington phone 04 386 3861
Anxiety Support Canterbury(external link) Canterbury phone 03 377 9665
Social Anxiety Support(external link) Canterbury 03 377 9665
Find a GP or Counsellor(external link) Mental Health Foundation of NZ
Grow(external link) A support group for mental wellness using the 12-step programme run by people who have experienced mental illness.
Togetherall(external link) UK

The following links provide further information about phobias. Be aware that websites from other countries may have information that differs from New Zealand recommendations.

Phobias(external link) Mental Health Foundation, NZ
Find out how to tell if someone is struggling with their mental health(external link) BBC, UK, 2021
Just a thought(external link) NZ
Phobias(external link) Patient Info, UK
Phobias(external link) NHS, UK
Anxiety(external link) Clinical for Interventions, Australia
Dental Phobia(external link) UK
Small Steps(external link) NZ

Online courses

Panic and agoraphobia course(external link) Evidence-based online course to do on your own or with clinician support. This Way Up, Australia
Coping with panic attacks(external link) Centre for Clinical Interventions. Australia, 2016

Panic disorder and agoraphobia(external link) Royal Australian and NZ College of Psychiatrists, 2005. Available in English (external link)and Japanese
(external link)Living with anxiety: Understanding the role and impact of anxiety in our lives(external link) Mental Health Foundation, UK, 2014
Situational exposure(external link) Centre for Clinical Interventions, Australia
Anxiety disorders – your guide(external link) The Royal New Zealand College of Psychiatrists, 2017
A guide to talking therapies in NZ(external link) Te Pou, NZ
What is an anxiety disorder?(external link) National Mental Health Strategy, Australi
Anxiety – manawarū [PDF, 1.7 MB] Books on Prescription, NZ
Panic attacks – hopohopo Books on Prescription, NZ
A guide to what works for anxiety(external link) Beyond Blue, Australia, 2016
Mind over mood – change how you feel by changing the way you think (2nd. ed)(external link) Dennis Greenberger & Christine A. Padesky, 2016
Living with it – a survivor's guide to panic attacks(external link) Bev Aisbett
Feel the fear and do it anyway(external link) Susan Jeffers, 1987
He rongoā kei te kōrero – talking therapies for Māori(external link) Te Pou, NZ, 2010