Treating phobias


Many people with a phobia do not need treatment and find that avoiding the object of their fear is enough to control the problem.


However, it may not always be possible to avoid certain phobias, such as a fear of flying. You may want to get professional help and advice to find out about treatment options or you may wish to try self-help techniques.


Most phobias are curable, but no single treatment is guaranteed to work for all phobias. In some cases, a combination of different treatments may be recommended. The main types of treatment are outlined below.


Talking treatments


Talking treatments are often very effective for people with phobias. There are several different types of talking therapy:


  • Counselling: a trained counsellor listens to your problems, such as feeling anxious in certain situations, and helps you to overcome them.

  • Psychotherapy: a psychotherapist uses an in-depth approach to find the cause of your problem and suggests ways to deal with it.

  • Cognitive behavioural therapy: a type of counselling that explores your thoughts, feelings and behaviour to develop practical ways of effectively dealing with the phobia.

Speak to your GP to find out if talking treatments would be suitable for you and whether they are available on the NHS in your area.


Desensitisation


Many simple phobias can be treated using a form of behaviour therapy known as desensitisation or self-exposure therapy. It involves being gradually exposed over a period of time to the object or situation of your fear so that you start to feel less anxious about it.


Sometimes, a combination of behaviour therapy and medication may be recommended.


Medication


Medication is not usually recommended for treating phobias because talking therapies are normally successful. However, medication is sometimes prescribed for treating the effects of phobias, such as anxiety.


Three types of medication are recommended for treating anxiety. The medication used may include:


Antidepressants


Antidepressants are often prescribed to help reduce anxiety. Paroxetine (Seroxat), a selective serotonin reuptake inhibitor (SSRI), is licensed to treat social phobia. Citalopram (Cipramil) and escitalopram (Cipralex) are licensed for the treatment of panic disorder. Venlafaxine (Efexor) is licensed for generalised anxiety disorder (GAD).


Common side effects of these treatments include:


Initially, they may make your anxiety worse.


Clomipramine (Anafranil) is a type of tricyclic antidepressant (TCA) that is licensed to treat phobias. Side effects include:


  • dry mouth

  • drowsiness

  • blurred vision

  • tremors (shaking)

  • palpitations (irregular heartbeat)

  • constipation

  • difficulty urinating

Moclobemide (Manerix) is a type of antidepressant from the monoamine oxidase inhibitor (MAOI) group of antidepressants. It is sometimes prescribed to treat social phobia. Moclobemide interacts with certain types of food, so if you are prescribed this medication, read the information leaflet that comes with it to find out which foods you should not eat.


Other possible side effects include:


  • sleep problems

  • dizziness

  • stomach problems

  • headaches

  • restlessness

  • agitation

Antidepressants can cause withdrawal symptoms. If you are prescribed antidepressants, it is important that you don’t stop taking them suddenly. See your GP, who will lower your dose gradually over time.


Tranquillisers


Benzodiazepines are a group of medicines that are also known as minor tranquillisers. They are sometimes used to treat severe anxiety, but are usually only prescribed in the lowest possible dose for the shortest possible time. This is because they are associated with withdrawal and dependence problems.


Benzodiazepines are usually only prescribed for a maximum of four weeks at a time. Like antidepressants, their use should be stopped gradually. Benzodiazepines that are often used include:


Side effects of these medications include:


  • drowsiness

  • tiredness

  • confusion

Two other types of tranquillisers that are licensed to treat severe anxiety are buspirone and meprobamate. Like benzodiazepines, these drugs are only prescribed on a short-term basis.


The side effects of meprobamate are similar to those of benzodiazepines. The side effects of buspirone include:


  • nausea

  • dizziness

  • headaches

  • nervousness

  • light-headedness

Beta-blockers


Beta-blockers are often used to treat cardiovascular conditions, such as heart problems and high blood pressure (hypertension). They are also sometimes prescribed to help reduce the symptoms of anxiety, such as palpitations (irregular heartbeat).


Beta-blockers slow down your heart rate and decrease your blood pressure. Propranolol (Inderal) is a beta-blocker that is commonly used to treat anxiety. Side effects include:


  • stomach problems

  • cold fingers

  • tiredness

  • sleep problems





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