Specific & Social Phobias

Anyone can experience a degree of anxiety or unease due to certain situations, demands or reasonable fears, such as spiders, injections, bumpy air flights or giving a public talk. Most individuals find ways to minimize or even avoid what they would prefer not to encounter.

Specific Phobia

A specific phobia occurs when fears of objects or situations that pose little real danger are overwhelming, unreasonable and persistent, disrupting life in avoiding the cause of that fear. Although individuals may recognize their fear is out of proportion to the actual threat, they remain unable to control their reaction.

Among the most common anxiety disorders, specific phobias are long lasting, cause intense physical and psychological reactions and can affect the ability to function normally at work, at school or in social settings.

An individual with a specific phobia may experience an anxiety attack when encountering the feared situation or object, as in fainting at the sight of blood and being overwhelmed by a simple dental procedure.

Read about the difference between anxiety attacks and panic attacks.

Common specific phobias

Situations: airplanes, enclosed spaces, going to school, loud noises, clowns
Nature: thunderstorms, heights
Animals or insects: dogs, spiders, snakes
Physical: needles, accidents, medical procedures, choking
Acrophobia: fear of heights
Claustrophobia: fear of confined spaces

Social Phobia

In contrast to normal feelings of shyness or discomfort in certain situations, individuals with social phobia fear being scrutinized or judged negatively by others in their daily interactions. Social phobia—more frequently called social anxiety disorder— is a chronic mental health condition. It causes significant anxiety, self-consciousness and avoidance that interferes with relationships, work, school or other routines and activities. Social phobia typically begins in the early to mid-teens, though it can affect younger children or adults.

Not all social unease is a sign of social phobia, particularly in shy or withdrawn children. Comfort levels in social situations vary, depending on personality traits and life experiences. Some people are naturally reserved, while others are more outgoing.

Avoidance behavior: Individuals with social phobias may find common, everyday experiences hard to endure, for example:

Interacting with unfamiliar people or strangers
Dating, attending parties or social gatherings
Going to work or school
Starting conversations
Making eye contact
Entering a room where people are already seated
Returning items to a store
Eating in front of others
Using a public restroom

Commonalities of Specific & Social Phobias

Causes

Although causes are unclear and in dispute, specific or social phobia disorders likely arise from a complex interaction of biological and environmental factors:

Inherited traits. Anxiety disorders tend to run in families. However, it is less clear how much is due to genetics versus learned behavior.

Brain structure. Changes in brain functioning may be a cause of phobias. Those with an overactive amygdala may be less able to control the fear response.

Negative experience. A cause may result from conditioning or trauma in a specific situation, such as being hit riding a bicycle or giving a public talk. Phobias may also be the result of:

– Parents who either model anxious behavior in certain situations or are more controlling or overprotective of their children.

– Receiving false or exaggerated information (being told dogs are dangerous) or seeing or hearing of someone else being injured or distressed (seeing someone being bitten by a dog).

– Worsening of lifelong behaviors and personality factors. (Among individuals who are “basically shy” in work meetings see their problems grow more severe once they take on new responsibilities.)

Symptoms

Specific or social phobias are likely to produce these types of reactions:

Emotional and behavioral symptoms

- Intense fear, anxiety or panic when exposed to or even thinking about the fear, making normal functioning difficult
- Intense fear, anxiety or panic during social situations or while interacting or talking with strangers
- Awareness that fears are unreasonable or exaggerated, but feeling powerless to control them
- Avoiding or enduring social situations or speaking to people where one might be the center of attention, be noticed for appearing anxious, be judged negatively or be fearful of embarrassing or humiliating oneself
- Expecting the worst consequences from a negative social experience
- Anxiety in anticipation of a feared situation, which worsens as the situation gets closer in time or physical proximity
- Fear of embarrassing physical symptoms, such as blushing, sweating, trembling or having a shaky voice
- In children, tantrums, clinging, crying, refusing to leave a parent’s side or approach their fear

Physical symptoms

- Trouble catching one’s breath
- Dizziness or lightheadedness
- Blushing, trembling, sweating
- Fast heartbeat, tight chest
- Feeling nauseated, stomach pains
- Mind going blank
- Muscle tension

Risk factors

Age. Specific phobias can first appear in childhood, usually by age 10. Social phobias typically appear in adolescence. Both can occur later in life.

Family history. A child of biological parents or with siblings with phobias or anxiety are more likely to develop phobias. This could be an inherited tendency or a learned one, as children observe family member’s fearful reactions to entities or situations.

Negative experiences. Children having or learning about negative experiences—trapped in an elevator, attacked by a dog, being bullied, rejected or humiliated, hearing about plane crashes, witnessing family conflict, experiencing trauma or abuse—may develop social and/or specific phobias.

Temperament. Children who are more sensitive, more inhibited or more negative than the norm are at greater risk when facing new people or situations.

New social or work demands. Meeting new people, giving a public speech or handing in homework on time may trigger social phobias for the first time.

Having an outward appearance or condition that draws attention can trigger social phobias in some people.