13.Phobias

13.1.What Are Phobias?

A phobia is an excessive or unreasonable fear that can be identified. Itis triggered by the presence or anticipation of a specific object or situation.Children and teens with one or more phobias have consistent anxiety whenexposed to the object or situation. Fear of animals, blood, heights, closedspaces or flying are common phobias. In children and teens, the fear must lastat least six months to be called a phobia rather than a passing (transient)fear.

13.2.Types of phobias seen in children and teens include:

Specific phobia. Anxiety linked to a specific object or situation. Theobject or situation is avoided, anticipated with fear, or endured with extremeanxiety. This causes problems with normal routines and activities.

Panic disorder with or without agoraphobia. A period of intense fear ordiscomfort that is hard to expect or predict. The person feels short of breath,dizzy, light headed, and shaky. They feel like they are losing control, andhave an increased, racing heart beat. This is called a panic attack. Symptomscan last hours, but most often peak after 10 minutes. Agoraphobia is a fear ofopen spaces (such as being outside or leaving home alone) linked to one or morephobias or the fear of having a panic attack.

Social anxiety disorder. This is also known as social phobia. It is thefear of one or more social or performance situations. These situations arenormal for the person’s age and occur with others from their age group (like aschool play, recital, or giving a speech or book report in front of the class).

Selective mutism. The person is not able to speak in specific socialsituations, but they can and do speak in other situations.

13.3.What Causes Phobias?

Research suggests that both genetic and environmental factors impact theonset of phobias. Specific phobias have been linked to a fearful firstencounter with the phobic object or situation. Sometimes children developphobias by seeing the fearful reactions of others. Symptoms get worse when theykeep avoiding the feared object or situation.

13.4.Who Is Affected by Phobias?

Anxiety disorders are common in all ages. The rate of specific phobias inchildren and teens is thought to range from 1 percent to as high as 9.2percent. These often start in childhood. These are not the fears that arenormal for their age. Social anxiety disorder is thought to occur in up to 1.4percent of children and teens. Panic disorder can start at any age, but mostoften starts during the teen and young adult years.

13.5.What Are Symptoms in a Child with a Phobia?

When a child or teen is exposed to, or anticipates exposure to, a specificobject or situation that leads to intense fear or anxiety, they often:

Have an increased heart rate

Sweat

Tremble or shake

Feel short of breath

Feel like they are choking

Have chest pain or discomfort

Have an upset stomach

Feel dizzy or faint

Fear they are losing control or going crazy

Fear dying

Feel numb

Have chills or hot flashes

Each child’s experience can be different.

In panic attacks, at least four of the symptoms must happen with or withouta known cause.

The symptoms of a phobia may look like other physical or mental healthproblems. Always consult your child's doctor for a diagnosis.

13.6.How Are Phobias Diagnosed?

A child psychiatrist, psychologist or other health or mental health expertwill diagnose an anxiety disorders after a full medical and psychiatricevaluation. Parents who note signs of severe anxiety in their child or teen canhelp by seeking an evaluation and treatment early. Early treatment can preventfuture problems.

13.7.Treatment for Phobias

Treatment for phobias will be advised for your child based on:

 Age, health and history

Extent of symptoms

Type of phobia

How they handle specific medicine, procedures or therapy

What is expected for the course of the condition

Your thoughts or preference

There is effective treatment for phobias, like there is for other anxietydisorders. Treatment should always be based on a full evaluation of the childand family.

Parents play a vital support role in any treatment process. Treatment mayinclude:

Individual or cognitive behavioral therapy for the child. This is focusedon helping the child learn new ways to control anxiety and panic attacks.

Family therapy

Meeting with the child's school

Medicine for some children

13.8.Prevention of Phobias

Preventive measures to reduce the incidence of phobias in children are notknown at this time.

Early detection and intervention can:

 Reduce how severe the symptoms are

Enhance the child's normal growth and development

Improve the quality of life of children and teens with anxiety disorders