Acrophobia: The Fear of Heights

Acrophobia is a type of specific phobia that involve an intense fear of heights.

Acrophobia causes people to feel extremely fearful and anxious about situations that involve being far off the ground, such as climbing a ladder or going to the top of a tall building. Because of the intensity of this fear, people with acrophobia often avoid any situation that involves heights.

It is normal to be somewhat apprehensive about heights, particularly if those heights are unusual, significant, or unstable. Acrophobia involves a much more significant or disruptive fear that can affect a person's ability to function in everyday life.

Symptoms of Acrophobia

Emotionally and physically, the response to acrophobia is similar to any other phobia. Some of the common symptoms associated with acrophobia include:

Emotional Symptoms

You may feel a sense of panic when you perceive that you're high off the ground. You may instinctively begin to search for something to cling to and find that you're unable to trust your own sense of balance.

Physical Symptoms

The physical symptoms of acrophobia are similar to those of other specific phobias and may include:

• Chest pain
• Dizziness
• Nausea
• Rapid heartbeat
• Shortness of breath
• Trembling

Anxiety and Avoidance

If you have acrophobia, you will likely begin to dread situations that may cause you to spend time in high places. For example, you may worry that an upcoming vacation will put you in a hotel room on a high floor. You may put off home repairs for fear of using a ladder. You might avoid visiting friends' homes if they have balconies or upstairs picture windows.

This avoidance can interfere with your ability to function in your daily life. For example, you may not be able to attend school, go to work, visit friends, or leave your home due to extreme fear and avoidance.

Conditions Related to Acrophobia

Conditions that are related to acrophobia and may occur with it include:

Vertigo

True vertigo is a medical condition that causes a sensation of spinning and dizziness. Illyngophobia is a phobia in which the fear of developing vertigo can actually lead to vertigo-like symptoms.

See a doctor for tests if you experience vertigo symptoms. Medical tests may include blood work, computed tomography (CT) scans, and magnetic resonance imaging (MRI), which can rule out a variety of neurological conditions.

Bathmophobia

The fear of slopes and stairs, called bathmophobia, is sometimes related to acrophobia. In bathmophobia, you may panic when viewing a steep slope, even if you have no need to climb it. Although many people with bathmophobia have acrophobia, most acrophobia sufferers do not also experience bathmophobia.

Climacophobia

This fear is related to bathmophobia, except that it generally occurs only when you're contemplating making a climb. If you suffer from climacophobia, you're probably not afraid to see a steep set of stairs as long as you can remain safely at the bottom. However, climacophobia may occur in tandem with acrophobia.

Aerophobia

This is the specific fear of flying. Depending on the severity of your fear, you may be afraid of airports and airplanes, or may only feel the fear when you're in the air. Aerophobia may occasionally occur alongside acrophobia.

Risks of Acrophobia

The biggest danger that most phobias present is the risk of limiting your life and activities to avoid the feared situation. However, acrophobia is unusual in that having a panic attack while high off the ground could actually lead to the imagined danger.

The situation may be safe as long as normal precautions are taken, but panicking could lead you to make unsafe moves.

Causes of Acrophobia

Research shows that a certain amount of reluctance around heights is normal, not only for humans but for all visual animals. Acrophobia seems to be at least partially ingrained, possibly as an evolutionary survival mechanism.

In 1960, famed research psychologists Eleanor J. Gibson and Richard D. Walk did " The Visual Cliff" experiment which showed crawling infants, along with babies of numerous species, refusing to cross a thick glass panel that covered an apparently sharp drop-off. The presence of the infant's mother, encouragingly calling him, did not convince the baby that it was safe.

Nonetheless, most children and adults use caution but are not inordinately afraid of heights. Acrophobia, like all phobias, appears to be a hyper-reaction of the normal fear response. This may be a learned response to a previous fall or a parent's nervous reaction to heights.

Research also indicates that irrational fear of falling plays a greater role than the perception of height.

Diagnosing Acrophobia

Acrophobia is not a distinct disorder recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), the tool doctors and mental health professionals use to diagnose mental disorders. Instead, this condition would be diagnosed as a specific phobia.

To be diagnosed with a specific phobia, your doctor or therapist will ask questions about the nature, duration, and severity of your symptoms. The diagnostic criteria for specific phobias require:

• Excessive and intense fear and out of proportion to the actual threat
• Feeling anticipatory anxiety, which involves being fearful and worried about encountering the thing that you fear
• Avoidance of situations that would place you in contact with what you fear
• Life-limiting disruptions in daily activities
  

Treatment for Acrophobia

Acrophobia can share certain symptoms with vertigo, a medical disorder with a variety of possible causes, as well as with other specific phobias. For these reasons, if you experience the signs of acrophobia, it's extremely important to seek professional help as soon as possible.

Treatments for acrophobia include:

Psychotherapy

Cognitive-behavioral therapy, or CBT, is the main treatment of choice for specific phobias. Behavioral techniques that expose you to the feared situation either gradually (systematic desensitization) or rapidly (flooding) are frequently used. In addition, you're taught ways of stopping the panic reaction and regaining emotional control.​

Exposure

Exposure therapy is considered the gold standard for treating specific phobias. Traditionally, actual exposure to heights is the most common solution. However, a research study published in 2017 demonstrated that virtual reality may be just as effective.

A major advantage of virtual reality treatment is the savings in both cost and time, as there is no need for "on-location" therapist accompaniment. This method is not available everywhere, but with the costs of virtual reality equipment coming down, it will likely be easier to access as time goes on.

Medication

Sometimes, sedatives or beta-blockers may be used for short-term relief in specific situations to help relieve the panic and anxiety you feel. The drug D-cycloserine has been in clinical trials for anxiety disorder treatment since 2008.

A study in 2012 found that using the medication in tandem with cognitive-behavioral therapy may improve results. However, more research on dosing and length of treatment time is needed.

Relaxation

There are many lifestyle modifications and relaxation strategies that can play a part in relieving symptoms of acrophobia. Doing yoga, deep breathing, meditation, or progressive muscle relaxation can help you cope with stress and anxiety. Regular exercise can help too.