Acrophobia: the Fear of Heights

Related Conditions, Symptoms, Risks, Causes, and Treatments

Edge of the roof of a building looking down
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Acrophobia is defined as a fear of heights. Unlike a specific phobia such as aerophobia, which is the fear of flying, acrophobia can cause you to fear a variety of things related to being far from the ground. Depending on the phobia's severity, you may fear being on a high floor of a building as much as simply climbing a ladder.

Acrophobia and Related Conditions

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. Acrophobia can induce similar feelings, but the three conditions are not the same. 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.

Symptoms

Emotionally and physically, the response to acrophobia is similar to the response to any other phobia. You may never experience vertigo symptoms, but you may experience the following with acrophobia:

  • 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. Common reactions include descending immediately, crawling on all fours, and kneeling or otherwise lowering your body.
  • Physical symptoms: You may begin to shake, sweat, experience heart palpitations, and even cry or yell out. You may feel terrified and paralyzed. It might become difficult to think.
  • Anxiety and avoidance: If you have acrophobia, it's likely that you will 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.

Risks

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. Therefore, it's extremely important that your acrophobia is professionally treated as quickly as possible, particularly if heights are a regular part of your life.

Causes of Acrophobia

Research shows that a certain amount of reluctance around heights is normal, not only for humans but for all visual animals. 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.

Therefore, acrophobia seems to be at least partially ingrained, possibly as an evolutionary survival mechanism. 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. Many experts believe that this may be a learned response to either a previous fall or a parent's nervous reaction to heights.

Treatment

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: Traditionally, actual exposure to heights is the most common solution. However, several research studies have shown 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 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. Some studies have shown that using the medication in tandem with cognitive-behavioral therapy may improve results. However, one meta-analysis, which combines multiple study results, questioned D-cycloserine's usefulness and whether it's as helpful as originally believed, citing that more research needs to be done.
  • Relaxation: Doing yoga, deep breathing, meditation, or progressive muscle relaxation can help you cope with stress and anxiety. Regular exercise can help too.
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