The Different Treatment Options Available for Phobias

Researchers are still unclear on exactly what causes phobias. The latest studies show that there is likely a complex interaction of factors including genetics, brain chemistry, environmental triggers, and learned behavior. Consequently, the most successful treatments typically address more than one of these factors. There are currently two major theories on how best to treat phobias—medical and therapeutic—based on differing beliefs about the nature of the mental illness.

Girl experiencing extreme fear due to phobia
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Medication

The medical model places emphasis on the genetic and brain chemistry components of phobias. Medications are prescribed to balance the chemicals in the brain or to treat symptoms, but studies on their efficacy are limited compared to the research on cognitive behavioral therapy for phobias.

Antidepressants

There are two classes of antidepressant medications that are sometimes used to treat phobias: selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs). While anti-depressants are most commonly associated with the treatment of mood disorders like depression, the thought behind prescribing for phobias is similar—the aim being to manage imbalances in the brain that are believed to connected to phobias.

SSRIs like including Celexa (citalopram), Zoloft (sertraline), Prozac (fluoxetine), and Paxil (paroxetine) are often used for social phobia and agoraphobia as they increase the amount of serotonin in the brain, improving mood and reducing anxiety.

Common side effects include:

  • Headaches
  • Dry mouth
  • Drowsiness
  • Sexual dysfunction
  • Diminished sex drive
  • Weight gain

MAOIs, including Nardil (phenelzine), Manerix (moclobemide), and Parnate (tranylcypromine), are mostly prescribed for people with social phobia.

Common side effects include:

  • Agitation
  • Dizziness
  • Stomach issues

Benzodiazepines

Benzodiazepines, including Valium (diazepam), Xanax (alprazolam), Klonopin (clonazepam), and Ativan (lorazepam), are used for a short period of time to induce muscle relaxation and reduce anxiety associated with phobias.

Common side effects include:

  • Drowsiness
  • Impaired coordination
  • Slowed mental processing
  • Confusion
  • Memory impairment
  • Fatigue

Beta Blockers

Beta blockers, including Sectral (acebutolol), Tenormin (atenolol), and Inderal LA (propranolol), are sometimes prescribed as a short-term treatment to help control trembling, sweating, and other physical symptoms of phobia-related anxiety.

Common side effects include:

  • Weight gain
  • Fatigue
  • Cold hands and feet

While medication is helpful for some, others find the benefits aren't worth the side effects. If you're experiencing unpleasant side effects of your medication, it's always best to consult your doctor prior to stopping.

Those who choose to use medications to treat their phobias must visit a psychiatrist or other doctor for medication management, even if they also see a therapist.

In most states, psychologists are not permitted to prescribe medications, although this is slowly changing. However, no mental health practitioner with less than a doctoral degree is permitted to prescribe medication in any state.

Therapy

Many professionals believe that the most important causes of phobias are environmental triggers and learned behaviors. They argue that a phobia is ultimately a learned response to a stimulus. By “unlearning” the response and substituting rational reactions, the phobia can be cured. This model favors therapy as a preferred treatment.

Many people who live with phobias are best treated with a combination of medication and therapy, which may include cognitive behavioral therapy (CBT), exposure therapy, individual therapy, and group therapy.

Cognitive Behavorial Therapy

Cognitive behavioral therapy (CBT) is often the first-line of treatment for phobia. It can help you overcome the negative automatic thoughts that lead to a phobic behavioral reaction, teaching you to gradually change the way you think and overcome your fear.

Exposure Therapy

Like the name implies, exposure therapy gradually exposes you to the situations you fear with the goal of desensitizing and reducing anxiety. Exposure therapy is often part of a cognitive behavioral treatment program, but can also be incorporated into your daily life.

Before the exposure process begins, people first learn relaxation techniques to use to stay calm when facing their fears, including deep breathing, progressive muscle relaxation, visualization, and guided imagery. The next step is to practice using these relaxation strategies gradually and progressively in the face of the feared object or situation. 

For example, if you have a phobia of public speaking, your therapist may help you gradually face difficult public speaking scenarios to overcome your fears perhaps starting with reading a passage aloud to a friend and ending with giving a public presentation.

Alternative Treatments

Increasingly, mental health professionals and patients are turning to alternative treatments to augment traditional means of treating phobias, but these options are not considered first-line treatments and often come with their own set of side effects. Some alternative therapies include:

  • Hypnotherapy, which varies from guided relaxation techniques to regression, in which the therapist helps you confront the memory that originally triggered the phobia
  • Homeopathy, which uses minute quantities of toxic substances to treat disease, is not widely accepted in the medical community
  • Herbal remedies, including catnip, ginseng, chamomile, and valerian root

Although these treatments have not undergone the rigorous, controlled testing necessary for endorsement by the mainstream medical community, many people find symptom relief through alternative channels. Of course, any alternative treatment should only be undertaken with guidance from a mental health professional.

A Word From Verywell

Getting help for your phobia may feel uncomfortable and anxiety-provoking—but you can take comfort in the fact that you are taking the best first step to alleviate your anxiety, manage your phobia, and start enjoying your life.

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