Phobias and Addiction

 

A phobia is a kind of anxiety disorder involving an intense, illogical fear of something that involves little or no real danger. There are countless specific phobias, including fear of heights, fear of public places, fear of closed-in places, fear of water, fear of flying, and many more. One of the most common phobias is social phobia, or anxiety and extreme self-consciousness in everyday social situations.

phobias and alcohol

Phobias differ from normal anxiety because the fear experienced is unreasonable for the amount of danger actually posed. Compared to the everyday anxiety experienced by most people, phobias trigger intense physical and psychological reactions. They are long-lasting, persisting across time and in different circumstances, and they can negatively impact a person’s ability to function normally in daily life.

It is not uncommon for people with phobias to abuse drugs or alcohol. It is generally believed that this connection exists because people with phobias try to self-medicate through illicit substances. One of the most commonly cited connections between addictive substances and phobias is the use of alcohol by those with social phobia. Many people with this phobia rely on alcohol to control the anxiety they experience when confronted with the feared situation. For example, an individual may drink alcohol before performing on stage or drink when socializing with friends, in an attempt to control their symptoms of anxiety. People with other phobias may also attempt to use alcohol or drugs to self-medicate. Drugs with a sedating or depressive affect are among the most commonly abused by people with phobias.
 

 

Types and Symptoms of Phobias

 
Mayo Clinic lists three main categories of phobias:

  • Specific phobias: These phobias involve a strong irrational fear of a specific object or situation. This category includes a fear of situations, like airplanes or small spaces; fear of nature, like thunderstorms or heights; fear of animals or insects, including dogs or spiders; fear of blood, injections, or injury, such as knives or injections; or fear of other specific phobias, including loud noises or clowns. It is not uncommon to have more than one specific phobia, and there are many other phobias it is possible to have.

  • Social phobia: Also called social anxiety disorder, social phobia is an excessive fear of public humiliation or judgment and excessive self-consciousness. These symptoms are experienced in everyday social situations. While everyone may become somewhat nervous in certain situations, such as public speaking, a person with social phobia is overwhelmed by fear. Social situations trigger strong fears of rejection or negative evaluation by others in someone with social phobia.

  • Agoraphobia: While the word agoraphobia literally translates to “fear of open spaces,” this phobia actually involves fear of a situation that the person believes would be inescapable or lead to being trapped. Examples include using public transportation, being in enclosed spaces, being in a crowd or waiting in line, or leaving home alone. The fear of these situations is caused by anxiety about becoming trapped in these situations if the person becomes anxious and having no one there to help. This phobia is common among people with panic disorder; individuals fear having a panic attack in certain situations, such as a public place, and worry that they would be unable to leave the situation if a panic attack were to occur. Agoraphobia can become so severe that the individual is unable to leave home.


People with phobias experience severe symptoms of anxiety when they are confronted with the object or situation they fear. The National Library of Medicine lists these symptoms as including:

  • Panic and fear
  • Rapid heartbeat
  • Shortness of breath
  • Shaking and trembling
  • An overpowering wish to escape the situation


The symptoms of a phobia often first appear during childhood or adolescence and persist into adulthood. People with phobias are often aware that their fear is irrational or disproportional to the actual danger posed, but feel powerless to control their reactions. Children with phobias may lack communication skills to explain what they are experiencing, and so they may throw tantrums, cry, or cling to an adult when experiencing symptoms.

 

Causes of Phobias

 
The specific causes of phobias are unknown and probably vary from person to person. It is generally believed that phobias develop as a result of both genetics and environmental factors. Mayo Clinic lists the following factors as likely contributors to the formation of phobias:

  • Age: Phobias tend to develop at a young age. Social phobia typically first appears before age 13, while specific phobias often develop by the age of 10. Agoraphobia is most likely to occur during the late teens or early adulthood, typically before age 35.

  • Relatives: You are more likely to develop a phobia that is shared by a parent or sibling. If someone in your family has a phobia of snakes, for example, you are at an increased risk of developing the same phobia. This could be due to inherited genetic factors, or children may learn the behavior from their parents.

  • Temperament: People who are more sensitive, more inhibited, or more pessimistic than others may be more likely to develop phobias.

  • A traumatic event: The experience of a traumatic event can trigger the development of a phobia. Becoming trapped in an elevator or attacked by an animal can cause a person to develop a phobia involving that specific situation.

 

 

Substance Abuse and Phobias

 
The British Journal of Psychiatry has found that as much as a third of people in treatment for substance use disorders have a diagnosable phobia. Another third of those in treatment have milder phobia symptoms that do not necessitate a diagnosis.

Substance abuse among people with phobias is generally a result of attempts at self-medicating the symptoms of anxiety. A study published by the Journal of the American Medical Association found that people with phobias were more likely to abuse alcohol and sedatives. While those who used these substances to manage their anxiety believed they were helping their symptoms, the effectiveness of the alcohol or sedatives in treating the disorder was actually low.

This same study found that people with co-occurring phobias and substance abuse tended to recover from their substance use disorders after their phobias were successfully treated with medication. Because substance abuse among this population is generally a result of self-medication, treating the phobia with legitimate medications is often an important first step in recovery from substance abuse.
 

 

Treatment Options

 
Both behavioral therapy and medications are typically used in the treatment of phobias. Medications can be very helpful, as they assist in the therapeutic process by lowering anxiety levels enough to let the individual experience the feared situation in a calm state. Some common medications used to treat phobias include:

  • Beta blockers block the effects of adrenaline. This can prevent the person from becoming panicked when confronted with the feared item or situation. This medication is typically used on a short-term basis and only directly before the object of the phobia is confronted. For example, someone with severe stage fright may take a beta blocker directly before a performance.

  • Antidepressants are some of the most commonly used medications in the treatment of phobias. Selective serotonin reuptake inhibitors (SSRIs) help to increase the amount of serotonin in the brain, which can help improve mood and lessen anxiety. This type of medication is taken regularly, often every day.

  • Sedatives can be very effective at reducing severe anxiety. Benzodiazepines trigger relaxation and may be prescribed in severe cases. However, this type of medication is not recommended if the individual has a history of drug or alcohol abuse. Mixing benzodiazepines with other substances can be extremely dangerous, and sedatives can be addictive, so these types of drugs should be used with caution.


Psychotherapy, also called talk therapy, is typically recommended for the treatment of phobias. The University of Pennsylvania Perelman School Of Medicine recommends the following models of therapy for the treatment of phobias:

  • Exposure therapy: In this model of therapy, the individual is gradually introduced to the feared situation over and over to an increasing degree, until the feared situation no longer triggers an anxiety response. For example, a person suffering from a phobia of snakes may begin by imagining a snake until that no longer triggers any anxiety. The person may then repeatedly look at a picture of a snake, then a video, then look at an actual snake from a great distance, and finally touch or hold a snake. This approach works best when it is done frequently, and when each situation is tolerated until it no longer produces any anxiety.

  • Cognitive therapy: In this model of therapy, the individual suffering from a phobia learns to examine irrational or anxious thoughts, and replace them with healthy or productive thoughts. This can be helpful for some people with social phobia or agoraphobia, but it may be less useful for people with specific phobias. Those suffering from specific phobias often recognize their fear is irrational, so confronting their irrational thoughts is not always helpful.

  • Relaxation training: Relaxation techniques like breathing exercises can help individuals cope with the anxiety triggered by their phobias. This approach can help to reduce the anxiety experienced and sometimes help the individual overcome the phobia in its entirety.