Treatment - Phobias

Many people with a phobia do not need treatment.

Avoiding the object of their fear can help them control the problem. They can still have a normal daily routine.

But it may not always be possible to avoid certain phobias, such as a fear of flying. You may decide to get professional help and advice to find out about treatment options.

Most phobias can be successfully managed. But no single treatment is guaranteed to work for all phobias. In some cases, a combination of different treatments may be recommended.

The main treatment types are:

• self-help techniques
• talking therapies
• medicine

Talking therapies

Talking therapies, such as counselling and psychotherapy, are often effective for treating phobias.

Cognitive behavioural therapy is usually very effective.

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) is a type of counselling. It can help you manage your problems by changing the way you think and behave. It can be used to develop practical ways of dealing with your phobia.

The process can involve gradual exposure to your fear, so you feel less anxious about it. This is called desensitisation or exposure therapy.

Exposure therapy works by gradually increasing the level of exposure to your fear. This helps you to gain control over your phobia. As the treatment progresses, you should begin to feel less anxious about your phobia.

For example, if you have a fear of snakes (ophidiophobia), your therapist may ask you to read about snakes. They may later show you a picture of a snake. They may then arrange a visit to the reptile house in a zoo to look at some real snakes. The final step would be for you to hold a snake.

Learn more about talking therapies

Medicine

Medicine is not usually recommended for treating phobias. This is because talking therapies are usually effective and do not have side effects. But medicine is sometimes prescribed on a short-term basis to treat effects of phobias such as anxiety.

Three types of medicine are recommended for treating anxiety.

These are:

• antidepressants
• tranquillisers
• beta-blockers

Antidepressants

Antidepressants are often prescribed to help reduce anxiety. The following types can be used:

Selective serotonin reuptake inhibitors (SSRIs)

These are most often used to treat anxiety, social phobia or panic disorder.

They include:

• escitalopram (Cipralex)
• sertraline (Lustral)
• paroxetine (Seroxat)

A serotonin and noradrenaline reuptake inhibitor (SNRI) may also be prescribed for anxiety. For example, venlafaxine (Efexor).

Common side effects of these treatments include:

• nausea
• headaches
• sleep problems
• upset stomach

They may also initially make your anxiety worse or cause sexual problems.

Clomipramine

Clomipramine (Anafranil) is a type of tricyclic antidepressant (TCA) that is licensed to treat phobias.

Side effects include:

• dry mouth
• drowsiness
• blurred vision
• tremors (shaking)
• palpitations (irregular heartbeat)
• constipation
• difficulty urinating

Moclobemide

Moclobemide (Manerix) is a type of antidepressant from the monoamine oxidase inhibitor (MAOI) group of antidepressants. It's sometimes prescribed to treat social phobia.

Moclobemide interacts with certain types of food. Read the information leaflet to find out which foods to avoid.

Other possible side effects of moclobemide include:

• sleep problems
• dizziness
• stomach problems
• headaches
• restlessness
• agitation

Stopping antidepressants

If you are prescribed antidepressants, do not suddenly stop taking them. Suddenly stopping can cause withdrawal symptoms. Talk to your GP and they can gradually lower your dose.

Find out more about antidepressants

Tranquillisers

Benzodiazepines are a group of medicines that are categorised as minor tranquillisers. They include medicines such as diazepam (Valium). These are sometimes used on a short-term basis, at the lowest possible dose, to treat severe anxiety.

Like antidepressants, benzodiazepines should be stopped gradually to avoid withdrawal symptoms.

Beta-blockers

Beta-blockers are often used to treat cardiovascular conditions such as heart problems and high blood pressure (hypertension). They are also sometimes prescribed to help reduce the symptoms of anxiety, such as palpitations (irregular heartbeat).

Beta-blockers slow down your heart rate and decrease your blood pressure.

Propranolol (Inderal) is a beta-blocker that's commonly used to treat anxiety.

Possible side effects include:

• stomach problems
• cold fingers
• tiredness
• sleep problems