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Dr Sacrifice Chirisa Mental Health Matters
Millions of Zimbabweans have a phobia which is an intense irrational fear when they face a certain situation, activity or object. With a phobia usually one knows the anxiety and fear are not warranted, but cannot help the feelings. The anxiety can be so intense and can paralyse an individual.

There are hundreds of different phobias and are divided into three main categories:

1) Agoraphobia: An intense anxiety in public places where an escape might be difficult. The agora was a market and meeting place in ancient Greece. Someone with agoraphobia is afraid of being trapped in a public place or a place like a bridge or a line at the bank. The actual fear is of not being able to escape if anxiety gets too high. Agoraphobia affects twice as many women as men. If left untreated in extreme cases, it can lead to someone becoming house-bound.

2) Social phobia: A fear and avoidance of social situations. Someone with a social phobia is not just shy. That person feels extreme anxiety and fear about how he or she will perform in a social situation. Will her actions seem appropriate to others? Will others be able to tell they are anxious? Will the words be there when it’s time to talk? Because untreated social phobia often leads to avoiding social contact, it can have a major negative impact on a person’s relationships and professional life.

3) Specific phobia: An irrational fear of specific objects or situations. Below are some of the most common specific phobia not in any order. If any one of these causes problems please see your psychiatrist.

Claustrophobia: An abnormal fear of being in enclosed spaces. A person with claustrophobia can’t ride in elevators or go through tunnels without extreme anxiety. Afraid of suffocating or being trapped, the person will avoid tight spaces.

Zoophobia: Is fear of any animal

Arachnophobia: Fear of spiders;

Ophidiophobia: Fear of snakes;

Ornithophobia: Fear of birds, and

Apiphobia: Fear of bees.

Brontophobia: Fear of thunder.

Acrophobia: Is an excessive fear of heights

Aerophobia: Is afraid of flying

Hemophobia: Is fear of blood

Trypanophobia: Is fear of receiving an injection

Phasmophobia: Is fear of ghosts

Emetophobia: is an unnatural fear of vomiting

Carcinophobia: Is an irrational fear of developing cancer

Gerontophobia: Is fear of old people

The best treatment for specific phobias is a form of psychotherapy called exposure therapy. Psychiatrists may also recommend other therapies or medication. The goal of treatment is to improve quality of life so that one is no longer limited by your phobias. As one learns to better manage and relate to your reactions, thoughts and feelings, one finds that anxiety and fear are reduced and no longer in control of your life.

The following treatment option can be considered:

Exposure therapy focuses on changing your response to the object or situation that you fear. Gradual, repeated exposure to the source of your specific phobia and the related thoughts, feelings and sensations may help one learn to manage the anxiety. For example, if one is afraid of elevators, the therapy may progress from simply thinking about getting into an elevator, to looking at pictures of elevators, to going near an elevator, to stepping into an elevator. Next, you may take a one-floor ride, then ride several floors, and then ride in a crowded elevator.

Cognitive behavioural therapy (CBT) involves exposure combined with other techniques to learn ways to view and cope with the feared object or situation differently. One learns alternative beliefs about your fears and bodily sensations and the impact had on your life. CBT emphasises learning to develop a sense of mastery and confidence with your thoughts and feelings rather than feeling overwhelmed by them. However, sometimes medications can help reduce the anxiety and panic symptoms experienced from thinking about or being exposed to the object or situation feared. Medications may be used during initial treatment or for short-term use in specific, infrequently encountered situations, such as flying on an airplane, public speaking or going through an MRI procedure.

Beta blockers. These drugs block the stimulating effects of adrenaline, such as increased heart rate, elevated blood pressure, pounding heart, and shaking voice and limbs that are caused by anxiety.

Sedatives. Medications called benzodiazepines help you relax by reducing the amount of anxiety you feel. Sedatives are used with caution because they can be addictive and should be avoided if you have a history of alcohol or drug dependence.

Phobias cause untold suffering to many an individual. Its time to face your fears with expect help.

Dr Sacrifice Chirisa is a passionate consultant psychiatrist at Harare Hospital Psychiatric Unit. He is a certified life and business coach and secretary-general of the Zimbabwe Medical Association