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Fear is a natural, instinctive reaction to dangerous situations. It is what causes us to escape from a burning building. A sudden rush of fear protects us, by alerting us to danger and stimulating adrenaline so that we think and move more rapidly than usual. But for people with phobias or panic disorder, fear is an overwhelming and unwelcome feature of their daily lives.  They are struck by fears which they know are irrational and illogical, yet which are so powerful and unpredictable that they drastically change their lives to avoid feared situations.


Phobias and panic disorder are anxiety disorders, which are among the most common of mental health problems. In fact, it is estimated that 1 in 10 people are affected by anxiety disorders. These conditions are medical disorders, but they are often mistaken for weakness or self-indulgence. Because of this common mistake and because of the stigma associated with mental illness, people with anxiety disorders are often misunderstood and neglected, by society and sometimes by health care professionals. 

Treatment exists to help people with phobias and panic disorder, and research into new therapies and techniques continues. By learning more about these conditions, you can help remove the social stigma that prevents so many people from seeking help to cope with their illness. 

Specific phobias, social phobia

There are two categories of phobia: specific phobia and social phobia. Studies have shown that people with social phobia often experience in their developmental years a history of family break-up, shyness, infrequent dating and parental discouragement of socializing. 

Specific Phobia - Specific phobias are believed to result from a combination of biological factors and life events. Some examples of specific phobias are fear of flying, heights, animals and blood. People with this type of phobia are consumed by inappropriate and involuntary fears. Their need to avoid those objects or situations which provoke high anxiety is so strong that they are unable to lead a normal life. 

Social Phobia - A person with social phobia is excessively fearful of social or performance situations. They feel extreme anxiety about the possibility of being judged by others or behaving in ways which might cause embarrassment. They may have fears about being unable to continue talking in public, choking on food when eating in front of others or being unable to urinate in a public lavatory. This can lead to attacks which may involve heart palpitations, shortness of breath and profuse sweating. They will usually go to great lengths to avoid feared situations. 

Panic Disorder

It is estimated that some 2 million Canadians suffer from panic disorder. Of those who have sought treatment for their symptoms, approximately two-thirds are women. Panic disorder typically begins in a person's late teen years, or early 2Os, but children are known to suffer from the disorder. Research is discovering more information about genetic causes of panic disorder. Studies have also shown that the occurrence or anticipation of stressful life events, anxiety in childhood, over-protective parental behaviour and substance abuse are common among people with panic disorder. 

Agoraphobia frequently accompanies panic disorder. This is the fear of being in places or situations which would be difficult to escape from, or in which it would be difficult to find help, should a person suffer a panic attack. 

Panic Disorder without Agoraphobia -Panic attacks are terrifying episodes during which the person is convinced they are about to die or collapse. Without warning, an individual is suddenly overwhelmed by emotional and physical sensations that signal imminent death. 

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These can include heart palpitations, choking, nausea, faintness, dizziness, chest pain and sweating. 

Panic Disorder with Agoraphobia - Women are roughly twice as likely as men to be diagnosed with panic disorder with agoraphobia. This occurs when a person with panic disorder goes to great lengths to avoid situations which they feel they could not escape from or obtain help if struck by a panic attack. In some cases, people develop a fear of being alone. People with agoraphobia often avoid public transport or shopping malls, others refuse to leave their homes, sometimes for years at a time. 

Associated conditions

Anxiety disorders can co-exist; in other words, an individual may suffer from two disorders at the same time. People with social phobia and people with panic disorder are prone to agoraphobia. As well, phobia and panic disorder are often associated with other mental health problems. Depression and alcohol abuse are common. People with these disorders often suffer from a reduced quality of life. They may have problems in the workplace and find it difficult to function. 

Treatment is available

Certain medications and cognitive-behaviour therapy (CBT) can be effective in treating social phobia. CBT techniques include expo-sure therapy, which helps people gradually become comfortable with frightening situations, and anxiety management training, which teaches techniques such as relaxation and deep breathing in order to control anxiety. 

People with specific phobia can benefit from various medication and self-help therapies. A combination of behavioral and cognitive psychotherapies can be designed for each individual case. The techniques used include deconditioning, which helps a person become less anxious when confronted with an anxiety-producing situation. 

Medication, in conjunction with psychosocial treatment, is often used to treat panic disorder. People are encouraged to understand their panic episodes, to explore exactly what triggers panic and to develop styles of coping with the sensations. Exercises in relaxation therapy give them tools to cope with rising tension or an anxiety-provoking situation. 

What can I do? 

Phobia and panic disorder are serious conditions, and can be as disruptive to family and work as a physical ailment. But it is important to understand that they are treatable. Friends can be supportive by learning all they can about the disorder, thereby increasing their sensitivity to the needs and concerns of an individual with phobia or panic disorder. Numerous support groups and community health associations exist to provide help to people affected by anxiety disorders. 

Would you like more information?

For further information about specific phobia, social phobia or panic disorder, contact a community organization like the Canadian Mental Health Association to find out about support and resources available in your community. 


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