Prevention

There is no way to prevent a phobia from starting. However, if you already have a phobia or any other anxiety disorder, you may be able to reduce your anxiety levels by avoiding stimulants, such as caffeine (in coffee, tea and cola drinks), chocolate and nicotine (in tobacco).

Treatment

Treatment usually includes some combination of psychotherapy and medication:

• Specific phobia - Cognitive-behavioral therapy can help, especially a procedure called desensitization therapy, also called exposure therapy. This technique involves gradually increasing your exposure to the thing you fear, at your own pace, under controlled circumstances. As you are exposed to the object, you are taught to master your fear through relaxation, breathing control or other anxiety-reducing strategies. For short-term treatment of phobias, your doctor may prescribe an antianxiety medication, such as lorazepam (Ativan). If the phobia is confronted only occasionally, as in a fear of flying, the use of medication can be limited.

• Social phobia - If your social phobia centers on one particular performance (for example, giving a lecture or playing in a concert), your doctor may prescribe a medication called a beta-blocker such as propranolol (Inderal). This medicine can be taken just prior to the performance. It dampens the physical effects of anxiety (pounding heart or trembling fingers), but usually does not affect the mental sharpness needed for speaking or the physical dexterity needed for playing an instrument. For more generalized or long-term forms of social phobia, your doctor may prescribe an antidepressant, usually an SSRI (selective serotonin reuptake inhibitor) such as sertraline (Zoloft), paroxetine (Paxil) or fluoxetine (Prozac). If an SSRI is not effective, your doctor may prescribe an alternative antidepressant or antianxiety medication. Cognitive-behavioral therapy also works well for many people with social phobia, in both individual and group settings.

• Agoraphobia - The treatment for this disorder is similar to the treatment for panic disorder. Drug treatment includes antianxiety medications, such as clonazepam (Klonopin), diazepam (Valium) and lorazepam (Ativan); SSRI antidepressants or older antidepressants, such as clomipramine (Anafranil) and imipramine (Tofranil). Psychotherapy is also helpful, particularly cognitive-behavioral therapy.