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You don't have to be afraid anymore

Dr. Gail Saltz talks about new treatments to beat your worst fears

Today show
Updated: 11:24 a.m. ET April 16, 2004


If you suffer from fear of flying, fear of open spaces or even bugs there may help for you. Doctor's have discovered new ways to cure your fear and put your mind at ease. "Today" contributor and psychiatrist Dr. Gail Saltz talks about new treatment options to beat the most common phobias.

What are phobias?
There are numerous categories of phobias, but the three most common are simple or common phobia, social phobia and agoraphobia.

Simple or Common Phobia
A simple or common phobia is an unreasonable fear of animals, insects, and natural elements like storms or water, heights and closed spaces. Even germs, odors or illnesses fall into this category.

If you have a simple phobia, it may have began when you faced a risk that provoked anxiety in your life. For example, you were thrown in a pool and had to learn how to swim. It's understandable you might develop a fear of water, but if you continue to avoid even shallow water, your anxiety will become excessive. Simple phobias, especially animal phobias, are very common with children, but they occur at all ages.

Social Phobia
If you have a fear of contact with crowds, or fear of intimate social situations then you have a social phobia. People with social phobia have no confidence with strangers because they fear they're being judged.

Agoraphobia
Agoraphobia is generally defined as fear of open or crowded spaces. Agoraphobics experience anxiety, panic and depression.

Most phobias start in early childhood, developing from a bad or unpleasant experience which caused or involved fear. That experience is stored in the person's memory, and fear is brought on whenever that unpleasant memory is triggered. For some people, the onset of phobias can be triggered by a stressful life event like death, trauma like 9/11, or simply getting hurt or injured by an object of situation.

Phobia Symptoms
Most people acknowledge they have fears that are out of control, unreasonable or unexplainable but that doesn't mean they're less anxious because they recognize it. If their phobia is not treated, it can be debilitating and interfere with their daily life, and result in the following symptoms.

Symptoms of common phobias include hyperventilation, sweating, feeling faint, fast heart beat, flashes, anxiety. In severe cases, these symptoms can occur when the person is thinking about, or standing close to the feared object.

Symptoms of social phobias include fear of saying something to embarrass yourself in front of other people. You'll avoid speaking to people because you're afraid of being judged. In severe cases, some people resort to drinking to make their fear go away. Others will not come in contact with the opposite sex because they fear being embarrassed.

Symptoms of agoraphobia are panic attacks and fear going anywhere or doing anything. They'll avoid going anywhere near their fear.

Other debilitating symptoms of phobias include difficulty sleeping, loss of appetite, inability to concentrate, constant fatigue, lack of pleasure, and feelings of worthlessness.

Treatment Options for Phobias

Psychotherapy
Traditional counseling or cognitive behavioral therapy

A therapist will try to understand where the phobia comes from, whether it's a traumatic event or an incident during their developmental years. This form of therapy teaches patients to understand their thoughts which contribute to their symptoms. The objective here is to change the patient's thoughts about their fear so their symptoms are less likely to occur.

Flooding and exposure
Focuses more on behavior vs. thoughts

This involves confronting the fear and trying to stop it -- meaning they're exposed to the feared object and taught to tolerate their anxieties, and conquer their fear. For example, if a person is fearful of birds, the therapist would show photos of birds, then move on to bird feathers to touch. Lastly the patient will go to the park and be taught to feed the birds. Some therapists will use anti-anxiety drugs in conjunction with flooding and exposure treatment.

Virtual reality
A new way of stimulating the situation your phobic about

This new technology is administered by a psychotherapist who operates the computer software while providing counseling. Each virtual reality session lasts about an hour, and runs anywhere from 8 to 10 sessions. The technology works this way: The patient is seated comfortably next to a computer. They'll put on a headset which provides 3-D animation and sound, and experience what they're afraid of. For example, if you're afraid of flying, you'll see animation of what it's like to be in the passenger seat. You'll also be able to look out a window and see the plane moving on the runway, taking off, flying and landing.

One of the leaders in virtual reality treatment is Dr. Joanne Difede at Weill Cornell Medical College's Department of Psychiatry in NYC. Dr. Difede has been using virtual reality on her patients who suffer from anxiety and trauma stress due to 9/11, and other simple phobias like fear of flying, heights and closed spaces. For more information on virtual reality, visit virtuallybetter.com or patss.com.

New Medication
Medications are rarely used to treat phobias unless it's an extreme case. However Dr. Michael Davis at Emory University has discovered a drug called D-cycloserine used to "dramatically reduce" a persons fear. He conducted a study on patients who were afraid of heights. He put them on the pill for several days, then exposed them to their fear by placing them in simulated elevators that went up and down. Those who took the pill learned to overcome their fear and become less anxious of heights. The drug should not be used on its own, but in conjunction with psychotherapy session. This will help speed up the process of learning and forming memories, helping the person get over their fear.
 
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