Phobic Anxiety disorders are one type of anxiety disorders that people should know about. When you consider this type of disorder, it has three characteristic features, the first of which is fear disproportionate to the subjective risk of the situation. The second one is severe anxiety along with anticipatory anxiety. The third one is avoidance of circumstances that provoke anxiety.A professional psychology consultant will tell you that there are three types of phobias namely specific/simple phobia, social phobia and agoraphobia. Explaining each of these further for you specific phobia is the inappropriate anxiousness in the presence of a particular object or situation, or when anticipating this encounter and has the urge to avoid the object or situation.
Example : blood, excretion, needles and injections, animals like spiders, snakes and butterflies or situations like doing to the dentist, darkness, elevators and closed spaces, heights, flying or airplanes. Management includes CBT and Medication with Graded exposure being the treatment of choice.When observing a patient you should know that social phobia is the inappropriate anxiety in social situations where the main worry is about being observed judgmentally by people which leads to the need for escape or evasion. It comes up in situations where they have to intermingle with people and they find it difficult to do things like walking, writing, eating and drinking. Blushing, quivering, stammering and perspiring are some of the common signs. Management is usually graded exposure therapy with social phobic groups or individually. Minor doses of anxiolytics and beta blockers may sometimes be used.A medico legal assessments and management should include the following. Make a diagnosis and identify any co morbid depressive disorder, decide on a clear plan, psychoeducation, problem solving and relaxation methods, management of hyperventilation, CBT and self-help books and computer courses, antidepressants.You should also know that agoraphobia is the anxiety which arises in circumstances which are unaccustomed and from which the patient cannot escape, or in which they recognize they have little control leading to avoidance of the situation. There may be numerous phobic circumstances. And there can be agoraphobia with and without panic outbreaks.
Management is again with CBT either in groups or individually with the use of antidepressants and anxiolytics.A panic attack is a period of extreme fear characterized by a group of symptoms like palpitations, tachycardia, sweating and flushing, trembling, dyspnea, nausea and vomiting and fears of an imminent medical emergency which develop quickly, lasts a few minutes, during which the patient fears that some disaster will occur. The individual is normal in-between these attacks. When there is greater than 4 attacks per month we call it a panic disorder.