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Ordinary Fear or Phobia?
What to do if a fear gets out of hand
Snake charmer
Orfelina Santana of Bethlehem triumphantly holds a python after having exposure therapy to overcome her snake phobia. Before, even pictures of snakes left her paralyzed with fear, and gardening was out of the question. Click here for her full story.
Everyone feels nervous or anxious sometimes. A big test, a visit to the doctor, a project due at work all can boost your heart rate, make your palms sweat and get your stomach churning.
Most of us plunge ahead anyway and get the job done. But for about 12 percent of people, such fears go well beyond a simple case of  nerves' to become phobias.  Lots of people are afraid of things for example, most of us fear heart surgery,  notes David Schwendeman, M.D., a psychiatrist at Lehigh Valley Hospital and Health Network.  But a phobia is a marked fear that's really obsessive or unreasonable. If they have a phobia about flying, for example, some people take medication or alcohol getting on the plane. Or they may not be able to fly at all.  People can have a persistent, immobilizing fear of almost anything, from clowns to sunlight to closets. But these are rare. The most common phobias include:
Fear of animals and insects (snakes, rats, spiders)
Fear of the natural environment (heights, storms, water)
Fear of blood or injury (needle injections, high-tech medical procedures, surgery)
Fear of public transportation (airplanes, bridges, tunnels)
Fear of social situations (public speaking, stage fright)
No one knows exactly what triggers phobias. Are they learned or inherited?  Psychiatrists used to think that phobias are traced to traumatic experiences for example, you needed to be bitten by a dog to have a dog phobia,  Schwendeman says.  But we've found that many phobic people have no experience with what they fear.  Also intriguing is evidence that phobias tend to run in families and are more common in women. Most show up suddenly in adolescence or adulthood and are more persistent than childhood phobias (like fear of the dark), which often disappear with time. Also, adult phobias often coexist with other mental problems, such as depression, alcohol abuse and anxiety disorders.  We now believe there's a biochemical component to phobias that may be genetically transmitted,  Schwendeman says.
Phobias don't usually disappear by themselves, but not all require professional help. Some fears relate to objects or situations that aren't likely to show up in regular life, like dragons or asteroids. Others are fears that people can work past on their own. For example, if you shake at the thought of speaking publicly, you might come to love the spotlight after giving repeated presentations.  You have to look at whether a fear interferes with your day-to-day functioning or pleasures in life,  Schwendeman says.  If you have a fear of snakes but are rarely exposed to them, you may not need to address it. But if gardening is something you enjoy and your fear keeps you from going out there, you need help.  Most phobias respond well to treatment. If a specific anxiety is interfering with your family life, friendships or career, seek help from a mental health professional trained in treating phobias.
The first step is usually a complete psychiatric and medical evaluation to ensure that your symptoms aren't caused by another condition.
Complex phobias like social fears (which often result from deep feelings of inferiority) typically respond best to a combination of medications and talk therapy. An antidepressant eases your symptoms while the therapy teaches you new coping skills.
Simpler phobias like fear of heights respond well to talk therapy alone. One effective type is desensitization or exposure therapy. You're gradually exposed to what you fear until you conquer your terror.
Lehigh Valley Health Network has three Magnet-designated hospitals, including Lehigh Valley Hospital-Cedar Crest and Lehigh Valley Hospital-17 th Street, both in Allentown, Pa., and Lehigh Valley Hospital-Muhlenberg in Bethlehem, Pa.. The health network is also comprised of labs, health centers, physician practices, home care, hospice and pharmacies, and serves the Pennsylvania communities of Easton, Doylestown, Quakertown, Hazleton, Lehighton, Perkasie, Pottstown, Pottsville, Reading, Scranton, Wilkes Barre, Stroudsburg, and the Poconos and also Phillipsburg and Flemington, N.J., and western New Jersey. Lehigh Valley Health Network has also been recognized by US News &amp; World Report as one of America's Best Hospitals and by the American Nurses Credentialing Center as a Magnet hospital for excellence in nursing care. You don't have to travel to Philadelphia or New York for quality health care.