By David Joel Miller.
There are lots of things you might be afraid of.
Most Specific Phobias are easy to recognize when you see them. If you have one of these fears you may even wonder how this could get called a mental illness. The key, as far as diagnosing them goes, is that people with a specific phobia are far more afraid of the thing, object or situation than the real danger might objectively warrant. But if you experience this particular fear there is no such thing as being objective about it.
About twenty-eight to thirty million Americans are believed to suffer from a specific phobia. This number may be low as some people can arrange their life to avoid ever having to experience the thing that scares them. If your job never requires flying that phobia may not come up.
Adults can tell you that this or that scares them. Children usually exhibit their fear by their behavior. The child may cry, scream, have a tantrum, freeze up or be clingy. For all age groups we expect this very specific fear or phobia to have lasted for a while, customarily six months or more. This particular “thing” almost always triggers the same fear.
The list of things that get diagnosed using the DSM is lengthy and even this list is likely not totally inclusive. See Coding below for the new improved ICD-10 list.
Coding Specific Phobia.
Specific phobia used to all be coded in the DSM-4 as 300.29 now in the DSM-5 with the ICD-10 numbers the “objects” which could be things, animals or situations, all get classified. Here is the list
F40.218 Animals as in snakes, mice etc.
F40.228 Nature, storms, water, heights etc.
F40.230 Medical, blood
F40.231 Medical, injections
F40.232 Medical, other procedures
F40.248 Situations, enclosed spaces, elevators, planes etc.
F40.298 Other stuff, choking, vomiting, in children – cartoon characters or loud noises
Yes, it is possible for someone to have more than one specific phobia. If you do, the profession should list all the codes and “objects” that cause you significant anxiety. In clinician jargon, this is “stacking up” or listing multiple diagnoses. Specific phobia also often coexists with other disorders such as Depression, Anxiety, and OCD. There are rules in the DSM to tell clinicians, which disorder to diagnose, when to diagnose several disorders and when to only diagnose one.
Seventy-five percent of those with Specific Phobia are afraid of more than one thing. The majority of all those with Specific Phobia have 3 or more fears that merit diagnoses. Typically these fears get stronger the closer you get to the thing that triggers your phobia. Just thinking about it can be a trigger. For example, people who need to fly but have a specific phobia of flying will begin to get anxious in the days before the flight every time they think about having to fly.
The treatment of choice for Specific phobias is systematic desensitization.
For some with specific phobia, the symptoms can be every bit as severe as those who experience panic attacks or panic disorder. See the “What is” posts on both of these for more on these topics.
FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5, some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.
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