A phobia is an excessive or unreasonable fear that can be identified. It is triggered by the presence or anticipation of a specific object or situation. Children and teens with one or more phobias have consistent anxiety when exposed to the object or situation. Fear of animals, blood, heights, closed spaces or flying are common phobias. In children and teens, the fear must last at least six months to be called a phobia rather than a passing (transient) fear.

Types of phobias seen in children and teens include:

• Specific phobia. Anxiety linked to a specific object or situation. The object or situation is avoided, anticipated with fear, or endured with extreme anxiety. This causes problems with normal routines and activities.
• Panic disorder with or without agoraphobia. A period of intense fear or discomfort that is hard to expect or predict. The person feels short of breath, dizzy, lightheaded, and shaky. They feel like they are losing control, and have an increased, racing heartbeat. This is called a panic attack. Symptoms can last hours, but most often peak after 10 minutes. Agoraphobia is a fear of open spaces (such as being outside or leaving home alone) linked to one or more phobias or the fear of having a panic attack.
• Social anxiety disorder. This is also known as social phobia. It is the fear of one or more social or performance situations. These situations are normal for the person’s age and occur with others from their age group (like a school play, recital, or giving a speech or book report in front of the class).
• Selective mutism. The person is not able to speak in specific social situations, but they can and do speak in other situations.

What Causes Phobias?

Research suggests that both genetic and environmental factors impact the onset of phobias. Specific phobias have been linked to a fearful first encounter with the phobic object or situation. Sometimes children develop phobias by seeing the fearful reactions of others. Symptoms get worse when they keep avoiding the feared object or situation.

Who Is Affected by Phobias?

Anxiety disorders are common in all ages. The rate of specific phobias in children and teens is thought to range from 1% to as high as 9.2%. These often start in childhood. These are not the fears that are normal for their age. Social anxiety disorder is thought to occur in up to 1.4% of children and teens. Panic disorder can start at any age, but most often starts during the teen and young adult years.

What Are Symptoms in a Child with a Phobia?

When a child or teen is exposed to, or anticipates exposure to, a specific object or situation that leads to intense fear or anxiety, they often:

• Have an increased heart rate
• Sweat
• Tremble or shake
• Feel short of breath
• Feel like they are choking
• Have chest pain or discomfort
• Have an upset stomach
• Feel dizzy or faint
• Fear they are losing control or going crazy
• Fear dying
• Feel numb
• Have chills or hot flashes

Each child’s experience can be different.

In panic attacks, at least four of the symptoms must happen with or without a known cause.

The symptoms of a phobia may look like other physical or mental health problems. Always consult your child's doctor for a diagnosis.

How Are Phobias Diagnosed?

A child psychiatrist, psychologist or other health or mental health expert will diagnose an anxiety disorder after a full medical and psychiatric evaluation. Parents who note signs of severe anxiety in their child or teen can help by seeking an evaluation and treatment early. Early treatment can prevent future problems.

Treatment for Phobias

Treatment for phobias will be advised for your child based on:

• Age, health and history
• Extent of symptoms
• Type of phobia
• How they handle specific medicine, procedures or therapy
• What is expected for the course of the condition
• Your thoughts or preference

There is effective treatment for phobias, like there is for other anxiety disorders. Treatment should always be based on a full evaluation of the child and family.

Parents play a vital support role in any treatment process. Treatment may include:

• Individual or cognitive behavioral therapy for the child. This is focused on helping the child learn new ways to control anxiety and panic attacks.
• Family therapy
• Meeting with the child's school
• Medicine for some children

Prevention of Phobias

Preventive measures to reduce the incidence of phobias in children are not known at this time.

Early detection and intervention can:

• Reduce how severe the symptoms are
• Enhance the child's normal growth and development
• Improve the quality of life of children and teens with anxiety disorders