Paralyzed by Fear on Friday the 13th

Phobias like fear of Friday the 13th require treatment if they interfere with your life

/ Author:  / Reviewed by: Joseph V. Madia, MD

It's Friday the 13th! Do you avoid ladders and black cats with a smirk and a wink? Or do you cower at home, truly worried about what might transpire on this superstitiously unlucky day?

The fear of Friday the 13th, known as paraskevidekatriaphobia, is very real for some people, but it's not a fear in the true sense of the word.

While fear is a response to actually perceivable danger, fear of Friday the 13th is a phobia, a type of anxiety disorder.

Interestingly, the fear of something like a specific day can become a self-fulfilling prophecy. A study published in BMJ in 1993 found that hospital admissions resulting from traffic accidents in England increased by as much as 52 percent during one Friday the 13th compared to the previous week's Friday.

But these numbers could have been skewed for other reasons. Researchers could have been more sensitive to recording accidents on Friday the 13th compared to another day, or an underlying anxiety about the date may have been distracting some people or subconsciously affecting the way they drove.

While many people might try to push aside their phobias, they can present a genuine threat to a person's mental health and well-being.

According to the American Psychiatric Institute for Research and Education, phobias are the most common psychiatric disorders among women of all ages. Among men over age 25, they are the second most common type of mental health disorders.

Often, facts about phobias are relegated to bits of trivia, but mental health professionals know to take these anxiety disorders seriously. Finding treatment options for a debilitating phobia may substantially improve a person's quality of life.

A severe phobia can lead to panic attacks when a person is faced with a certain situation that would seem unthreatening to others, whether it's a spider crawling on the wall or taking an airplane flight.

The National Institute of Mental Health reports that 12.5 percent of people - more than one in every ten - will experience a "specific phobia" at some points in their lives, and nearly 9 percent experience a phobia anxiety disorder at least once a year. Specific phobia is the term given to the group of different phobias a person might have.

Many people may experience the anxiety associated with a phobia without consciously realizing that it's an irrational figment of their imagination that's turning their insides cold.

Have you ever suddenly felt absolutely certain that the plane you were boarding was going to crash? Or that you will uncontrollably leap or fall from from the balcony of a skyscraper even if you don't go near the windows?

The occasional preoccupation with a phobia is not cause for alarm in and of itself. But if the phobia gains control of your life and prevents you from being able to work, socialize or otherwise function, then it's important to seek help.

TYPES OF PHOBIAS

In mental health, phobias tend to be grouped into three categories: agoraphobia, social phobia and specific phobia.

Agoraphobia is the intense fear associated with a place or situation where escape might be difficult, including social situations. It's different from claustrophobia, however, because it can - and often does - occur in open areas. Severe cases of agoraphobia can prevent a person from being in large crowds, traveling in a vehicle or airplane or even being able to leave their own home.

Although only about 0.8 percent of the U.S. population experience agoraphobia, about 40 percent of these cases are severe.

Those afflicted with social phobia, which is about 7 percent of the U.S. population each year, feel as though they are constantly being watched or judged by others. It is different from paranoia, though the two may occur together.

A person may feel as though everything he does looks foolish to others and therefore he feels ashamed or embarrassed by what he does.Social phobia can be among the most immobilizing disorders because it can interfere with work or school and prevent people from forming healthy relationships with others.

A specific phobia includes paraskevidekatriaphobia as well as phobias of other precise objects or situations. Some are broad categories, such as fear of the dark (nyctophobia) or Indiana Jones' fear of all snakes (ophidiophobia).

Others are extremely specific and unusual, such as nyctohylophobia (fear of dark wooded areas at night), pteronophobia (fear of being tickled by feathers), automatonophobia (fear of ventriloquist's dummies, animatronic creatures, wax statues, etc.) or arachibutyrophobia (fear of peanut butter sticking to the roof of the mouth).

Many specific phobias begin as childhood fears that follow people into adulthood, such as selachophobia (fear of sharks), spectrophobia (fear of ghosts) or cynophobia (fear of dogs).

While some seem illogical, like the fear of falling in love (philophobia) or a fear of heaven (uranophobia), others, such as the fear of throwing things out (disposophobia), can develop into more serious psychiatric conditions like hoarding.

Some of the most common phobias are already familiar to many people:

  • Arachnophobia - fear of spiders.
  • Aerophobia - fear of flying
  • Hydrophobia - fear of water
  • Claustrophobia - fear of being trapped in a small, confined area
  • Acrophobia - fear of heights
  • Brontophobia - fear of thunderstorms.
  • Necrophobia -fear of death or dead things

Dealing with medical and healthcare issues can sometimes bring out phobias that a person didn't know they had:

  • Emetophobia - fear of vomit
  • Carcinophobia - fear of cancer
  • Obesophobia - fear of gaining weight
  • Agliophobia - fear of pain
  • Parturiphobia - fear of childbirth
  • Pathophobia - fear of disease
  • Anginophobia- fear of chest pain or choking


TREATMENT OPTIONS

Among those who have a phobia, about 22 percent are severe, according to the National Institute of Mental Health, and the average age when a phobia begins is seven years old. Yet only about a third of those who have a serious phobia are receiving treatment each year.

While the object or situation that unsettles a person might vary, the treatment options are similar or identical regardless of the actual phobia. The two primary ways to treat phobias - often used together - are medications and behavior therapy.

“Treatment for phobias can involve behavioral therapy, which entails systematic de-sensitization," said Dr. Britta Ostermeyer, an associate professor of psychiatry and family community medicine at Baylor College of Medicine and chief of psychiatry at Ben Taub General Hospital. "In therapy, patients will gradually confront their fear, until their anxiety is gone."

The goal of this kind of desensitization, also called exposure therapy, is to gradually change a person's response to an object or situation that they fear.

While this sounds like a scary process itself, professionals will work with someone to very slowly confront these fears. A person with a fear of flying, for example, may move from talking about flying to looking at photos of airplanes to visiting an airport to eventually sitting in a model or real airplane - all before actually taking a flight.

A person with a fear of spiders might first draw their own pictures of spiders, then look at images of cartoon spiders, then view photos of real spiders, then hold a spider toy and then finally look at a real but dead spider in person.

A more comprehensive form of therapy is cognitive behavior therapy, in which a person works with their mental health professional to learn new ways to perceive and cope with their fears.

A hallmark of cognitive behavior therapy, according to the Mayo Clinic's information on treating phobias, is to empower people to have more control over their thoughts and feelings after they have learned how their beliefs impact their lives.

The Mayo Clinic describes three types of medications that can be used to treat phobias. Beta blockers block the effects of adrenaline in a person's body, such as a pounding heart, sweaty palms, a quivering voice, shaking limbs and increased blood pressure.

Beta blockers may be best used for temporary situations, such as an airplane flight, a boat ride or stage fright.

Antidepressants and anti-anxiety medications called selective serotonin reuptake inhibitors, or SSRIs, can also be prescribed to treat phobias. These are best for more persistent or consistent phobias, such as agoraphobia or social phobias.

Common SSRIs include Prozac (fluoxetine), Paxil (paroxetine), Zoloft (sertraline), Lexapro (escitalopram) and Celexa (citalopram). They act on the levels of serotonin in a person's brain. Serotonin is a neurotransmitter that influences a person's mood and feelings of well-being.

SSRIs can cause side effects ranging from insomnia and restlessness to headache, diarrhea or sexual problems, sometimes leading people to look at other antidepressant options like monoamine oxidase inhibitors, or MAOIs.

Finally, a doctor may prescribe someone a sedative to deal with a severe panic attack resulting from a phobia or for recurring responses to phobias. Common sedatives include Valium (diazepam), Ativan (lorazepam), Xanax or Niravam (alprazolam) and Librium (chlordiazepoxide).

However, sedatives can become addictive and should be used short-term under the care of a doctor who provides specific instructions on how to take the medication.

Regardless of how a person and his or her mental health professional decide to treat a phobia, these anxiety disorders are worth taking seriously. Any severe fear that prevents a person from working, attending school, socializing with others, going through a daily routine or simply enjoying life should be treated.

Meanwhile, if you want to carry an extra rabbit's foot this Friday the 13th, it's unlikely to hurt anyone. But if your severe leporiphobia, or fear of rabbits, just stopped your heart cold when you read that sentence, you might consider what phobias are lurking in your brain.

Review Date: 
April 12, 2012