What Treatments for Phobias Work Best?

Medication

The medical model places emphasis on the genetic and brain chemistry components of phobias. Medications are prescribed to reduce the symptoms associated with phobias, such as anxiety.

Studies show that in phobias, cognitive behavioral approaches tend to be more effective long-term than medication approaches. The latter, however, can help render your symptoms less impactful and allow the space and time for therapy to work.

Below are some examples of medications that a doctor may prescribe to help treat a phobia.

Antidepressants

There are two classes of antidepressant medications that are sometimes used to treat phobias: selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs). While anti-depressants are most commonly associated with the treatment of mood disorders like depression, they also have anti-anxiety effects that can potentially be helpful in phobias.

SSRIs like including Celexa (citalopram), Zoloft (sertraline), Prozac (fluoxetine), and Paxil (paroxetine) are often used for anxiety disorders.

Potential side effects include:

• Headaches
• Dry mouth
• Drowsiness
• Sexual dysfunction
• Diminished sex drive
• Weight gain

Benzodiazepines

Benzodiazepines, including Valium (diazepam), Xanax (alprazolam), Klonopin (clonazepam), and Ativan (lorazepam), are generally used for the short-term acute treatment of anxiety associated with phobias.

Common side effects include:

• Drowsiness
• Cognitive issues
• Impaired coordination

Beta Blockers

Beta blockers, including Tenormin (atenolol) and Inderal LA (propranolol), are sometimes prescribed as a short-term treatment to help control trembling, sweating, and other physical symptoms of phobia-related anxiety.

While medication is helpful for some, others find the benefits aren't worth the side effects. If you're experiencing unpleasant side effects of your medication, it's always best to consult your doctor prior to stopping.

In most states, psychologists are not permitted to prescribe medications, although this is slowly changing. However, no mental health practitioner with less than a doctoral degree is permitted to prescribe medication in any state.

Therapy

Many professionals believe that the most important causes of phobias are environmental triggers and learned behaviors. They argue that a phobia is ultimately a learned response to a stimulus. By “unlearning” the response, the phobia can be cured. This model favors psychotherapy as a preferred treatment.

Many people who live with phobias are best treated with a combination of medication and psychotherapy.

Cognitive Behavorial Therapy

Cognitive behavioral therapy (CBT) is often the first-line of treatment for phobia. It can help you overcome the negative automatic thoughts that lead to phobic reactions, teaching you to gradually change the way you think to help you overcome your fear.

Exposure Therapy

Like the name implies, exposure therapy gradually exposes you to the situations you fear with the goal of desensitizing and reducing anxiety. Exposure therapy is often part of a cognitive behavioral treatment program, but can also be incorporated into your daily life.

Before the exposure process begins, people first learn relaxation techniques to use to stay calm when facing their fears, including deep breathing, progressive muscle relaxation, visualization, and guided imagery. The next step is to practice using these relaxation strategies gradually and progressively facing the feared object or situation. 

For example, if you have a phobia of public speaking, your therapist may help you gradually face difficult public speaking scenarios to overcome your fears perhaps starting with reading a passage aloud to a friend and ending with giving a public presentation.

Alternative Treatments

Increasingly, mental health professionals and patients are turning to alternative treatments to augment traditional means of treating phobias, but these options are not considered first-line treatments and often come with their own set of side effects. Some alternative therapies include:

• Hypnotherapy
• Homeopathy
• Herbal remedies

Although these treatments have not undergone the rigorous, controlled testing necessary for endorsement by the mainstream medical community, many people find symptom relief through alternative channels. Of course, any alternative treatment should only be undertaken with guidance from a mental health professional.