Coping with phobias

Treatment and self-care for phobias is usually focused on helping you overcome your phobia. Bit by bit.

It can be very hard to believe that something that makes you feel so afraid won't harm you. Or that your phobia can be overcome. Particularly if your symptoms are very intense. Good treatment and support can help you challenge these beliefs. And make it easier to overcome or manage your phobia.  

Through using self-help books, to having professional CBT from my local Community Mental Health Team, I slowly learned how to change my negative thoughts to more realistic ones. And to finally overcome some of my deeply entrenched phobias.

Treatment for phobias

If you need support to overcome your phobia, there is treatment available.

A GP can assess you and explain what treatments there are. Or you may be able to refer yourself for some NHS services, like talking therapies.

Some local Minds may be able to offer support for phobias. The local Mind finder can help you find what's available in your area.

The National Institute for Health and Care Excellence (NICE) doesn't have guidelines on how the NHS should treat specific phobias. But treatments you should be offered are usually similar to ones for other anxiety disorders.

These include:

• Guided self-help
• Talking therapies
• Medication

If you see a GP about your phobia, they should explain all your options. They should consider your views before starting any treatment.

If your phobia stops you from seeking help

You may have a phobia of something you need to do to get treatment. For example, phone calls or leaving the house. You might also have a phobia of doctors, or medical settings.

If seeking help involves the situation or object you fear, you could:

• Book a different type of appointment. Most GPs can offer appointments online, in person or over the phone, depending on what you need. Some may be able to visit you at home.
• Get someone you trust to help. You may be able to bring someone with you to your appointment. Or have them nearby if you have a phone or online appointment.
• Prepare what you want to say in advance. You might be worried about speaking to your GP. Our information on how to get help from your GP might be helpful. It includes tips on what to say. 

For more information, see our pages on seeking help for a mental health problem.

Guided self-help

Guided self-help is when you're given tips and tools to manage your phobia.

A professional will guide you through it. They might show you how to do different exercises and check in on your progress. But you will do most of the work yourself. This can include:

• Filling out a written or online workbook
• Following written instructions to do exercises
• Using online platforms to complete tasks or track your progress

Many people find guided self-help useful. But it works best when you feel motivated to do it yourself. And if you can manage doing these tasks on your own.

There are other treatments if guided self-help doesn't feel right for you. Or if you tried it and it didn't work. 

Talking therapy for phobias

Talking therapy involves talking to a professional about how you feel.

There are lots of different types. The most common types of therapy offered for phobias are cognitive behavioural therapy (CBT) and exposure therapy. Therapists might combine techniques from both. 

Cognitive behavioural therapy

Cognitive behavioural therapy (CBT) aims to explore the connections between your thoughts and your actions. And help you develop skills to manage and challenge unhelpful thought patterns.

You'll normally be given exercises or homework to do between sessions. You might follow a workbook. Or complete tasks online.

For phobias, it's recommended that you have CBT weekly over 7 to 14 sessions.

For more information, see our page on CBT.

Exposure therapy

Exposure therapy means gradually exposing you to your phobia trigger.

Some people think exposure therapy means forcing you to confront your phobia right away. Or doing extreme tasks to overcome it. But this isn't what should happen. Exposure therapy should be done slowly. And in a safe and controlled way.

For example, if you have a phobia of the dentist, in exposure therapy you might:

• Read about the dentist
• Look at pictures of a dentist's chair
• Sit in the waiting room
• Talk to the dentist
• Finally sit in the dentist's chair

Through repeated exposure, many people feel less anxious. And more in control of their phobia.  

It's important that you fully understand the treatment and feel comfortable with your therapist. You will agree each of the steps in advance. The treatment will usually make you feel anxious and distressed at times. But you should still feel in control and supported. You should be able to stop at any time if you need to.

Exposure therapy will usually involve some elements of CBT. It might involve doing things digitally, such as looking at things online or using virtual reality.

Medication for phobias

Your GP might offer you some medication if your phobia symptoms are very intense. And if they stop you from being able to do other types of treatment.

Medication shouldn't be the only thing you're offered. This is because it doesn't treat the cause of your phobia. Just how it makes you feel.

Some medications are only offered for certain types of phobia, such as social anxiety. 

Antidepressants

Your GP might offer you antidepressants to help with symptoms of anxiety.

Usually this will be a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI). But they might offer other types as well. Such as:

• Clomipramine. A tricyclic antidepressant sometimes used for phobias and Obsessive-compulsive disorder (OCD).
• Venlafaxine. A serotonin and noradrenaline reuptake inhibitor (SNRI) sometimes used for social anxiety.
• Moclobemide. A monoamine oxidase inhibitor (MAOI) sometimes used for social anxiety. 

All antidepressants have side effects. And everyone will react to them differently. You can find out more about the different types and side effects on our antidepressants page.

Beta blockers

A beta blocker called propranolol is sometimes prescribed if your anxiety symptoms cause:

• A very fast or irregular heartbeat
• Shaking, this is sometimes called a ‘tremor’ 

Beta blockers are a medication that slows down your heart. They aren't a psychiatric drug.

The NHS has more information on beta blockers.

Courses to overcome specific phobias

Some companies and organisations run courses to help people overcome specific phobias. For example:

• Some airline companies run courses to help with fear of flying
• Some zoos have courses to help people overcome fears of certain animals or insects

These courses can be expensive. They're not available from the NHS. You can talk to your doctor if you're unsure whether a course would be helpful. 

Self-care for phobias

There are some things you can try on your own to address your phobia. They may help reduce the impact it has on your life. Some people find these ideas useful, but they may not be for everyone. Only try what you feel comfortable with.

The symptoms of your phobia can feel very intense. This might make you do things like avoid your phobia trigger. Or always have someone with you to manage it. These things are called ‘safety behaviours’. And while they can feel like they're helping, they can make your phobia worse.

That's why self-care recommendations for phobias focus on helping you overcome your phobia. So it stops impacting your life as much. 

Talk to someone you trust

Talking to someone you trust about your phobia can help. Having someone listen to you and show they care can help in itself.

If you find it hard to talk, try writing things down. You could try writing a letter to help you set out your thoughts more clearly. Or sending a text.

It might be useful to show them our page on how to help someone who has a phobia.

Learn to manage panic and anxiety

Learning to manage the panic and anxiety you feel from your phobia can be really hard. But it can make you feel more in control.

Relaxation techniques can help. There are many  types, including meditation, breathing control and stretching. See our page on relaxation for more information.

Our information on how to manage anxiety and worry might also be helpful. It includes information on managing panic attacks, if you experience these. 

If your phobia makes you faint, relaxation techniques probably won't help 

This is because relaxation slows down your heart rate. You need your heart rate to speed up to avoid fainting. 

Instead, you might find it helps to practise ‘applied tension’ techniques. This is when you tense the muscles in your body to increase blood pressure. 

To try it, you can:

• Sit somewhere comfortable
• Tense your arm and leg muscles
• Hold them like this for 10-15 seconds
• Release the tension
• Wait 30 seconds
• Tense your arms and legs again for 10-15 seconds
• Repeat this at least 5 times

It can help if you practise it. Try it a few times a day in the week before you need to encounter something that normally makes you faint. 

Be careful when tensing any part of your body where you have health problems. And if you get headaches after doing applied tension, you should stop.  

Build up tolerance

Building up a tolerance to our phobia trigger can help us overcome it.

You can build up tolerance bit by bit, and over a period of time. This is called ‘graded exposure’. It can help to:

• Make a list of things that trigger your phobia. And how they make you feel.
• Make a list of small tasks that slowly build into bigger tasks. These are things to help you confront your phobia trigger. For example, if you have phobia of snakes, the first task could be to look at a picture of a cartoon snake. Then a real snake. Then maybe a video of a snake.
• When doing a task, try to focus on what's happening. Your body might be reacting in a way that tells you there is danger. You might start to imagine something bad happening. But if you remind yourself that you're safe, this can help challenge the beliefs behind your phobia.
• Repeat the task until doing it doesn't make you feel anxious. Then move onto the next task.
• Be kind to yourself during the process. And reward yourself as you go.

Over time, many people find this approach helpful in overcoming their phobia.

Some NHS trusts have workbooks you can download to help you do graded exposure. You can find these online, or ask your GP. 

Challenge your thoughts

We might think or believe certain things about our phobia and how it will impact us. You might think:

• It's going to hurt you
• You won't be able to handle being around it
• That the worst-case scenario will always happen
• That you can predict exactly what will happen when you encounter it. And that it will be very bad

It can help to challenge these thoughts. You can ask yourself things like:

• Is there any evidence against this thought?
• Am I thinking of the most likely scenario? Or just the worst case?
• Can I look at the situation in a different way?
• What would I tell a friend who had similar thoughts?

You might find it helps to write down the answers to these questions. Over time, challenging your thoughts can help you create new beliefs about your phobia. And make it feel less overwhelming. 

Always remember that phobias are not life threatening and you are bigger than your phobias. A phobia is only as big as we make it and only as small as we make it, and it can be beaten.

Use self-help resources

Some people use self-help books or online programmes to help cope with phobias. These are often based on cognitive behavioural therapy (CBT) techniques. They aim to help you challenge your thoughts about your phobia. And build up steps to overcome it.

Self-help resources include:

• Books. Reading Well has a list of books recommended by experts and people with lived experience.
• NHS resources. Some NHS trusts have guides and workbooks to help people overcome phobias. Some of these are available online. Or you can ask your GP.
• Online programmes and resources. Some self-help programmes are available online. Your GP might be able to give you free access to an approved online programme. Or you may be able to find some guides for free. It can be hard to know if online guides are safe and reliable. Our information on looking after your mental health online might be helpful.

Try peer support groups

In peer support, you'll share experiences with others facing similar challenges. It can feel comforting to know that you're not alone. And share tips for coping and overcoming phobias.

Our pages on peer support groups for mental health have more information.

Some peer support groups meet in person. But there's also peer support online. This can be helpful if your phobia makes it difficult to go outside. Or speak to people in person.

Mind's online community Side by Side offers peer support.

No More Panic has online forums for people with phobias.

Our looking after your mental health online information has tips on how to use online communities safely. 

Useful contacts for phobias

Other organisations for phobia support