Phobias Overview

Phobias are mental health conditions which cause feelings of overwhelming worry or fear in a person, triggered by something such as going outside (agoraphobia), spiders (arachnophobia), or water (hydrophobia). People can experience these symptoms mildly up to severely, as well as alongside other anxiety-type mental health conditions like OCD. Phobias are thought to affect up to 10 million people in the UK.

What are the signs and symptoms and types of phobias?

Phobias consist of more than a fear or worry of a particular thing or situation – the fear is disproportionate to danger actually presented by the source of the fear, such as a spider.

Some examples of signs of phobias in an individual may include:

  • Restlessness
  • Feeling worried
  • Trouble concentrating
  • Difficulty sleeping
  • Panic attacks
  • Dizziness
  • Under/overeating
  • Irritability
  • Nausea
  • Sweating

Depending on the phobia source, some people may find that they rarely experience symptoms, whereas a day-to-day scenario such as going outside as a trigger will cause symptoms more frequently and/or severely in the person with the phobia.

There are two broad categories of phobia – complex and specific phobias.

Specific phobias are usually more easily managed and start out earlier in life, before diminishing in later life. These include animal phobias, fear of heights, deep water, bodily phobias such as vomiting or having injections and sexual phobias, such as the fear of getting a sexually transmitted disease (STI).

Agoraphobia and social phobia are more debilitating. More than feeling anxious in public or around people, these phobias are linked to the inability to escape from a social/public situation should their anxiety result in a panic attack. These phobias can stop people performing day-to-day tasks such as going shopping or seeing friends.

How do phobias get diagnosed and treated?

A person whose life is severely impacted by their phobia can go to a GP and receive a referral to therapy or another form of mental health service. Cognitive behavioural therapy can help someone with a phobia challenge their thought processes and how these dictate their behaviours – i.e. not spending time in public.

Many courses of phobia therapy involve desensitisation, or, gradual exposure to the source of the phobia.

Medication can be used to manage the anxiety-related symptoms, such as antidepressants or beta-blockers.

There is no way to avoid developing phobias and while the causes are not completely understood, it is thought that they may be in part learned behaviours (from family members, etc.) or genetic (some people are naturally more anxious than others).

There are a few ways to determine whether an employee with phobias might require reasonable adjustments:

The employee may or may not wish to disclose their phobias, as many people feel shame regarding their phobias. Regardless, questions regarding the nature of any additional needs and what extra support may be required can be broached sensitively. For example:

  • Have they required adjustments in the past? It is important that an employer does not jump to conclusions or assumptions based on their existing understanding of phobias, but instead keep up a dialogue with the employee, which in itself may help alleviate some anxiety symptoms.

What reasonable adjustments are possible for employees with phobias?

Employers have a legal duty to make reasonable adjustments for employees with phobias if they know, are aware of, or could ‘reasonably be expected to know’ that the employee has a phobia which has a long-term, adverse impact on their ability to function day-to-day. Most employees will tell their employer what reasonable adjustments they need. They often involve simple changes in the way an employer might usually do things.

If the employee does not disclose a health issue or disability which may affect their performance upfront, an employer should broach the subject sensitively if they suspect that there may be a disability behind the employee’s reduced performance. Reasonable adjustments can then be made in accordance with the employee’s needs, including, in the case of phobias:

  • Extra time to complete tasks to accommodate difficulties the person may have juggling work tasks and intrusive or anxious thoughts relating to their phobia.
  • A structured working day to allow the employee to concentrate more easily and to become less distracted by their phobias.
  • Providing regular, sensitive feedback and reassurance, so that an employee with phobias who may come across particularly vulnerable to criticism, or anxious in a work environment, can stay abreast of what they are doing well, or what they could improve on.
  • Time off to attend appointments, so that the person can work on recovery while staying in work.
  • Flexibility regarding working from home if the employee struggles with their phobias when in public or around other people, which may affect their commute or working in person alongside colleagues.
  • Raising awareness so that colleagues understand the employee’s phobias and can help ensure the employee feels comfortable at work. This might involve learning more about the condition to gain a better understanding of what the employee might be facing day-to-day.

Phobias Signposting

Triumph over Phobia UK charity working to help people living with phobias and OCD to manage their conditions through group Skype meetings and dialogue with other people in the same situation. The charity works with clinical experts to provide the best possible advice and support (01225 571740).

Anxiety UKcharity giving advice to people living with stress, phobias, phobias and depression on the basis of clinical expertise (03444 775 774).

No Panicorganisation offering advice, support and recovery tools for people living with mental health conditions such as OCD and phobias, particularly focusing on helping people cope with their condition through non-medical means (0844 967 4848).

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