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The Difference Between Fear and Phobia
“Fear is the emotional response to real or perceived imminent threat, whereas anxiety is anticipation of future threat,” the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) says. “Anxiety disorders differ from developmentally normative fear or anxiety by being excessive or persisting beyond developmentally appropriate periods.” Anxiety disorders are persistent, typically lasting six months or longer.
Phobias are anxiety disorders involving fear or anxiety that is excessive or out of proportion to the object or situation. Clinicians, with an MA in Counseling, will assess whether a client’s fear or anxiety is normal or excessive by using factors specific to cultural norms.
An old elevator or a high bridge may spark feelings of fear or anxiety. In these situations, some people are able to manage discomfort, control their fears and carry out daily activities without too much disruption. But a phobia produces a strong reaction of fear or anxiety. People with a phobia work hard to avoid certain situations, objects or places, and they may experience fear or anxiety even when the situation, object or place is not imminent.
Clinical Symptoms of Phobias
The DSM-5 names three anxiety disorders that contain the word phobia.
- Individuals with specific phobia are fearful or anxious about or avoidant of specific objects or situations.
- In social anxiety disorder (social phobia), the individual is fearful or anxious about or avoidant of social interactions and situations that involve the possibility of being scrutinized.
- Individuals with agoraphobia are fearful and anxious about two or more of the following: using public transportation; being in open spaces; being in enclosed places; standing in line or being in a crowd; or being outside of the home alone in other situations.
Specific phobia is the most common of the three phobia-related anxiety disorders; in fact, it is the most common type of anxiety disorder in the United States, affecting nearly 20 million adults, or 7 to 9 percent of the population. The median age of onset is between 7 and 11 years. Individuals typically have multiple specific phobias. The average individual with specific phobia fears three objects or situations.
Diagnostic Criteria for Specific Phobia
- Marked fear or anxiety about a specific object or situation.
- The phobic object or situation almost always provokes immediate fear or anxiety.
- The phobic object or situation is actively avoided or endured with intense fear or anxiety.
- The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and to the sociocultural context.
- The fear, anxiety or avoidance is persistent, typically lasting for six months or more.
- The fear, anxiety or avoidance causes clinically significant distress or impairment in social, occupational or other important areas of functioning.
- The disturbance is not better explained by the symptoms of another mental disorder.
Categories for Specific Phobia
- Animal (e.g., spiders, insects, dogs)
- Natural environment (e.g., heights, storms, water)
- Blood-injection-injury (e.g., needles, invasive medical procedures)
- Situational (e.g., airplanes, elevators, enclosed places)
- Other (e.g., situations that may lead to choking or vomiting; in children, e.g., loud sounds or costumed characters)
