Mental health disorders in seniors at times remains undiagnosed due to misconception about growing older. There is the belief that two common mental health disorders – depression and anxiety – are a normal part of becoming older. However, this is untrue. Seniors are just as prone, if not more so, of developing mental health problems later in life as younger people. Phobias are one of the possible disorders that may arise in the senior years.

What is a phobia?

Fear is a natural adaptive response that is intended, it seems, to steer us clear of dangerous situations. However, when the fear appears due to irrational reasons and becomes so intense that it affects normal daily activity, it is referred to as a phobia. It is important to note that phobia is different from fear as the mental and physical reactions evoked by phobias are intense and long-lasting.

Commonly people present with phobias of heights, closed places, driving on highway, insects, reptiles and social settings. Although the person realizes that the fear is irrational, they cannot control the feelings and opt to avoid a situation. Phobias generally do not require any treatment if it is minor and not significantly impacting on daily life but severe cases may need psychotherapy and medication.

Symptoms of Phobias

Irrespective of the type of phobia, it typically produces the following reactions :

• Intense, uncontrollable anxiety when exposed to the cause of fear.
• Taking every possible action to avoid the situation that evokes fear.
• Extreme anxiety that interferes with daily activity.

Physical reactions include:

• Sweating
• Rapid heartbeat
• Difficulty breathing or shortness of breath
• Chest pain or tightness
• Trembling or shaking
• “Butterflies in the stomach”

Psychological reactions include:

• Overwhelming anxiety or panic
• Feeling an intense need to escape or avoid
• Feeling detached from the real world
• Inability to control one’s reaction to the situation
• Feeling as if you are going to die

In some cases, merely thinking about the cause makes the person anxious and even agitated. Although the symptoms can be controlled with practice and self assurance, extreme cases usually tend to get worse with time.

Causes of Phobias

The actual cause of phobias is poorly understood.

Different areas of the brain communicate with each other using certain chemicals. A problem with the release of brain chemicals impairs the functioning of distinct brain areas. This serves as the most plausible reasons for the presentation of irrational fears.

A valid genetic explanation does not seem to exist. Although phobias may be inherited but the type of fear or the cause of phobia does not seem to be same across the generation. In certain cases, it may be learned behavior by witnessing parents with phobias.

Painful past experiences, be it emotional or physical, may also develop into phobias. Naturally, one becomes conditioned to avoid those fearful situations or any other related event or object.

Treatment

The main goal of the treatment is to relieve anxiety associated with phobias. Therefore, a central component of managing phobias is the use of anxiolytics. Antidepressants like  selective serotonin reuptake inhibitors (SSRIs) regulate moods through controlling serotonin levels. SSRIs commonly prescribed for phobias include citalopram, fluoxetine and sertraline. Therefore, MAO inhibitors which have relatively less side effects are prescribed.

For relieving the associated symptoms of phobias, other medications are suggested like:

• Beta -that block the effects of adrenaline, such as increased heart rate and elevated blood pressure.
• Sedatives like benzodiazepines, reduces the intensity of anxiety. However, these drugs could be addictive and should be used with caution.
• Repeated exposure to the cause of the fear helps a person gain control over the spontaneous physical and emotional responses.

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