Phobias in Children

What are phobias in children?

A phobia is an excessive fear of a certain object or situation. It’s a fear that lasts for at least 6 months. It is a type of anxiety disorder.

These are some different types of phobias:

• Specific phobia. A child has anxiety when exposed to a certain object or situation. They stay away from the object or situation, dread it, or endure it with so much fear that it interferes with normal activities. Some common phobias are a fear of animals, insects, blood, heights, or flying.

• Panic disorder. A child feels an unpredictable, unexpected period of great fear or discomfort. They may have a panic attack. Symptoms include shortness of breath, dizziness, lightheadedness, shaking, fear of losing control, and a racing heartbeat. Symptoms can last for hours. But they often peak after 10 minutes.

• Agoraphobia. This is a fear of open spaces, such as being outside or leaving home alone. It is linked to 1 or more phobias, or the fear of having a panic attack.

• Social anxiety disorder. A child is afraid of 1 or more social or performance situations with others of the same age group. Examples are acting in a school play or giving a speech in front of the class.

• Separation anxiety disorder. A child fears being apart from an attachment figure, such as a mother or father. This condition interferes with daily activities.

• Selective mutism. A child who can't speak in some social situations.

What causes phobias in a child?

The cause of a phobia may be both genetic and environmental. A child may develop a phobia if they have a fearful first encounter with an object or situation. But experts don’t know if this exposure leads to a phobia. The following may help lead to the development of phobias in children:

• Shyness or withdrawing from unfamiliar situations or people (behavioral inhibitions) as a child

• Having an anxious or nervous temperament

• Having negative or traumatic life events early in childhood

• Mental health issues in family members

• Certain physical health conditions (such as thyroid problems or heart arrhythmias), or certain substances or medicines. The physical health problems can produce anxiety symptoms, or make them worse.

What are the symptoms of phobias in a child?

Each child may have different symptoms when exposed to a phobia. But these are the most common:

• Increased heart rate

• Sweating

• Trembling or shaking

• Shortness of breath

• Feeling of choking

• Chest pain or discomfort

• Upset stomach

• Feeling dizzy or faint

• Fear of losing control or going crazy

• Fear of dying

• Numbness

• Chills or hot flashes

A child who has at least four of these symptoms may be having a panic attack. These symptoms may seem like other health problems. Have your child see their healthcare provider for a diagnosis.

How are phobias diagnosed in a child?

It's important to first make sure any physical problems are ruled out. Then a child psychiatrist or other mental health provider will evaluate your child. If your child's history and symptoms meet specific clinical criteria for a phobia, a diagnosis will be made.

Panic disorder may be hard to diagnose. Your child may need many tests in different settings.

How are phobias treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how bad the condition is.

Phobias can be treated. Your child may need:

• Individual or cognitive behavioral therapy. A child learns new ways to control anxiety and panic attacks when or if they do happen.

• Family therapy. Parents play a vital role in any treatment process.

• School support. Meeting with the child’s school staff, including counseling or social services, can be very helpful with the early diagnosis. It's also helpful in creating a coordinated treatment plan.

• Medicines. Some children may feel better with medicines, such as those used to stop panic attacks. If medicine is prescribed, be certain to ask about side effects and the risks versus benefits of the medicine use.

How can I help prevent phobias in my child?

Experts don’t know how to prevent phobias in children and teens. But finding and treating a phobia early can ease symptoms. It can help improve your child’s normal development. And it can also improve their quality of life.

How can I help my child live with phobias?

All children have fears at some point in their life. If severe and left untreated, phobias can become a lifelong issue. So treatment is important.

Here are things you can do to help your child:

• Be supportive and nonjudgmental. Help your child stick to the treatment plan. Be willing to listen to and advocate for your child if they have concerns about how treatment is going.

• Take part in family therapy.

• Keep all appointments with your child’s healthcare provider and educational team.

• If a medicine was prescribed, give it as directed. Call the provider if you are concerned about side effects. Don't increase or decrease the dose unless you talk to the provider. Don't let your child share the medicine or use someone else's, even if it is the same medicine and dose.

• Talk with your child’s provider about other providers who will be part of your child’s care. Your child may get care from a team that may include counselors, therapists, social workers, school psychologists, school staff, and psychiatrists. The care team will depend on your child’s needs. And it will depend on how serious the anxiety disorder and phobia are.

• Tell others who need to know about your child’s phobia. Work with your child’s healthcare provider and schools to create a coordinated treatment plan.

• Reach out for support from local community services. Being in touch with other parents who have a child with an anxiety disorder and phobia may be helpful.

Key points about phobias in children

• A phobia is an excessive fear of an object or situation. It lasts for at least 6 months.

• Common phobias are a fear of animals, insects, blood, heights, or flying.

• Some things that may put a child at risk for a phobia include shyness, a traumatic event in early childhood, or mental health issues in family members.

• Symptoms include increased heart rate, sweating, shaking, a feeling of choking, and upset stomach.

• A mental health provider can diagnose a phobia.

• Treatment may include therapy and medicines.

• Following up with advice from your child's healthcare providers and educational team can help manage the phobia and improve your child's quality of life.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s healthcare provider after office hours. This is important if your child becomes ill and you have questions or need advice.