Nursing Diagnosis for Phobia

Fear. It can hold a person back from completing small tasks, succeeding in a career, or finding real comfort and happiness. It's therefore imperative to be able to diagnose severe fears, or phobias, when they present themselves so that a person is able to function socially, emotionally and physically.

Phobia vs. Fear

• In order to be diagnosed with a phobia, a specific fear has to disrupt everyday life and persist for an extended period of time. They are different from normal fears in this way. For example, if a person watches a scary movie about spiders, then she may feel anxious immediately following the viewing of the film or for several hours afterward and not want to be near any arachnids; the anxiety goes away once the person is able to rationalize about the film's content or is distracted by other events and tasks. This is normal fear. If a person watches the same movie and is petrified by the sight of a spider for weeks or months afterward and can't go into his basement for fear of spider bites, then the person is experiencing a phobia.

Types

• There are three major phobia diagnoses that are given via observation rather than medical testing. These include agoraphobia (fear of being kept in embarrassing places or situations), social phobia (fear of humiliation in social situations) and specific phobia (fear of a particular object or situation). A person may suffer from more than one phobia, and they can be related. A example would be a social phobia resulting from a specific phobia, such as someone being afraid of going to a beach party because he doesn't want to be teased about his fear of water.

Symptoms

• Symptoms of phobias include fear levels that are not proportionate to the threat of the place, item, situation or person. Anxiety or panic attacks can occur, as can sweating, rapid heart rate, elevated blood pressure, avoidance of whatever is related to the phobia, loss of motor control and diminished self-esteem. When looking at symptoms, it is important to point out that, although phobias themselves are irrational fears, they do not guarantee the complete lack of rationality---people often know their phobias are irrational but can't do anything to eliminate them.

Alternate Diagnoses

• For all types of phobias, the anxiety cannot be related to another medical condition, mental condition or drug; these things have to be ruled out prior to a phobia diagnoses because they can affect hormone levels, the ability to rationalize and even what and how the person perceives to be present.

Treatment

• Following a phobia diagnosis, a patient usually is prescribed various forms of treatment, which may be used individually or in combination. The forms of treatment include behavior therapy, counseling and medication. Behavior therapies involve exposure to the item or situation feared in a controlled manner. Counseling involves discussion of the phobia and its possible roots, and medications usually are designed to reduce physical symptoms of fear (e.g., rapid heart rate) or emotional distresses caused by the phobia (e.g., depression).