Living with phobias

Experiencing phobias can be an overwhelming, frightening, isolating and debilitating experience. People may feel intense fear or that their world has fallen apart. Phobias place limitations on people's lifestyles. Many people are bewildered by their emotions when confronted with their phobias but feel powerless to control them.

Worse still, people experiencing phobias can lose hope or the belief they will recover and lead a worthwhile life. But people who have come through their mental health problems are able to look back and see how mistaken their loss of hope was. Everyone with mental health problems can lead a worthwhile life, even if it is not quite the life they had planned.

Discrimination and stigma

Many people feel ashamed of their phobia and can sense other people's fear, prejudice and low expectations for them. Media coverage can give the wrong impression that all people with mental illness are likely to be violent. Employers and landlords don't really want to know people who have a mental illness.

Workmates and friends may turn their backs on a person they know who has mental health problem. Even families and whanau and mental health workers can be over-anxious, controlling and pessimistic about lives of people with phobias. None of this helps. Sometimes the discrimination feels worse than the illness itself.

Support and information

People with phobias often do better if they seek support people who are caring, unjudgemental and see their potential. Some get their best support from others who have been through the same kind of experience. Other people find a counsellor or another type of mental health worker who is supportive. Their friends and family or whanau may offer good support.

People with phobias can make more informed choices if they educate themselves about their condition and the types of treatment and support available. It is also useful to know about your rights.

Using services

Many people with serious phobias, sooner or later, go to see their GP or a counsellor or are referred to mental health services.

If you fear you might harm or kill yourself it is vital that you seek help immediately.

Sometimes it is hard for people to seek help because they feel ashamed and want to hide their distress. Acknowledging they have a mental health problem and need help can be very scary. People with phobias often say the best services are ones where they are listened to, treated as equals and are given support or treatment that works for them. Otherwise, the service is unlikely to meet their needs.

Recovery

Most people with phobias make a good recovery. But even if you continue to have episodes you can still experience recovery and live a happy and worthwhile life.

 Important strategies to support recovery:

• Learn about phobias and recovery from them.
• Face up to your phobia. This is the main therapy. If your fear is great you may need to have some professional help to do this. But you can do a lot for yourself. If you are aware you have a phobia and feel you are able to confront it, then the best strategy is to face the object or situation as often as possible. If you have recovered from a phobia it is good to keep in practice at being in a situation you used to fear. For example, if you know you are quite anxious about meeting new people, do not avoid doing this. If you take every opportunity to meet new people, your confidence will grow.
• See your general practitioner for recommendations about therapy. If you have agoraphobia and panic attacks your GP may suggest you have a physical check up to make sure your symptoms do not have a physical cause.
• Make sure you go out often if you have mild agoraphobia and have some anxieties about leaving home because of panic or feeling unsafe. Ask family or whanau and friends to keep you company if this helps. Explain your problem to them. If they know you might have to wait for a panic attack to pass, or even to go home, this can help you feel less pressured or embarrassed.
• Relax. If you are anxious much of the time (in addition to having a phobia) relaxation can be helpful. If you already have some way of relaxing, do this regularly. If you need to, learn a relaxation technique or find something to do with your family or whanau or friends that is relaxing and enjoyable. Phobias usually affect only one part of your life. Keep up all your other activities, especially those you enjoy.
• Avoid alcohol and other drugs. They are not good ways of relaxing to overcome a phobia. You will probably feel more anxious afterwards and you risk becoming addicted. Many people without social phobia feel a bit more relaxed socially with a few drinks, but if you are unable to socialise without drinking you are at risk of becoming dependent on alcohol.
• Know if you are sensitive to caffeine and nicotine. These have no special effect on phobias unless you have agoraphobia and panic, in which case you may be sensitive to these substances. Stopping alcohol and cannabis can also be very helpful. Breathing exercises are good if you over-breathe (hyperventilate), causing panic attacks.

Family/whanau views

Families and whanau often experience real grief, isolation, powerlessness and fear if they witness their loved one struggling with phobias. They may find they cannot understand the person's behaviour or communicate with them any more. They may find their relative withdrawn or hard to be around. Their feelings for their relative can swing from compassion for their pain, to grief at the loss of the person they once knew to hostility towards their relative for disrupting their lives.

Families and whanau often worry that their relative will never get better and may have to revise their expectations for that person. Families and whanau often live through all this without support from their community or from mental health services.

Families and whanau, especially parents, can worry that they caused their relative to develop phobias. Sometimes they feel blamed by mental health professionals which can be very distressing for them. Most families and whanau want the best for their relative. It is important for them to understand what factors have contributed to their relative's problem and to be able to discuss their own feelings about this without feeling guilty or blamed.

Discrimination and stigma

Families and whanau may feel shame or embarrassment if their relative behaves in an unusual way when they are very unwell. They may shut themselves off from their friends and neighbours or feel that these people are avoiding them.

Support and information - family and whanau

Families and whanau often feel drained and stressed and need support to look after themselves as well as their relative with phobias. Their other family or whanau relationships can get neglected when the needs of the person with mental illness have to take priority.

There are several ways families and whanau can get support. They can get in touch with other families and whanau who have had similar experiences. Some mental health services provide good support options for families and whanau. Families and whanau need information on the person's condition, their options for treatment and their rights.

Experiences with services

Families and whanau frequently find that services do not listen to their views about their relative. Professionals may not always give families and whanau any information about their relative, particularly if they are an adult and don't want their family or whanau to know the information.

Ideally, families and whanau who are involved in caring for someone with a debilitating phobia need to be able to communicate freely with professionals about their relative.

Recovery

Most, if not all families and whanau want to help their relative recover. Unfortunately, sometimes the person blames their family or whanau and does not want them to be involved in their care. Research shows that if families and whanau can share information, skills and support with their relative and the professionals who look after them, the likelihood of recovery is much greater.

Important strategies to support recovery

Family, whanau and close friends of people with phobias have found the following strategies important and useful:

• Recognise that the fear people with phobias experience can be extreme. It may be very hard for them to just be brave. Telling them their fear is ridiculous is not helpful - they already know that. You can help them think through whether they want to overcome their fear or avoid whatever it is they fear. If they are trying to face up to it, encourage them, but do not force them.
• It is very helpful to provide someone with social phobia with genuine information about how they are looking and performing in a social setting. How other people react is crucial to them. If they look calm and are functioning adequately, them tell them so. On the other hand, if they look tense or anxious and their performance is not so good as a result, you may want to give them some gentle feedback.
• It is best not to get angry with someone in your family or whanau who has agoraphobia, though this can affect you all and be very frustrating. You need to understand and agree how much they will try to overcome their fears, and then support them to do this.

You may need to be careful you do not do too much for them if this prevents them from getting their confidence back. You may be able to help them through their therapy and even act as an assistant therapist, eg, helping with tasks they have been asked to undertake from home. A first stage of recovering from agoraphobia might be to go out more in your company, before they are ready to go out alone.

See also: Phobias; phobias - treatment

Support groups

See the support organisations (which include helplines) under Further information and support below.

Original material provided by the Mental Health Foundation of New Zealand, 2002. Edited by everybody, May 2005.