Pediatric Specific Phobias

A child has anxiety when exposed to a certain object or situation. He or she stays away from the object or situation, dreads it or endures it with so much fear that it interferes with normal activities. Some common phobias are a fear of animals, insects, blood, heights or flying.

The cause of a phobia may be both genetic and environmental. A child may develop a phobia if he or she has 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 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.

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 the symptoms may be having a panic attack. These symptoms may seem like other health problems. Have your child see his or her health care provider for a diagnosis.

At Children’s National Hospital, child psychologists, psychiatrists and other mental health professionals may interview the child or adolescent and his or her parents. We may have the patient and family fill out questionnaires about different aspects of the child’s or adolescent’s life, including physical health concerns, difficulties at school or behavior with friends and family.

Following a full assessment, a member of the Children’s National care team will discuss treatment options with the child or adolescent and his or her family. Both cognitive behavioral treatment (CBT) and certain types of medicines are effective in treating general anxiety disorder in youth.

• CBT includes working with a therapist to help the child or adolescent (and his or her family) learn how to cope with feelings of fear. During treatment, patients learn to gradually face their worries and learn how to manage their anxiety, especially with the use of exposure response prevention.
• Medications, such as selective serotonin reuptake inhibitors, may be recommended. These medicines affect neurotransmitters (nerve cells in the brain that carry signals) linked to anxiety.

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 his or her quality of life.

All children have fears at some point in their life. When 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 health care provider.
• Talk with your child’s health care 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, 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 about your child’s phobia. Work with your child’s health care 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.