Part 1: Background Information
Fear is a common subject for many. Everyone is scared of something. But what happens when this fear is elevated to the extent where it interferes with one’s life? This is my description of what a phobia is: a fear so extreme that it disrupts one’s life when encountered with it. From conversations I have had with others along with the knowledge I gained from my AP Psychology class in high school, there are tons of methods that can be done in order to help someone from their phobias. Desensitization, group therapy, psychodynamic therapy, etc. And from what I know, a lot of phobias are easily curable with enough work. From what I know, a lot of individuals with phobias are treated or in the process of treatment with different forms of therapy. But what about other mental illnesses?
When we hear about other mental illnesses such as depression, schizophrenia, social anxiety disorders, we do not hear of such success in these departments. A lot of these illnesses are treated, but only due to medication. And during the times when therapy is done, it is rather more of a check-in rather than a way to cure these illnesses. Depression and anxiety, being regarded as some of the most common mental disorders, has no means of therapeutic treatment, and is considered a lot harder to cure than phobias.
Why are these illnesses so hard to treat compared to phobias? I know both involve brain chemistry, but what is the difference? Why are phobias not really treated with medication? Why is there medication for depression and anxiety? I hope to answer some of these questions, if not all of them, and maybe take steps into the right direction for curing diseases, like the ones mentioned before, with as high of a rate as phobias are.
Part 2: The Impact of Perceptions on Treatments of Generalized Anxiety Disorder and Specific Phobia Disorder
Mental health awareness has been on the rise in the last few years. Due to this rise in awareness involving mental health, we have developed dramatically from how we used to treat mental health disorders. We have done thorough research regarding the actual science behind these disorders, allowing for better diagnoses, treatments, and ways of potentially preventing these mental illnesses from impacting more individuals. One prevalent category of disorders is still impactful on many individuals today: anxiety. Anxiety is a rising issue within our societies today, as an estimated 31.3% of U.S. adults experience any anxiety disorder at some time in their lives (National Institute of Mental Health). And from how far we have come, physicians, psychologists, scientists, and other professionals have accomplished great feats as to helping treat those who have forms of anxiety. We have made several forms of therapy along with a variety of medicinal treatments which have been, for the most part, successfully treating individuals with anxiety. But the treatments are not the same for everyone. There are several types of anxiety disorders, including generalized anxiety disorder, panic disorder, separation anxiety disorder, selective mutism, specific phobia, etc. And each disorder may depict what type of treatment one gets. However, specific phobias are generally considered to be relatively easy-to-treat disorders due to the nature of the general premise around the disease. But how have the treatments evolved for specific phobia disorders in comparison to a more complicated disease, like generalized anxiety disorder? Well even with the drastic perceptions between the two disorders, it thankfully has not impacted why they are treated so differently.
When referring to mental disorders, one should always refer to the Diagnostic and Statistical Manual of Mental Health Disorders, also known as the “DSM.” The DSM-5 (the “5” referring to the fifth edition of the book) is a book which psychiatrists, psychologists, and other mental health providers utilize to diagnose patients with mental illnesses. This book refers to the diagnostic criteria, features, prevalence, risk factors, functional consequences, etc. for each disorder. For the description regarding generalized anxiety disorder (GAD), the DSM-5 defines it as excessive anxiety and worry about several events in one’s life (American Psychiatric Association 222). It also refers to the intensity, duration, or frequency of this worry to be “out of proportion” to the actual likelihood of the event being pondered about. The DSM-5 utilized highly emphasized wording to describe GAD, using things like “excessive worry,”, “intensity…out of proportion,” “interferes significantly with psychological functioning.“ The usage of wording suggests the severity of the disease along with its lasting impact on one’s everyday life. In comparison to the specific phobia description, it is defined within the DSM-5 to be fear or anxiety in the presence of a particular stimulus (American Psychiatric Association 198). Many individuals fear objects or situations. Regarding the wording behind the disorder, the DSM-5 characterizes it as, “intense or severe,” “suffered,” “fear or anxiety is out of proportion.” Contrary to what is believed, it seems as if the teams of psychiatrists, psychologists, and other professionals deemed it to describe it in a similar way as GAD. Both disorders were referred to in an urgent and important manner; exaggerating the concepts of the disorder as a way of portraying the big issues surrounding it. But even within the DSM-5, the choice of wording seems a lot similar in regards to the way the disorder is emphasized. But specific phobias are considered to be a lot less serious compared to GAD.
This may be prevalent within the general nature of the disorders in others’ minds. For the longest time, I had the perception that fears were just glorified fears. I thought that they were just more serious fears and we could get over it naturally. This is also the case for others as well. It is a common myth to think that phobias are just overrated fears (Hull). But a lot of people do not understand that phobias are linked with extreme biological and psychological foundations which cause a fear response. And these perceptions may have caused issues involving the development of treatments. Within Susan Sontag’s book, Illness as Metaphor, she refers to the use of metaphors in disease and how others may perceive them, choosing to specifically analyze cancer and tuberculosis. She found that regardless of their degree of significance, they are perceived differently. Cancer will be seen as a death sentence which should be taken seriously on all accounts, whereas tuberculosis was more romanticized as one of the “better” diseases to have (Sontag). This may be the same case regarding the dynamic between GAD and specific phobia. GAD takes the place of cancer within this example. People perceive GAD to be a more serious illness, as it hinders their everyday lives significantly and it requires a lot of therapy, work, and sometimes medication to get over it. The increasing amount of awareness being spread about GAD has helped its understanding a lot for others. But when referring to specific phobias it is not the same. Specific phobia is seen as something small and insignificant, something similar to how tuberculosis was seen within Sontag’s text. It is seen as just a fear and nothing more and is taken very lightly. As a result of this, this may be a reason why they are treated so differently.
For GAD, treatments include cognitive behavioral therapy, medication, and relaxation treatments (Darwyn Health). For specific phobias, treatments include mostly therapies such as exposure therapy and, again, cognitive behavioral therapy. But barely any of the patients for specific phobia receive medication for their disorder. It can be seen that these disorders are treated differently, although they are classified within the same category of disorder. Is this due to the perceptions that people have regarding the illnesses?
Well, treatments can vary between the disorders due for several factors. This includes the nature of the disorder, the effectiveness of the treatments in the field, the patients’ responsiveness to therapy, and the general knowledge we have regarding the disorders (Darwyn Health). Specific phobia involves irrational fear upon one specific stimulus, whereas GAD involves excessive worry regarding multiple areas of life. The focal point of disorder is more known within specific phobia cases compared to GAD, thus, easier to combat with the direct stimulus. In GAD, however, it is a lot harder to pin-point the exact issue which the patient is dealing with, therefore, is a lot harder to treat. This is expanded upon in Episode 221 of the podcast, Speaking in Psychology, by the American Psychological Association. Within this episode, they invite a professor of psychology at Toronto Metropolitan University, who is well known for his books and research on anxiety disorders, which includes specific phobias. When asked if some phobias were easier to treat than others, he stated that, “…more complex kinds of problems like social anxiety where people are nervous in a wide range of social situations, that can take longer to overcome.” Simply, he stated something similar to what Darwyn Health stated, as the treatability of the disorder varies based on the factors in which it is caused. The more variables which cause the disorder to be enacted, the harder it is for it to be treated.
Other than the nature of the disorders, the effectiveness of treatments is also an impactful factor. Specific phobia patients are normally treated with exposure therapy, in which individuals are continuously exposed to their phobia in hopes of becoming desensitized to it. This form of therapy is shown to be efficient in curing those who have specific phobias to a specific stimulus, as the therapist patient forces an interaction between the patient and their fear. I have also heard from other individuals, such as some of my high school teachers and family members, that this form of therapy is helpful. Compared to GAD, this requires broader treatments (due to the nature of the disorder discussed previously), such as cognitive-behavioral therapy (CBT) along with certain medications. This can also be observed in the patient’s responsiveness to the treatments. For each treatment respective to their disorder, the patients react positively, for the most part, to their treatments and show improvement. Lastly, the exact cause of GAD is not fully understood (Darwyn Health). As a result, it is hard to treat a disorder if we do not fully understand the science behind it, as is hard to come up with treatments without all the knowledge necessary to come up with an effective cure. Specific phobias are often rooted in a traumatic experience or a learned response, thus, resulting in a similar reaction to the stimulus presented in the past compared to present.
In conclusion, it can be seen that there is a vast difference between the perceptions of generalized anxiety disorder and specific phobia disorder. While the DSM-5 portrays the disorders in a similar light, they are seen as something different. GAD is seen as a more serious disorder, impacting the patient significantly throughout their everyday life. On the other hand, specific phobia is seen as many see specific phobias as just glorified fears, it is prioritized less compared to illnesses such as GAD, similar to how tuberculosis is prioritized less than cancer to the public. Regarding the treatments, the differences in treatment are not due to the perceptions of the disorders. As a result of the nature of each disease, the disorders are treated differently. Since specific phobias focus on a single stimulus, whereas GAD incorporates several crucial factors in the patients’ lives, it is a lot easier to pinpoint the exact issues going on. While this may be the case, there could be other illnesses which are impacted by the public’s perceptions of them, thus, we should try to spread as much awareness regarding all diseases, including mental disorders, to eliminate this issue.
Works Cited
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed., Text Revision, American Psychiatric Publishing, 2022, https://doi.org/10.1176/appi.books.9780890425787.
de Vries, Y.A., et al. “Perceived Helpfulness of Treatment for Specific Phobia: Findings from the World Mental Health Surveys.” Journal of Affective Disorders, vol. 288, 2021, pp. 199-209. PubMed Central, 1 June 2022, www.pmc.ncbi.nlm.nih.gov/articles/PMC8154701/.
Gordon, Heather L., et al. “The Relationship Between Anxiety and Depression: A Review of the Literature.” National Library of Medicine, U.S. National Institutes of Health, 2020, www.pmc.ncbi.nlm.nih.gov/articles/PMC8154701/.
Hull, Megan. “5 Common Myths & Facts About Phobias.” The Recovery Village, 2024, www.therecoveryvillage.com/mental-health/phobias/phobia-myths/.
Jensen, Henrik. “Specific Phobias vs. Generalized Anxiety Disorder: Understanding the Difference.” DarwynHealth, 31 Jan. 2024, darwynhealth.com/mental-health/mental-health-disorders/anxiety-and-stress-disorders/specific-phobias/specific-phobias-vs-generalized-anxiety-disorder-understanding-the-difference/?lang=en.
Mills, Kim. “Understanding and Overcoming Phobias, with Martin Antony, Phd.” American Psychological Association, American Psychological Association, Jan. 2023, www.apa.org/news/podcasts/speaking-of-psychology/overcoming-phobias#:~:text=The%20other%20thing%20I%20would,can%20take%20longer%20to%20overcome.
National Institute of Mental Health. “Prevalence of Any Anxiety Disorder Among Adults.” National Institute of Mental Health, U.S. Department of Health and Human Services, 2023, www.nimh.nih.gov/health/statistics/any-anxiety-disorder.
Nunn, Megan. “What Are the Best Medications for Anxiety and Depression?” Verywell Health, Dotdash Meredith, 25 Oct. 2024, www.verywellhealth.com/medications-for-anxiety-and-depression-8348994.
Siddique, Juned, et al. “Comparative Effectiveness of Medication Versus Cognitive-Behavioral Therapy in a Randomized Controlled Trial of Low-Income Young Minority Women With Depression.” Journal of Consulting & Clinical Psychology, vol. 80, no. 6, Dec. 2012, pp. 995–1006. EBSCOhost, https://doi-org.ccny-proxy1.libr.ccny.cuny.edu/10.1037/a0030452.
Sontag, Susan. Illness as Metaphor. Farrar, Straus and Giroux, 1978.
Part 3: Reflection
During my research, I increased my knowledge on psychological disorders and their treatments. I always had the perception that therapy was not really useful and that you could really talk to anyone. But the more I learned about how therapy worked, the more I began to understand why it is used. Therapy, in some ways, is kind of like a doctor check-up. Where you go into the office and the psychologist gives you a check-up on how you’re feeling. Through reading about psychological treatments within articles and expert perspectives, I also learned more about medicinal treatments. Due to disorders involving heavy impacts on brain chemistry, it is somewhat hard to treat without impacting the internal mechanisms of the human brain. As a result, one may have to resort to medicinal treatments as a way of helping with their illnesses rather than just purely through therapy. I have heard the word “anxiety” being thrown around, yet I never truly understood the concepts behind it. Rather, I gained more of an understanding for anxiety disorders than I ever did in AP Psychology. In addition, I learned the concepts behind specific phobias. For many, specific phobias are just seen as a slightly more extreme fear. Yet many do not understand how much of an impact it has on individuals. In order for psychological conditions to be classified as disorders, they must impact the individual’s life when encountering their condition. Normal fears can be encountered. But phobias are something different. And through my research, I was able to learn how serious phobias were to those who had a specific phobia. It changed my perspective on the disorder as I myself underestimated the concept of the disorder. I also underestimated generalized anxiety. As someone who was never aware of how these illnesses work, I was glad that I was able to understand more about how individuals live with anxiety, and not to underestimate how someone is feeling. Through these narrative medicine readings, as a part of my research, it is all but a matter of perspective. Through being in the place of those with these illnesses, as a result of narration, I was able to understand a lot more than I did previously in regards to other psychological disorders. The brain holds a lot of power, more than a lot of people know. And although I do not fully understand how it feels to be in their place, this is a start.
