One of the most intriguing parts in Psychiatric Nursing is phobic disorders. Phobia is defined as a type of irrational fear with things, activity or events. The Statistical Manual of Mental Disorders 4th Edition and its Text Revision both standard references for classifying phobic disorders classified it into three types:
Classification of Phobic Disorder
- Social Phobia or social anxiety disorder – fear of being in situations where one may be scrutinized by others
- Specific or simple disorder – type of phobia with specific objects or events
- Agoraphobia – fear with being alone or in public places
Patient profile:
- May complain of having fear with simple activities such shopping, going outside or going out with friends for there are cases that they experience panic.
- May exhibit physical symptoms such as palpitations, dizziness, hyperventilation or signs of anxiety when they think about the feared object or event.
- Observance of occurrence may be rampant among people in their early 20s
- Previous childhood experiences may influence the type of phobia
- Being treated in the early stage of life with rigid and very orderly lifestyle
Some examples of phobic disorders:
- Ablutophobia – irrational fear of washing or bathing
- Acrophobia – irrational fear with heights
- Bacillophobia – irrational fear with microbes
- Bibliophobia – irrational fear with books
- Cyclophobia – irrational fear of bicycles
Psychopathophysiolgy
A person with phobic disorders may use compensatory mechanism when he or she begins to panic. The precipitating factors of such phobic disorders may be pointed out as early exposures to pressured decision-making about lifestyle issues. Unconsciously, the anxiety can be transferred to objects which may symbolize the event or the previous situation that creates the fear to the person.
Medical Management
- Apply behavior modification in order to avoid repetitive exposure to feared objects or situations.
- Administration of antianxiety medications.
- Gradual systematic desensitization.
Nursing Management
- Assess the patient if he or she is using projection, displacement, repression and sublimation.
- Be alert for signs of unrealistic fear of objects, things or situations.
- Acknowledge the need for the patient to avoid such source of irrational fear.
- Assist the client has self-awareness so that he or she may know if his or her reactions were normal or not.
- Avoid forcing the patient to confront the source of his or her fear.
- Interrupt the patient’s attention to the feared object or event by things that may preoccupy his or her thoughts.
- Encourage compliance with anti-anxiety medications.
- Encourage the patient that he or she can help himself or herself.
