Phobia Making a Difference Today

Phobia
Making a Difference Today
Phobia, a disabling type of anxiety disorder, is the most common psychi-
atric illness among women and the second most common illness among
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TORIES
men older than 25, according to the American Psychiatric Association. It
affects more than 14 million adults in the United States.
No everyday fright, phobia involves extremely overwhelming, irrational,
and debilitating fears of some specific object, situation, or feeling that can
obstruct an individual’s ability to live a normal life. A person can develop
a phobia of anything. And whether it’s, for example, highway driving or
social situations, any exposure can trigger an extreme reaction of fear that
may include a pounding heart, shortness of breath, and sweating. Some
S
UCCESS
people even believe they are about to die. As a result, phobia can sideline
daily life activities, relationships, and careers. Some people with the anxi-
ety disorder may even become housebound, unable to fully contribute to
society.
An increased understanding of how the brain
controls our fears is pushing forward the
Financially draining, anxiety disorders, including phobia, cost America
development of new treatments for phobia on
more than $42 billion a year.
a number of fronts. One line of research sug-
ESEARCH
gests that two brain areas, the amygdala and
Research Equals New Treatments
R
the prefrontal cortex, play key roles in the
fear control process. Some researchers believe
Fortunately inroads are being made. Basic science research including work
that the development of a memory that can
with animals has helped researchers develop treatments that sometimes
control a fear originates in the amygdala. It’s
aid people with phobia. Today, therapy mainly centers on behavioral tech-
thought that the prefrontal cortex helps
niques that involve gradual exposure to the feared object or situation until
retain this new fear control learning. These
a person learns to control his or her physical reactions of fear. In the latest
insights are helping researchers determine
advance, scientists recently discovered that virtual reality techniques can
where they should focus the actions of new
be used successfully in the doctor’s office to help therapeutically expose a
medicines being developed for phobia.
patient to his fear.
RAIN
Recently, researchers also determined that some drugs used for depression
that alter certain brain chemicals and decrease anxiety can help treat
B
Continued funding for
some types of phobia.
research could lead to:
Other medicines sometimes used include anti-anxiety drugs called benzo-
• A clearer understanding of how
diazepines and beta blockers.
the brain manages our fears.
Continued Advances In Care
• The further development of the
These therapies help many, but they do not adequately treat every person’s
compound D-cycloserine for pho-
phobia. In addition, behavioral therapy is costly and slow. Some people
bia, which is being investigated
also forgo the strategy because they fear the treatment itself.
based on positive animal
research.
Scientists suspect that greater success may come from compounds designed
to work directly on the molecular mechanisms that underlie the brain’s
• Additional new therapies for
fear control system. With support from the National Institutes of Health
people with phobia that tap into
(NIH), scientists already have uncovered some of the major biology
specific brain mechanisms.
behind the brain’s ability to overcome fear. What’s more, on the basis of
these findings, researchers recently discovered that a compound called
D-cycloserine shows promise as a new treatment for phobia.
With continued funding from NIH, researchers could further advance this
area of study, expand treatment options, and help a wider range of people
conquer their fears.
For more information please email brss@sfn.org.
www.sfn.org
© 2005 Society for Neuroscience. Image credit: Illustration by Lydia Kibiuk. Adapted from Brain Briefings, published by the
Society for Neuroscience. Graphic credit: Adapted with permission from Paul Greenberg, et al., J Clin Psychiatry 1999; 60:
427-435. V.14.0.05

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Phobia
Making a Difference Tomorrow
Doctors are better able than ever to help those who suffer from phobia, a
Costs of Anxiety Disorders
serious type of anxiety disorder that can leave its victims housebound. But
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TORIES
Total
Mortality
while treatments exist, they are not for everyone. Many people with pho-
workplace
costs
costs
bia continue to experience irrational and disabling fears that obstruct
3%
10%
their ability to live a normal life.
Pharmaceutical
costs
2%
Did you know that:
•
More than 14 million adults in the United States suffer from some
Direct
Total direct
nonpsychiatric
type of phobia.
psychiatric
medical
treatment
treatment
costs
costs
•
Anxiety disorders, including phobia, cost America more than $42
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UCCESS
31%
54%
billion a year, according to conservative estimates published by the
Anxiety Disorders Association of America.
•
More than half of the costs associated with anxiety disorders such
as phobia come from repeated use of health-care services, because
Anxiety disorders, including phobia, cost
individuals with anxiety disorders seek relief for symptoms that
America more than $42 billion a year,
according to conservative estimates published
mimic physical illness.
by the Anxiety Disorders Association of
America. More than half of the costs are
With additional funding from NIH, scientists could develop ways to
ESEARCH
associated with the repeated use of health-
improve treatment and reduce the cost of phobia to patients and society.
R
care services, since individuals with anxiety
disorders seek relief for symptoms that mimic
Research Equals Hope for the Future
physical illness. Someone who has phobia,
for example, can experience symptoms such
Already, studies supported by NIH and others have led to the initial test-
as a pounding heart, shortness of breath, and
ing of a promising new treatment that works directly on the biological
sweating when they encounter a feared
mechanisms that underlie the brain’s fear control system.
object, situation, or feeling. New treatments
aim to diminish this fear response and cut
First, animal studies indicated that overcoming fear requires learning and
associated costs to society.
the formation of a new memory rather than the erasure of an old fear
RAIN
memory. Following up on this finding, researchers examined a brain cell
Already research has
component implicated in general learning, termed the NMDA receptor.
Studies revealed that the compound D-cycloserine, which boosts activity
B
led to:
of the receptors, enhanced the ability of rats to conquer their fears.
• The development of behavioral
In the latest development, scientists found evidence that the drug can cut
therapies that help treat phobia.
the amount of behavioral therapy needed to help people overcome their
phobias. A small number of people with a fear of heights who were treated
• The discovery that some drugs
with D-cycloserine did as well after two sessions of therapy as patients
used for depression that alter
without the drug normally do after seven sessions. Treated individuals also
certain brain chemicals and
were twice as likely to expose themselves to heights in daily life and, for
decrease anxiety can help treat
example, peer over a bridge. Preliminary results of another patient study
indicate that
some types of phobia.
D-cycloserine also may help other types of phobia, like social
phobia, in which people fear social situations.
• An increased understanding of
Researchers also have identified additional methods that target the fear
some of the major biology
control system and may help those with phobia. For example, early results
behind the brain’s ability to
reveal that a compound that acts on another chemical in the system,
overcome fear, which has led to
dopamine, can accelerate the ability of mice to overcome fear. Several
the testing of a promising new
other strategies are also under investigation.
treatment.
Additional NIH funding will hasten the development of these new treat-
ments. Advances mean improved lives and less cost to the government
and public.
For more information please email brss@sfn.org.
www.sfn.org
© 2005 Society for Neuroscience. Image credit: Illustration by Lydia Kibiuk. Adapted from Brain Briefings, published by the
Society for Neuroscience. Graphic credit: Adapted with permission from Paul Greenberg, et al., J Clin Psychiatry 1999; 60:
427-435. V.14.0.05

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