Case history
Case history #1
A 40-year-old man experiences intense worry several weeks before scheduled airline travel. However, he is required to fly several times each year with his work. His fear developed 2 years ago following an extremely turbulent flight. He has recurring, vivid images of himself dying in a fiery crash while flying. He is hyperaware of any sound and unexpected movement of the plane.
Case history #2
A 25-year-old woman has increased physiologic arousal when exposed to spiders, and experiences intense fear when confronted with anything resembling spiders. Her symptoms have existed for as long as she can remember. She rarely ventures into the garage or attic, and prior to going to bed each evening her husband must thoroughly inspect the bedroom. She admits she has never been bitten by a spider, is embarrassed about her reaction, and realizes that spiders are not always dangerous; however, she is flooded by fearful thoughts that all spiders are aggressive and threatening.
Other presentations
Phobias can develop to almost any object or situation. A common presentation in recent years is the patient who is hesitant to get vaccinated against coronavirus disease 2019 (COVID-19) due to a fear of needles.[2] Patients with diabetes mellitus who have fears of blood, needles, and/or injections may present as noncompliant with blood glucose monitoring and avoidant of scheduled blood draws. They may also present with lightheadedness, nausea, and/or fainting, as these symptoms are often associated with blood and injection phobias. Other medical phobias may include fears of being sedated or being trapped inside a scanner during imaging studies. Less common phobias include fears of choking, leading to significant changes in eating habits; irrational fears of touching plastic, leading to significant tactile aversion and avoidance behavior; and fears of vomiting, leading to intense panic when nauseated or when hearing others vomiting.
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