What To Know about Acrophobia

Acrophobia is an irrational and extreme fear of heights. It falls under the umbrella of anxiety disorders and is considered a type of specific phobia. People with acrophobia experience a severe fear of heights, which can be triggered by situations like climbing ladders, standing near windows in high-rise buildings, and driving across a bridge. Acrophobia causes anxiety and may motivate a person to avoid any situation that might trigger these anxious feelings.

Acrophobia is one of the most common phobias. Some studies have found that 28% of adults experience it at one point in their lives, while others have found a lifetime prevalence of 3-6%. Acrophobia can have serious effects, including agoraphobia (extreme fear and anxiety of places where leaving or escaping may be challenging) and avoidant behavior.

Effective treatments include cognitive behavioral therapy (CBT), exposure therapy, and mindfulness therapy.

Acrophobia Symptoms 

Agoraphobia can cause strong symptoms when faced with a triggering experience or when thinking about potential scenarios where you might be faced with a trigger.

Common trigger situations for agoraphobia include:

• Looking down from the windows of a tall building
• Looking down from a tower
• Hiking in mountainous or hilly areas
• Standing at the tops of mountains
• Climbing ladders
• Walking or driving over bridges
• Amusement park rides, like Ferris wheels
• Thinking about any situation involving elevated heights

Primary Symptoms

Although specific phobias induce general feelings of anxiety, you may experience symptoms specific to acrophobia during height exposure. These include:

• Vertigo or dizziness
• Feeling off-balance or unsteady
• Feeling like you’re going to fall
• Experiencing weakness in your knees
• Agitation
• Shaking and sweating

Other Anxiety Symptoms

People with acrophobia experience general anxiety symptoms when exposed to elevated heights. These symptoms can include:

• Racing heartbeat
• Nausea
• Sweating
• Tremors
• Hypervigilance

About 22% of people with a fear of heights experience panic attacks related to their fear. This may involve symptoms like extreme levels of anxiety, feelings of doom, nausea, disorientation, pounding heartbeat, and trouble breathing.

What Causes Acrophobia? 

Experts aren’t entirely sure why some people develop acrophobia and some don’t. Specific phobias like acrophobia are usually caused by a variety of factors, including genetic and biological, psychological, and social. Many people with acrophobia have a family history of anxiety or phobias.

Acrophobia is likely to present for the first time in childhood. One belief is that how a parent handles their child’s acrophobia may influence whether the child will continue to experience acrophobia later in life. For example, overly critical and overprotective parenting styles may make a child more prone to anxiety.

Modeling is also a factor. Parents who model anxious behavior regarding elevated heights may induce the same fears in their children.

Risk Factors

Certain risk factors may make a person more likely to develop acrophobia. These include:

• Family history of vertigo
• Motion sickness
• Menière’s disease (a chronic condition that causes periodic bouts of vertigo, ringing in the ears, a sense of ear fullness, and hearing loss)
• Anxiety disorders
• Migraines
• Depression

Diagnosis

Visit a mental health professional (e.g., a therapist) if you have signs and symptoms of acrophobia. This visit will typically involve taking a complete history of your mental and overall health. The mental health provider may ask you questions about your symptoms, when they started, and how they are experienced. They will ask what situations trigger your symptoms and how these symptoms affect your daily life.

Specific phobias like acrophobia are frequently diagnosed using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) criteria for specific phobias. An acrophobia diagnosis requires the following:

• Clear signs of anxiety related to elevated heights
• Fear almost every time you are faced with a situation involving elevated heights
  
• Irrational and out-of-proportion fear of heights for at least six months
  
• Actively trying to avoid situations where you may experience elevated height
• Serious distress or inability to function in your daily life as a result of your fears
• No other explanation for these fears, such as other mental health disorders, obsessions, or traumas

Acrophobia Treatment

Living with acrophobia can be challenging, but several effective treatment options can help treat and manage it.

Therapy

Therapy is the most commonly recommended treatment for acrophobia. Sometimes, therapy is combined with medication options, though there aren’t any approved medications for specific phobias like acrophobia.

The two types of therapy used to treat acrophobia are:

• Cognitive behavioral therapy (CBT): Learning to identify negative or disruptive thinking patterns and replacing them with healthier or more helpful thoughts and emotions.
• Exposure therapy: Exposing yourself to the thing you fear in the safe space of a therapist’s office

Virtual Reality (VR)

Virtual reality (VR) is a new and innovative way to treat specific phobias like acrophobia. It involves using virtual reality (computer technology and virtual reality equipment) to simulate situations of height elevation. Treatment is usually conducted over three or four sessions.

Research has found that virtual reality can be an effective way to reduce acrophobia symptoms.

Prevention

To a certain extent, having a fear of heights is normal. It’s common in children and is thought to be a protective mechanism to help them avoid dangerous situations. Most children outgrow this fear of heights as they develop and grow older.

Of course, fear of heights can become chronic (long-lasting) and develop into acrophobia. The best way to manage acrophobia is to connect with a licensed mental health professional who can support you using therapy, medication, or a combination of the two. Treatment for acrophobia may also help prevent future attacks or lessen their severity.

In addition to therapy, adopting healthy lifestyle choices can help reduce overall anxiety. For example, mindfulness meditation and deep breathing techniques may help prevent or reduce stress when you encounter a situation where you will be at an elevated height. Mindfulness strategies can help you become more attuned to the present moment and reduce fear-based reactions to triggers.

Complications

One of the main challenges of acrophobia is that the fear of heights itself isn’t the only problem. This fear can have a ripple effect on various parts of your life, including your daily functioning and the development of other mental health conditions.

Potential complications of acrophobia include an increased risk of developing:

• Depression
• Agoraphobia
• Generalized anxiety disorder (GAD)
• Social anxiety disorder (SAD)
• Substance use disorder (SUD)
• Obsessive-compulsive disorder (OCD)
• Migraines
• Heart disease
• Gastrointestinal (GI) disorders
• Breathing issues
• Hypertension (elevated blood pressure)

Living With Acrophobia

It’s common to experience a fear of heights as a child and intermittently as you get older. Acrophobia refers to a fear of heights that lasts longer than about six months and interferes with daily functioning. It’s one of the most common phobias, with 28% of adults experiencing it at one time or another in their lives.

Cognitive behavioral therapy (CBT), exposure therapy, and virtual reality are some effective treatment options for acrophobia. Mindfulness practices can also help reduce and prevent symptoms.