Acrophobia

Acrophobia is an excessive or irrational fear of heights. It is classified as a specific phobia and is characterized by intense fear responses to heights or situations involving height, such as tall buildings, ladders, or looking down from a balcony. The fear leads to avoidance of height-related situations and may cause distress or impairment in daily functioning.

Symptoms include rapid heartbeat, sweating, trembling, dizziness, nausea, a sense of choking, or a feeling of unreality when confronted with heights. In some cases, exposure to heights can trigger panic attacks. People may avoid balconies, stairs, bridges, or traveling in tall buildings, which can limit work, travel, or leisure activities.

Causes are believed to involve a combination of genetic predisposition and environmental factors. A history of traumatic falls or other height-related incidents, modeling by caregivers, and temperament may increase risk. Brain mechanisms involving the amygdala and fear circuitry are thought to play a role in heightened fear responses.

Diagnosis is typically made by a clinician using criteria for specific phobias, including a persistent, excessive fear for at least six months, immediate anxiety in the presence of the height cue, and avoidance or functional impairment. Treatments include cognitive-behavioral therapy with graded exposure to heights, including real-world or virtual reality exposure. Other approaches include relaxation techniques and, when appropriate, pharmacotherapy to manage anxiety symptoms. Many people respond well to treatment, though some may require longer-term therapy.