Acrophobia: Definition, Causes, Symptoms, Diagnosis, Treatment and Complications

It is an abnormal and relentless fear of heights.

Victims of this condition are known as “acrophobes.” They always feel excessive discomfort and nervousness at heights.

Acrophobia, also known as ” Fear of heights ,” is an anxiety disorder in which people develop panic behavior when they are at a certain height.

Whether on the sixth floor of a skyscraper, from a high mountain or standing on a ladder, the patient feels that he is exposed, regardless of the magnitude of the height, it triggers an inexplicable anxiety and the fear that he is going to plunge into the depths. .

The term acrophobia is derived from the Greek words “acron” which means height and “phobos” which refer to fear.

Causes of acrophobia

The condition belongs to a particular category of phobias called “space and movement discomfort,” which refers to the situational specificity of the symptoms that occur in some patients with balance and panic disorders.

Such ailments are marked by visual information inadequate for the normal orientation of the body.

The vestibular system in the body controls the balance mechanism that requires coordination between the eyes, the inner ear, the joints, and the muscles.

Each of these organs sends important signals about the position of the brain to balance the body.

However, there is a sudden loss of vestibular function in acrophobes, resulting in balance dysfunction.

Visual cues perceived by patients gradually decrease with increasing height. This causes difficulty in maintaining proper balance.

At higher altitudes, an appropriate visual system is needed for a normal view of any object.

The perception of movement as well as the integration of locomotion deteriorates severely, when the individual is at a certain height, causing a weak response.

Many medical researchers claim that fear of heights can be attributed to the following factors:

  • Fear conditioning is an adaptive mechanism that protects an individual from serious consequences by associating an unpleasant stimulus with a neutral one.
  • The expression of fear is neutral and experienced by almost everyone. Elevated heights are also an unpleasant stimulus and create a state of fear in each individual, but are more pronounced and persistent in acrophobic patients.
  • The phenomenon basically involves the amygdala, groups of almond-shaped nuclei in the brain, responsible for memory processing and emotional reactions. When the amygdala is abnormally activated, there is an expression of excessive fear.
  • Previous traumatic events involving heights such as falling from a high place or seeing another person experience a similar trauma can also be a contributing factor.
  • Such experiences are often stored as images in the brain that trigger a feeling of fear in some people when they find themselves in situations involving heights to prevent a recurrence of the previous trauma.


This type of phobia is often underreported as many patients try to avoid the situations that cause it.

Affected people tend to fear a variety of things that are considerably higher than ground level.

The severity of the disorder determines the degree of fear and other related conditions.

Acrophobic patients may begin to panic when they are on a high floor of a building, standing near a window on the upper floors of a tall building, standing in a chair, or climbing a ladder.

In fact, patients may even deliberately start looking for something to hold onto to avoid falling. The sense of balance is lost due to lack of confidence.

These patients feel that they can fall at any time while walking or even while standing still.

Despite the knowledge that heights do not cause any fatal consequences, as long as one is careful, acrophobic patients can experience severe anxiety and nervousness.

The immediate response to heights generally results in the following behavioral and emotional symptoms:

  • Excessive sweating
  • Nervous jerks
  • Nausea.
  • Dizziness.
  • Dry mouth.
  • Cold or hot sensations.
  • Anguish in the stomach.
  • Short of breath.
  • Inability to speak
  • Descending spontaneously.
  • They kneel, lower their body, or crawl.
  • Feeling of suffocation
  • Anguish of the stomach.
  • Cry or yell
  • Feel palpitations.
  • Fainting sensations
  • Temporary feelings of paralysis.
  • Loss of the ability to think rationally or normally.
  • Visualization of extreme agitation when asked to get off safely.
  • Intense desire to leave the high place.

The phobia becomes so intense that patients begin to avoid situations or activities that involve high places. Some of these include:

  • Reside on floors of tall buildings.
  • Practice paragliding, hang gliding, mountaineering and rappelling.
  • Home repairs that may require the use of a ladder.
  • Visit places that have balconies.
  • Sit near the window in an airplane.

Diagnosis of acrophobia

The phobia can be diagnosed by an experienced mental health specialist.

Patients are usually asked a few questions to understand and evaluate all the symptoms that they are actually experiencing.

These questions generally include:

  1. The reaction of patients in a high place.
  2. The duration of the prevalence of this irrational fear.
  3. The degree of severity of the symptoms.

The condition can be confirmed based on the answers provided by the patients.

The diagnosis is appropriate only when fear seriously interferes with patients’ functioning and results in extreme distress.

Based on the information collected, healthcare providers decide on the type of medical treatment to be administered to the affected person.


Here are some of the corrective methods that doctors generally implement to treat phobia:

Cognitive behavioral therapy

It is a form of psychotherapy that focuses on present thinking, behavior, and communication, rather than on past experiences.

Its main goal is to eliminate the symptoms of the condition and induce positive thinking.

The way acrophobes interpret a situation or an object, which involves heights, is usually reversed using various cognitive techniques.

Behavior therapy

In this process, therapists gradually expose patients to the source of fear in order to eradicate the phobia.

A series of exercises are performed to help patients cope. This particular technique is called systematic desensitization.

In other cases, affected people receive flood therapy, in which prolonged exposure to the fear-provoking situation helps to observe their reactions.

The method is faster and produces effective results. Behavioral assessment is essential to monitor the progress of patients undergoing treatment.


The hypnotherapeutic method, together with the fear exposure sessions, helps mental therapists to detect emotional triggers and eliminate irrational phobia.


Although there are no proven medications available to treat the condition, the use of D-cycloserine can help reduce panic attacks and anxiety.

Breathing therapies

Subtle changes in breathing cause anxiety and other physical symptoms.

In this technique, the fast breathing pattern is changed to a slow one for later reduction of symptoms.

Complications of acrophobia

This unusual phobia can seriously affect an individual’s normal life. These patients can restrict their activities to avoid sources that generate their fear.

Precautionary measures can be taken to ensure safety, although in the event of panic attacks, these people may end up taking an extreme step to avoid falling.

Vertigo is an abnormal condition characterized by a spinning sensation and dizziness. Inner ear problems could be one of its underlying causes.

Poor communication results between the visual and vestibular systems, leading to this balance disorder. Morbid fear of heights has often been associated with illness.

However, acrophobic patients do not normally experience a sensation of movement when stationary.

Acrophobia must be treated early before it manifests itself into a more complicated and incurable anxiety disorder.

Patients should be taught various methods to overcome the phobia and resume a normal life.

It is very important that family members provide constant support and care to such patients, as most of them begin to lead isolated lives and feel depressed .