Atlanta — Time (and her family) flew right by as Kathy Heart kept her feet planted firmly on the ground.

"I told myself that I could fly anytime I wanted to, but I just didn't want to," said the Atlanta woman, who did not see her relatives in New Jersey for 20 years. "Then I had to realize that I really couldn't."

The irrational, uncontrollable fear of certain situations, places or objects, coupled with physiological reactions such as intense breathing, pounding heart and sweating, paralyzes about 6.3 million people in the United States. Phobias can disrupt daily routines and alter lives as sufferers avoid the triggers, which include:

Animals. The most common specific phobia includes dogs, snakes, insects or mice.

Situations such as flying, riding in a car or on public transportation, driving, going over bridges or through tunnels or being in a closed-in place.

Natural environment such as storms, heights or water.

Blood/injection/injury. These involve a fear of being injured, of seeing blood or of invasive medical procedures, such as blood tests or injections.

Other phobias include fear of falling down, a fear of loud sounds and a fear of costumed characters such as clowns.

A rational fear of snakes is healthy, says Raymond Crowel of the National Mental Health Association, referring to someone walking in the woods or working in their yard. "But if you're on a city street downtown looking for snakes, that's a preoccupation and a phobia," he says.

While some phobias develop during childhood, most occur during adolescence and early adulthood in response to a stressful event associated with a place or object.

Common fears

• Arachnophobia. Fear of spiders. (Half of women and 10 percent of men have a fear of spiders.)

• Aviophobia. Fear of flying.

• Agoraphobia. Fear of any place or situation where escape might be difficult or help unavailable.

• Claustrophobia. Fear of being trapped in confined spaces.

• Acrophobia. Fear of heights.

• Brontophobia. Fear of thunder.

• Necrophobia. Fear of death or dead things.

Do you have a phobia?

Take this test to see.

Are you troubled by:

Powerful and ongoing fear of social situations involving unfamiliar people?

Fear of places or situations where getting help or escape might be difficult, such as in a crowd or on a bridge?

Shortness of breath or a racing heart for no apparent reason?

Persistent and unreasonable fear of an object or situation, such as flying, heights, animals, blood, etc.?

Being unable to travel alone, without a companion?

If you answered yes to any of the questions, talk with your doctor.

Source: Anxiety Disorders Association of America

Treatment options

Phobias are highly treatable, said Rebecca Beaton, director of the Anxiety & Stress Management Institute in Atlanta. Here are some treatment options:

Cognitive-behavior therapy. Irrational beliefs are addressed as clients think through situations and draw conclusions based on facts. They use reassuring words, such as "I can do this," "Anxiety is normal, and it will pass," or "I've made negative predictions before, and nothing bad has happened." Clients construct a hierarchy of fears from least to greatest and are gradually exposed to what frightens them (starting with an imagined or virtual setting and moving into the real environment) until fears diminish. Prolonged exposure desensitizes clients to feared objects or situations as self-talk helps work through them.

Meditation/deep breathing. Slow, deep abdominal breaths reduce the production of stress hormones such as adrenaline and cortisol and reduce blood pressure and heart rate. Anxiety is tied to a physical response, so the body cannot be anxious when it is relaxed.

Workbooks raise awareness of the origin of fears, introduce the concept of rational self-talk and typically include a journal.

Support groups help to remove isolation and should be facilitated by a therapist.

Medications. For short-term treatment, low doses of tranquilizers such as Valium and Xanax may be prescribed. They can be very addictive and should be used sparingly. For more generalized anxiety, selective serotonin reuptake inhibitors (such as Lexipro, Zoloft or Paxil) or selective norepinephrine reuptake inhibitors may be effective.