What is claustrophobia?

Claustrophobia is a type of anxiety disorder in which a panic attack may result from an unreasonable fear of no escape or being closed-in.

Accordance to Diagnostic and Statistical Manual 5 (DSM-5) it is considered a specific phobia.

Triggers can involve being inside an elevator, a small space without windows, or an airplane.

Some people have said wearing tight-necked clothing can trigger claustrophobic feelings.

Important facts about claustrophobia:

Here are a few key points on claustrophobia. More details are given in the main article.

  • Claustrophobia affects some people when they are in a small space.
  • It can lead to feelings of panic.
  • Causes may include conditioning and genetic factors.
  • A variety of tips and treatments may help people overcome their fear.

What is claustrophobia?

Shocked woman with claustrophobia in the moving modern elevator
Claustrophobia is the fear of a closed-in place from which escape would be difficult or impossible.

The term claustrophobia derives from the Latin word claustrum meaning “a closed-in place,” and the Greek word, phobos meaning “fear.” People with claustrophobia can go a long way to avoid small spaces and circumstances that cause their panic and anxiety.

You should avoid areas like the metro, and choose to take the stairs instead of an elevator, even though there are several floors involved.

Claustrophobia can occur in up to 5 percent of Americans.

Symptoms can be serious but there are also people who are not seeking treatment.

Diagnosis

A psychologist or psychiatrist should ask the patient what signs they have.

During a consultation on another anxiety-related problem a claustrophobic diagnosis can arise.

The Doctor is going to:

  • ask for a description of the symptoms and what triggers them
  • try to establish how severe the symptoms are
  • rule out other types of anxiety disorder

To establish some details, the doctor may use:

  • a claustrophobia questionnaire to help identify the cause of anxiety
  • a claustrophobia scale to help establish the levels of anxiety

For a specific phobia to be diagnosed, certain criteria need to be met.

These are:

  • a persistent unreasonable or excessive fear caused by the presence or anticipation of a specific situation
  • anxiety response when exposed to the stimulus, possibly a panic attack in adults, or, in children, a tantrum, clinging, crying or freezing
  • a recognition by adult patients that their fear is out of proportion to the perceived threat or danger
  • employing measures to avoid the feared object or situation, or a tendency to face the experiences but with distress or anxiety
  • the person’s reaction, anticipation or avoidance interferes with everyday life and relationships or causes significant distress
  • the phobia has persisted for some time, usually 6 months or longer
  • symptoms cannot be attributed to another mental condition, such as obsessive-compulsive disorder (OCD) or post-traumatic stress disorder (PTSD)

Symptoms

The anxiety disorder is claustrophobia. Symptoms typically develop during infancy or adolescence.

Being in or thinking of being in a confined space can cause fears of being unable to breathe properly, running out of oxygen and being trapped in distress.

When levels of anxiety reach a certain level, the person may start experiencing:

  • sweating and chills
  • accelerated heart rate and high blood pressure
  • dizziness, fainting, and lightheadedness
  • dry mouth
  • hyperventilation, or “over breathing”
  • hot flashes
  • shaking or trembling and a sense of “butterflies” in the stomach
  • nausea
  • headache
  • numbness
  • a choking sensation
  • tightness in the chest, chest pain, and difficulty breathing
  • an urge to use the bathroom
  • confusion or disorientation
  • fear of harm or illness

The anxiety is not necessarily caused by the small spaces, but by fear of what might happen to the individual if confined to that area.

Hence the individual is worried about running out of oxygen.

Examples of small spaces that could cause anxiety include:

Claustrophobia trapped
Claustrophobia can stem from a feeling of being trapped, and what could happen if they stayed confined to that area.
  • elevators or changing rooms in stores
  • tunnels, basements, or cellars
  • trains and subway trains
  • revolving doors
  • airplanes
  • public toilets
  • cars, especially those with central locking
  • crowded areas
  • automatic car-washes
  • some medical facilities, such as MRI scanners
  • small rooms, locked rooms, or rooms with windows that do not open

Reactions include:

  • checking the exits and staying near them when entering a room
  • feeling anxious when all the doors are closed
  • staying near the door in a crowded party or gathering
  • avoiding driving or traveling as a passenger when traffic is likely to be congested
  • using the stairs instead of the elevator, even if this is difficult and uncomfortable

Claustrophobia includes a fear of being restricted or confined to one area, and having to wait in line at a checkout may also cause it in some people.

Treatment

Cognitive behavioral therapy (CBT)
can be used to reduce the frequency and potency of the fear reaction’s triggers.

After a diagnosis, the doctor may prescribe one or more of the treatment options below.

Cognitive behavioral therapy (CBT): The aim is to retrain the patient’s mind so that the places they fear no longer bother them.

This can include the patient being slowly introduced to small spaces and helping them cope with their fear and anxiety.

Facing the situation which causes fear may dissuade people from seeking care.

Observing others: Seeing others interact with the source of fear may reassure the patient.

Drug therapy: Antidepressants and relaxants can help relieve symptoms but the underlying issue will not be solved.

Exercises of relaxation and visualization: taking deep breaths, meditating and performing exercises of muscle relaxation can help deal with negative thoughts and anxiety.

Alternative or complementary medicine: Many supplements and natural products can help control panic and anxiety in patients, for example, lavender oil or “rescue remedies.”

Treatment typically lasts about 10 weeks, with twice weekly sessions. Claustrophobia may be surmounted with adequate care.

Tips for coping

Strategies that can help people cope with claustrophobia include:

  • staying put if an attack happens. If driving, this may include pulling over to the side of the road and waiting till symptoms have passed.
  • reminding yourself that the frightening thoughts and feelings will pass
  • trying to focus on something that is not threatening, for example, the time passing or other people
  • breathing slowly and deeply, counting to three on each breath
  • challenging the fear by reminding yourself that it is not real
  • visualizing positive outcomes and images

Longer-term solutions may be to take a yoga class, carry out an exercise routine, or book an aromatherapy massage to help cope with stress.

Information video

Stella Lourency, assistant psychology professor at Emory University, explains in this video that people with higher rates of claustrophobic fear appear to underestimate distances.

Causes

Past or childhood experience is often the cause leading a person to equate small spaces with a sense of fear or potential risk.

Experiences which may have this effect may include:

  • being trapped or kept in a confined place, by accident or on purpose
  • being abused or bullied as a child
  • getting separated from parents or friends when in a crowded area
  • having a parent with claustrophobia

The trauma encountered at that time would rationally affect the capacity of the individual to deal in the future with a similar situation. This is called Classic Conditioning.

It is assumed that the mind of the person associates the limited space or confined area with the sense of being in risk. The body then responds differently, or in a way that would seem rational.

Also can inherit classic conditioning from parents or peers. For example, if a parent is afraid of being close in, the child may watch its actions and develop the same fears.

Possible genetic or physical factors

Other theories that may explain claustrophobia include:

Having a smaller amygdala: This is the brain portion that regulates how the body expresses fear.

Genetic factors: A dormant mechanism of evolutionary survival is triggering responses that are no longer required in the environment today.

Mouse experiments have shown that a single gene can cause certain individuals to have a greater degree of “resident-intrusive stress.”

One group of researchers proposed that people who experience claustrophobia interpret objects as closer than they are, and that this activates a defensive mechanism.

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