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All about Claustrophobia – The Fear of Enclosed Spaces

All about Claustrophobia – The Fear of Enclosed Spaces

Updated on May 27, 2022 | Published on Jan 13, 2022

Reviewed by Dr. Nereida Gonzalez-Berrios, MD , Certified Psychiatrist

Claustrophobia - Signs, Symptoms, Causes, Types & Treatment
https://ocdla.com/phobia-test

Are you uncomfortable getting into an elevator? Do you fear being stuck in a small room with a low height? Do you always want someone to go with you to a public restroom? 

Does anxiety creep in immediately if someone tells you to get inside a very small and tight place? If yes, then you are suffering from a situational anxiety disorder known as Claustrophobia.

This is a form of irrational and illogical fear that follows a situation or a place that feels tight, trapped, and confined.

You may experience the fear of being trapped and may not know how to overcome the tight space.

The fear gets overwhelming and kick starts several physical reactions and emotional manifestations.

It leads to unnecessary avoidance and can interfere with the routine functioning of daily life.

In this article, we will discuss the various signs, causes, and treatment procedures of this mental health problem.

Read on….

Claustrophobia Infographic

Claustrophobia - Signs, Symptoms, Causes, Types & Treatment
Claustrophobia – Signs, Symptoms, Causes, Types & Treatment

What is Claustrophobia?

Summary
Claustrophobia refers to a type of immediate fear response that stems from exposure to closed and tight places. The fear is intense and irrational and it gives the person a choking feeling that is so extreme that a panic attack starts to set in no time.

Claustrophobia is a common type of specific phobia that affects about 7 to 10% of the population. Studies were done in the ‘Center for the treatment of phobia, anxiety, and depression have suggested that claustrophobia is far more common than what is actually reported in journals and study findings.

If you have a fear of constricted and enclosed spaces, you may have seen that your fear response actually makes you feel sick. You start behaving in odd ways that are generally not found elsewhere.

Claustrophobia is an intense fear and that is what makes it a phobic condition, requiring treatment at some point in time.

The term ‘Claustrophobia’ comes from a Latin word, ‘Claustrum’ which means “a closed-in space’ and the Greek term ‘Phobos’, meaning fear. Thus, together it means fear of confined and closed spaces.

The fear intensifies when you feel that the exit point is nowhere and you are totally stuck and confined. This feeling immediately causes panic symptoms that are intense and brings a lot of emotional discomforts.

People with claustrophobia may suffer from anxiety symptoms while being in a closed space. They may avoid elevators, window-less storerooms, caves, airplanes, and changing rooms in a shopping center.

Some people have also reported claustrophobic symptoms while wearing tight-fitted clothes where they feel discomfort in breathing.

Your claustrophobic symptoms can be debilitating and can stop you from moving freely in and around constricted spaces. 

If you are suffering from claustrophobia, you might be aware of the fact that even though there is no real threat around, you are still in the grip of fear. This makes the fear an irrational and baseless one.

When faced with a real fearful situation, a person with claustrophobia reports a feeling of choking, as if something got stuck in the throat and restricting the airflow, breathing feels tight as well.

In DSM-5, claustrophobia falls under specific phobias, situation types. The disease may get worse if treatment is not undertaken.

Yet, the recovery rate is well and the patient can overcome their intense feelings gradually.


Claustrophobia symptoms and signs

People with claustrophobia fear the possibilities of what could happen if they get stuck in a small space. It is not always the real threat that triggers the fear response.

The virtual perception of threat and a feeling of being helpless and immobile with no immediate help can bring a host of physical and psychological symptoms that are painful and agonizing.

Claustrophobia symptoms may vary from one person to the other. It can be intense anxiety causing symptoms of panic disorder or it could be mild discomfort, coupled with an avoidance response.

The past experiences of the patient, family history, and the specific situations that trigger the fear response do play a role in its severity.

If you have severe symptoms, you would be too scared to speak out, may feel completely numb and still. The symptoms of claustrophobia can be both physical as well as emotional.

Physical symptoms

The physical symptoms of claustrophobia match with panic disorder. Here, the person experiences bodily discomfort that is tiring as well as overwhelming.

  • A tight chest
  • Feelings of choking
  • Irregular breathing patterns
  • Excessive trembling of the hands and feet
  • Hot flushes or cold chills with a shivering sensation
  • Racing heart with irregular heartbeats
  • Stomach issues
  • Dry mouth
  • Numbness in the body
  • Ringing sensations in the ear
  • Nausea
  • The walls of the space may feel like too close to your body

Psychological symptoms

These symptoms of claustrophobia feel awkward and disturbing. This is because the fear response is intense and may leave you in a state of shock and confusion.

  • An intense need to avoid closed spaces.
  • You will always look for quick exits
  • Fear of small spaces
  • Confused state of mind 
  • Feeling afraid that the doors of the room may close on their own or it might not open
  • Standing near the door or exit point wherever you go.
  • You may avoid a busy road to avoid the traffic snarl
  • Use of staircase and avoid the use of lifts if traveling alone.
  • Feelings of extreme fright where the person may seem to faint or lose consciousness
  • Panic attack can come after minutes of exposure to the closed space
  • The person always goes out of his/her way to avoid the situation.

What causes Claustrophobia?

There is not enough literature that can actually tell us the reasons behind developing claustrophobia.

Many researchers have pointed out the role of bad childhood experience and trauma as a causal factor.

Many theories claim that claustrophobia is a defense mechanism that a person uses in times of threat. The motive is to safeguard oneself from danger and fear. 

This theory claims the role of evolution and pinpoints that humans have an innate need to stay protected in face of fear. Thus, they try to avoid situations that feel dangerous and scary.

If you suffer from other phobias such as agoraphobia, social phobia, fear of losing control, or even the fear of getting injured, you may develop claustrophobia.

But, study findings have also shown that nervous and fearful people are more likely to develop claustrophobia because of their insecurities and deep-seated fears.

Childhood trauma

If you ever had a bad experience in a closed space, it may trigger claustrophobia. You may develop the symptoms of extreme fear if you were ever trapped in a small space and struggled to come out of it. 

Childhood bullies and abuse related to a confined place such as a dark, locked room may lead to claustrophobia in adulthood. 

Claustrophobia occurs if you perceive your confinement as linked with some future threat, such as a door, not opening, or your need to escape from the place but you’re unable to do so.

Size of Amygdala

Studies done on anxiety have found that people with claustrophobia have smaller Amygdala volumes. It means that these groups of people are more anxious-prone than others who do not suffer from panic symptoms. 

Learned response

Reports of people suffering from claustrophobia also suggest that family influence also plays an important role.

If you have any parent suffering from the illness, you might also develop similar symptoms in adulthood. 

The anxiety and helplessness of the parent may manifest in their children’s behavior as well through observation and learned responses.

Conditioning experiences in the development of symptoms

Some classical conditioning experiences of childhood may leave deep-seated scars in the psyche. Later on, these may lead to anxiety and phobia in later life.

  • A child who is locked in a dark room and has no clue of how to escape the feared situation
  • Getting locked in a closet (may happen with small children while playing)
  • A child getting his/her hand stuck in a drawer
  • Separation from parents in a large crowd
  • Falling in a dark pit and no help to be found around
  • If a child is left alone in a car in jam-packed traffic
  • Feeling stuck in a place with no windows, such as store-rooms, old house basements, etc.

Genetic factors

Claustrophobia has a genetic basis and researchers have found that the disease runs in families. A single gene defect GPm6a has shown abnormal mutations in claustrophobic patients than those who were not suffering from the disease.

Distortions in space perception

Scientific studies have shown that the position of near and far off things plays an important role in the development of claustrophobia. It all depends upon how the patient perceives the space around them.

Claustrophobic patients tend to believe that nearby objects are approaching them. This feeling makes them nervous and anxious because they perceive the situation as dangerous. 

Many people reported small perceptions of objects placed on the left side. People with short arm lengths think that the space between their body and the nearby objects are less. 

Thus, they feel that they might get stuck in a bad way. But, those with longer arm length perceive the space as larger than the others. 

People with claustrophobia suffer from space distortions. They may not perceive the actual space as it actually is.

The evolution theory of prepared phobia

This theory says that claustrophobia is a type of prepared phobia. If a person perceives a threat, he/she will try to move away from it.

The phobia becomes a natural response to safeguard oneself from a danger that may harm one.

The prepared phobia helps the person to recognize the danger and avoid or escape quickly from it.

As the confined, close spaces are suffocating and might give a choked feeling, the person wants to move away from the situation as soon as possible.


Types of Claustrophobia

People with claustrophobia always try to avoid situations where they may have to face a small and confined space. 

Even if there is no real threat, they might perceive the situation as dangerous. This may give rise to an irrational fear that is persistent and can go on for a long time.

The types of claustrophobia involve those set-ups where the person may feel fearful and try to avoid the situation. The situations that trigger claustrophobia involve the following:

  • Lifts
  • Closed changing rooms
  • Tunnel
  • Stuck in traffic in a narrow lane
  • Basements with no windows
  • Constricted narrow roads with houses on both sides
  • Public toilets
  • Subways
  • Revolving doors in shopping centers
  • Darkroom with or without light
  • Certain medical procedures such as MRI scanners, CT-scan machines
  • Crowded train
  • Airplane
  • Caves or small holes where one needs to crawl to get inside and out of it
  • Crowded spaces like cinema halls or concert rooms without good ventilation
  • Feeling stuck inside a carwash shed, if at all needed to be there

How is Claustrophobia diagnosed?

If you are suffering from a persistent fearful state that is not getting better in any other way, you should visit a mental health professional for help and guidance.

Your therapist will review your condition by a proper mental status examination where they might ask you several questions about your problem. 

The purpose is to rule out that you are really suffering from claustrophobia and not from a normal fear. 

If you are suffering from claustrophobia, your doctor will tell you about the diagnosis or treatment plan that will cater to your individual needs.

Your therapist will ask you several questions such as the following:

  • What are the symptoms and the immediate triggers?
  • Do you have any family history of claustrophobia?
  • For how long are you suffering?
  • Do you get panic attacks along with the fear of confined spaces?
  • What are the different situations that give you such a choked feeling?
  • Are you taking medicines to improve your condition?
  • Have you ever been to a therapy session?
  • How do you help yourself? 
  • What made you come for a psychiatric consultation?

From these questions, the therapist makes an action plan which consists of your symptoms, the diagnostic criteria for claustrophobia, and the treatment plan for reducing the symptoms.

As claustrophobia is a specific phobia. The diagnosis is done according to the criteria for specific phobias as given in DSM -5. (Diagnostic and Statistical Manual, Edition 5)

The diagnosis goes like this –

  • A persistent, extreme fear of the situation, either real or perceived
  • Anxiety, and fear response when exposed to the feared situation such as crying, screaming, yelling, clinging, or even freezing
  • Patients are aware that the fear is not normal and much more in intensity than the actual threat
  • Avoiding the feared situation because it causes a lot of distress.  It interferes with your daily life
  • The phobia has been there for 6 months or more
  • Your symptoms are not related to any other mental health condition

The ill-effects of Claustrophobia

Have you ever experienced the feeling of intense fear when you have stepped inside an elevator? Your heart started racing, you were badly perspiring and still trying to make yourself at ease, but couldn’t do so. 

The ill-effects of claustrophobia go much beyond normal fear. During the panic episode, you’ll feel out of control. Though you know that the fear is irrational, you may not be able to help yourself.

This is because fear has consumed your thoughts and feelings. You are emotionally overwhelmed and may start to feel dizzy and die out of excessive fear.

Claustrophobia leads to avoidance of all closed spaces that give choking and trapped feelings. This feeling of suffocation may trigger a fear response in any situation that appears constricted.

The panic episode may last for 10 minutes but can leave you severely sick and tired. Sometimes the fear response can make you feel restless for quite some time. 

Feelings of detachment from reality are obvious. You will feel confused about your next course of action.

Claustrophobia interferes with your daily life and you will not be able to enjoy things in the way you should.

Some regular activities such as air travel, driving a car through narrow lanes or crowded streets may feel stressful.

People with claustrophobia find it extremely difficult to go through medical procedures such as MRI scans or CT-scan, etc.


Difference between Claustrophobia and Agoraphobia

Both these disorders involve persistent and intense fear response that is much more than the normal fear. 

Thus, the anxiety is proportionally much more and it can cause significant distress in the day-to-day life of the person.

These two mental health conditions may appear similar in many aspects but are distinct in nature. There are many differences between the two that are given in the table below:

ClaustrophobiaAgoraphobia
Fear of close, confined, and restricted spaces such as MRI machines, dark basement rooms, window-less corridors, etcFear of crowded and densely populated spaces such as markets, busty streets, etc.
The size of the space leads to fearThe size of the people moving around causes the fear
Claustrophobia comes under the category of specific phobias, situation type in DSM-5Agoraphobia is an independent psychiatric illness referred in DSM-5
Less  closely associated with panic attacksMore closely associated with panic attacks
People with claustrophobia get uncomfortable with medical procedures such as MRI scans, CT-scanners.Agoraphobics do not have problems with medical procedures. 
Claustrophobia vs. Agoraphobia

Claustrophobia test

There are no formal standardized tests that can identify whether a person is suffering from claustrophobia. However, several online tests are found that can give you a fair idea of your anxious state of mind.

Two such online tests are – https://www.fearof.net/anxiety-disorder-test-your-fear-level/

To get yourself diagnosed with claustrophobia, you need to consult a therapist or mental health doctor. They will guide you through the much-needed treatment plan in an appropriate way.


How common is Claustrophobia?

According to trusted sources and medically reviewed journals, Claustrophobia is quite common and the global prevalence rates are of the following nature –

  • Claustrophobia is a common mental health illness and about 12.5% of people suffer from some type of specific phobia in their lifetime.
  • Another research finding suggested that 2.2% of people suffer from Claustrophobia per year globally. (From World Mental Health Survey, 2017).
  • Research study pieces showed that 5% of the US general population may suffer from claustrophobia in the mild and severe versions of the disease. 
  • In a research study involving an MRI diagnosis and claustrophobia, 13% of patients receiving an MRI scan reported symptoms of mild to severe panic attack while undergoing the medical procedure.
  • Research reports showed that 60% of the things that people with claustrophobia fear will never actually take place now or any other time in the future.
  • The number of Americans who are diagnosed with at least 1 phobia is 6.3 million.
  • In an NIH study on MRIs and claustrophobia, a total of 95 patients (1.97%) suffered from claustrophobia and 59 (1.22%) prematurely terminated the examination due to claustrophobia.

How to overcome Claustrophobia? (Self-help tips)

Besides psychotherapy, you can also do certain things on your own to feel better and manage your symptoms. If you want to cope with your illness, it is important to follow the guidelines of your therapist as well. 

In some severe cases of phobia, coping needs a definite plan and guidance. The self-help techniques will make you feel better and facilitate the recovery rate.

1. Meditation

Meditation helps to train your mind in positive ways. Moreover, it relaxes the muscles of the body. Thus, the physical symptoms of phobic responses can be managed in a better way.

Studies have shown that 10 to 15 minutes of regular meditation practice can actually lower your stress levels.

2. Walking and physical exercises

Your therapist may recommend walking and other forms of physical exercise to manage your phobic symptoms.

A regular doing of such exercises stimulates the release of endorphins, which is also known as the feel-good hormone.

This helps to reduce your anxiety and fear responses. Sometimes, regular exercises help to relax the body muscles and improve heart health as well.

3. Deep breathing

You should practice deep breathing if you are suffering from claustrophobia. It triggers positive emotional changes in you that help to counteract your anxious responses.

Deep breathing relaxes your mind and makes it more rational and agile.

Along with deep breathing, you can also do progressive muscle relaxation that will help to ease your fear responses. In this way, your sensitivity to the feared element will reduce and you will be in control of your anxious responses.

4. Positive self-talk

We feel the way we think. Is it right? Yes, it is. Thus, to correct your fear, you need to change your negative thoughts and replace them with positive ones. And how can you do that? It’s simple.

Start practicing positive self-talk and fine-tune the way you think. Try to correct your irrational fear and unrealistic thoughts about closed spaces by telling yourself that it is not that bad. 

You have the power to face your fear and overcome them completely. You will have to stop the negative mind chatting and counter the fears with real facts.

5. Adequate self-care

Self-care is an important part of your treatment plan. If you have the symptoms of the illness, you should follow a healthy diet, with adequate sleep.

Try to do something you really love doing, so that the stress triggers can be minimal and fear response can be delayed.

You can cut down on caffeine or substance abuse if any. But, it is also important to spend time in positive situations that can relax your mind and give you a sense of happiness and peace. 

Slowly, you can learn to hug life as it is. You’ll be able to free yourself from the continuous fear that you might be experiencing.


Treatment for Claustrophobia

Many people live with their phobias throughout their lives. But there are many who may feel too overwhelmed when faced with fear. 

These individuals may need to treat their condition because their symptoms are interfering with their normal functioning. 

Claustrophobia is treatable and gets cured after exposure to the feared situation gradually. Thus, self-exposure therapy and cognitive behavior therapy are mostly used to treat this disorder.

There are various treatment options available for claustrophobia. The choice of an ideal treatment is usually taken by your therapist. 

They will assess the severity of your symptoms and shall decide on the techniques to be used in the psychotherapy sessions.

The various treatment options for treating claustrophobia are as follows:

Cognitive behavior therapy (CBT)

In CBT, the patient changes their negative thoughts and perceptions with positive ones. Here, they explore their thoughts and try to analyze the feared situation in detail, so as to know whether the fear is really irrational or not.

In most CBT sessions, the therapist uses talk therapy where the patients are asked about their symptoms, the likely triggers, and the ways they deal with the situation.

They can recognize their irrational fears and reevaluate the situation. In this way, the focus of treatment is to alter mind states and change the way they think. 

Moreover, you will be taught some effective problem-solving skills to manage your symptoms in the best ways. You’ll learn to relax and face your fear rather than avoid it.

Exposure therapy

This therapy is the widely used treatment followed for claustrophobia. This is also known as the desensitization method. 

In this form of treatment, your exposure will be slow and gradual to the feared situation. In this way, you’ll be able to note your feelings and be aware of the difference between the perceived threat and the real threat.

The aim of exposure therapy is to make the person feel comfortable in the situation. The gradual exposure helps you to face your fear confidently. Sometimes exposure therapy is done along with virtual reality therapy.

In this method, the pictures of enclosed spaces are shown to the patient. Then they are told to imagine facing those situations virtually. 

In this way, the patient is exposed to simulated situations that feel real.  This helped the patient adjust to their fear well.

When you have learned to recognize and recall your feared experiences, be sure that you have even mastered the art of controlling them.

You will no longer feel the same level of fear if placed in a confined and constricted space.

Virtual Reality Exposure Therapy (VRET)

This is an exposure technique where you will be put in a virtual setup that can provoke fear; the virtual environment will be designed in such a way that it will elicit the same level of fear response as the real one. 

This is an indirect exposure that helps the patient face the feared stimulus inside the therapist’s office. This process can save time but the equipment needed is costly.

So, it is not an affordable one to treat claustrophobia.

Medication

This treatment is done by a licensed psychiatrist and is usually followed by psychotherapy. Medications such as anti-depressants such as Selective Serotonin Reuptake Inhibitors (SSRs) are given to manage the symptoms. 

If the symptoms are persistent, then SSRIs are given to make serotonin more readily available in the brain. Serotonin is a neurotransmitter that affects emotions. 

If the level is inadequate, the person may suffer from anxiety and panic attacks. Thus, the purpose of SSRIs is to increase the level of serotonin to improve brain health and reduce anxiety.

Sometimes the use of anti-anxiety medications can manage physical symptoms of claustrophobia. 

Note: Medications should be taken as per the prescribed dosage as given by your doctor. In case, you are not comfortable with the medicine, seek medical advice without delay.

Grounding

This method makes you aware of your surroundings. You are turned away from your source of fear and anxiety and made to think and focus on something else. 

The technique allows deeper relaxation and helps you get adjusted to the feared situation. It improves awareness as you will be able to attend to your senses and how you feel about it.

One of the best grounding techniques for anxiety disorders and phobias is the 54321 technique.

In this one, you will have to bring your wandering mind into a calm state in the present time. You can perceive information with the senses and be present in the moment you are in.

You will have to focus on:

  • 5 things that you can see
  • 4 things you can feel just now
  • 3 different things that you can hear right away
  • 2 things that you can smell
  • 1 thing to touch now

Imagery

This is a guided technique where the therapist will tell you to imagine a peaceful situation from your past that was devoid of worries and anxieties. 

It can be a scene of spending a happy time with your family and friends, walking around a beach on a sunny morning, etc. 

You can recreate the happy scene now and see how you feel about it. The purpose of this method is to teach the person to think of positive scenes while they are in fearful closed situations. 

In this way, they will learn coping skills of not avoiding the situation. Thus, they can reduce their anxious responses and feel at peace with themselves.

Progressive Muscle Relaxation

This treatment procedure involves relaxing the different muscles of the body by inhalation and exhalation of air.

The process regulates muscle tension and breathing. You will have to tense a muscle of your body while breathing in the air (inhalation), then breathe out (exhalation) and relax the tight muscles. 

In this way, the various muscles of fists, shoulders, arms, legs, will be relaxed. The process can be practiced for 5 to 10 minutes.

Progressive muscle relaxation can help in reducing the tensed feelings of the body that happens during the phobic episode.


Claustrophobia Statistics

Claustrophobia Statistics
Claustrophobia Statistics (Sources – Cleveland Clinic, Pub Med, Hopkins Medicine)

Summing Up from ‘ThePleasantMind’

Freeing yourself from claustrophobia is easy if timely treatment is done. Most patients recover from their fear successfully. 

By knowing about the situations that cause the fear, you will be able to manage your symptoms in a better way, thereby living a life of joy and complete freedom from fear.

Article Sources


1. https://en.wikipedia.org/wiki/Claustrophobia
2. https://www.medicalnewstoday.com/articles/37062
3. https://www.nhs.uk/conditions/claustrophobia/
4. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/claustrophobia

Are you interested to know more about ‘Acrophobia’ then click here?

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