Have you experienced an overwhelming sense of terror towards certain objects or situations? Have you noticed that you become afraid of enclosed spaces or rooms?
The term “phobia” originates from the Greek word “Phobos” and, in the late 19th century, it referred to an intense, irrational fear towards specific situations or objects. Individuals suffering from phobias tend to avoid these situations as much as possible. There are various types of phobias, each with its specific medical terminology. Claustrophobia significantly impacts the lives of those affected and their families, both on personal and professional levels.6
Definition of claustrophobia
Claustrophobia is a fear of confined spaces. Enclosed spaces include areas such as engine rooms, small or locked rooms, basements, tunnels, elevators, X-ray machines, crowded places, and more.1 Many claustrophobic individuals experience a fear of suffocation when in confined spaces, which is closely related to a sensation of breathlessness. This fear can be distressing, but most patients find ways to cope by avoiding small or confined places.3
Prevalence and impact
Claustrophobia affects approximately 12.5% of the population and is more common among females. While specific phobias can develop at any stage of life, they often emerge during childhood and adolescence.4 Claustrophobia can significantly limit a patient's social life, affecting activities such as using elevators, changing rooms, and public transport. In severe cases, it can even lead to panic attacks and suicidal thoughts. Environmental fears related to confined spaces generally have a more detrimental impact on daily life and social functioning than fears of animals.3
Causes and triggers
Phobias can be triggered by traumatic experiences or events associated with specific objects or situations. Some common triggers for claustrophobia include:2
Some adults with claustrophobia report incidents where they were trapped or confined to a small space during childhood, which left a lasting impact.2 You may have a fear of losing control or fear of fainting.
Traumatic events, such as being stuck in an elevator or experiencing severe turbulence during a flight, can trigger claustrophobia.4
Genetics and neurobiology
There may be a genetic component that increases susceptibility to developing phobias, including claustrophobia. Research suggests that individuals with specific phobias show unique brain responses, particularly in the amygdala, a part of the brain involved in processing fear.
Researchers acknowledge that individuals with specific fears activate distinct areas of the brain. In contrast, those without these fears do not exhibit the same neural response, as certain neurochemicals dominate a region of the brain — the amygdala — in the presence of fear.2,4
Symptoms and manifestations
The symptoms of claustrophobia are similar to those of anxiety and panic attacks, and healthcare professionals often use these symptoms for diagnosis.
It includes the following but is not limited to:3
- Difficulty breathing
- Dry mouth
- Chest pain.
Emotional and behavioural reactions:
Profound side effects include but are not limited to
- Overwhelming anxiety or fear
- Fear of losing control
- An intense urge to leave the situation
- Understanding that the agitation is irrational but feeling unable to overcome it.4
Diagnosis and assessment
This can be done with the assistance of a psychiatrist or psychologist as follows:
- Diagnosis of a claustrophobic patient begins by examining their symptoms.
- Practitioners also attempt to differentiate between the patient’s phobia, normal fear, or any underlying mental conditions such as anxiety, depression or obsessive-compulsive disorder (OCD).3
- Try to evaluate how the patient’s fear impacts their daily lifestyle and discuss their medical history.2,4
- Practitioners employ questionnaires, interviews and fear rating scales to assess the patient’s condition and determine how much the fear affects them.3,4
Your healthcare professional may recommend various treatments or medications. Understanding the cause of the fear is less important than engaging in the most effective method to address the avoidance behaviour that has developed over time. The objective of the treatment is to enhance your quality of life so that you are not consistently limited by your fears. The therapies mentioned below are utilised to treat your condition.2
Cognitive behavioural therapy
CBT is a talking therapy that helps patients manage their fears by changing thought patterns and behaviours. While typically used for anxiety and depression, it can also be effective for other mental and physical health issues.5
In this therapy, you are gradually exposed to your feared situation. With progress, you will become more comfortable.5
This strategy might include:
- Confronting your feared fear directly and progressively in a safe environment.
- Recalling and describing your feared experience.
- Focusing on images or using virtual reality to immerse yourself in the fearful situation but with precautions.5
Medications are used for a short time to alleviate the symptoms related to the developed condition in specific circumstances or situations. The classes of medications include:3,4
- Benzodiazepines: These belong to the drug class of sedatives used to induce relaxation and reduce anxiety.4
- Selective serotonin reuptake inhibitor: A class of antidepressants that have shown effectiveness in some studies.3
In addition to professional treatment, there are self-help techniques and support systems that can be valuable:2
Maintaining a healthy lifestyle, including adequate sleep, proper nutrition, regular exercise, and reducing or eliminating caffeine, can help manage anxiety. Celebrating personal achievements can boost self-confidence and morale.2,4
Sharing claustrophobic feelings with trusted individuals and joining support groups can provide understanding and guidance for managing claustrophobic fear.4
Tips for overcoming claustrophobia
In addition to consulting your primary healthcare provider or psychologist, you can try any of the following techniques to help you feel at ease:
- Gradually be in situations that you dread.
- Practice being near the feared objects or situations as much as possible rather than completely avoiding them.
- Your family, friends, and therapist can assist you in this practice.
- Implement what you've learned during treatment, and collaborate with your therapist to create a plan in case your symptoms worsen.2
- Try deep relaxation methods to calm your mind, such as breathing exercises (breathing in slowly and deeply through your nose, holding for three seconds, exhaling slowly through your mouth), meditation, mindfulness, progressive muscle relaxation (tensing and relaxing muscle groups), and other relaxation techniques.
- Visualize and focus on something that brings you peace.4
Claustrophobia is an irrational fear of confined spaces that can disrupt daily life. Understanding the causes and triggers, symptoms, and available treatments is crucial for individuals affected by this condition. Seeking professional help, such as therapy or medication, can significantly improve one's quality of life. Support from trusted individuals and making positive lifestyle changes are also essential for managing claustrophobia effectively.
Does every person facing a phobic condition need treatment?
Not every individual requires treatment. If you feel that your phobia is disrupting your normal life, seek medical advice from your GP as soon as possible.
Which treatment strategy is much more effective in preventing claustrophobic conditions?
The type of treatment that might work best for one individual might not be as effective for another. The effectiveness of treatments can vary between individuals. Exposure therapy is an effective method for dealing with claustrophobic conditions.
Which doctor should I consult if I’m facing an extreme phobia?
A psychiatrist, psychologist or counsellor can be of great help in understanding your condition.
What lifestyle changes do patients need to make to deal with claustrophobic conditions?
Patients should aim to share their thoughts with trusted individuals and focus on maintaining good eating and sleeping patterns.
How do you differentiate between normal fear and phobia?
While fears in childhood are normal, if they persist into adulthood and lead to avoidance behaviour, they should be considered a phobia.
What are the complications of claustrophobia?
Complications of claustrophobia can include anxiety, panic attacks, depression and even suicidal thoughts.
- Radomsky AS, Rachman S, Thordarson DS, McIsaac HK, Teachman BA. The claustrophobia questionnaire. Journal of anxiety disorders. 2001 Jul 1;15(4):287-97. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0887618501000640.
- Specific Phobias - Symptoms and Causes [Internet]. Mayo Clinic. 2016. Available from: https://www.mayoclinic.org/diseases-conditions/specific-phobias/symptoms-causes/syc-20355156
- Vadakkan C, Siddiqui W. Claustrophobia. InStatPearls [Internet] 2022 Jul 20. StatPearls Publishing. Available from: http://www.ncbi.nlm.nih.gov/books/NBK542327/.
- Claustrophobia: What Is It, Symptoms, Causes & Treatment [Internet]. Cleveland Clinic. 2021. Available from: https://my.clevelandclinic.org/health/diseases/21746-claustrophobia
- NHS. Overview - Cognitive behavioural therapy (CBT) [Internet]. nhs.uk. 2021. Available from: https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/cognitive-behavioural-therapy-cbt/overview/#:~:text=Cognitive%20behavioural%20therapy%20(CBT)%20is
- Doctor RM, Kahn AP, Adamec CA. The encyclopedia of phobias, fears, and anxieties. Infobase Publishing; 2010 May 12.