Claustrophobia. Symptoms, Causes and Treatment

Claustrophobia. Introduction

The word “claustrophobia” comes from Latin and Greek words meaning “fear of closed places.” People with claustrophobia avoid situations that trigger their panic and anxiety. For example, they might choose stairs instead of elevators, even if it means climbing many floors. It’s important to know that claustrophobia is a diagnosed condition that can seriously disrupt someone’s life.

Understanding the difference between fear and phobia is very important. Many fears make sense; we naturally try to avoid things that make us uncomfortable. But when fear becomes intense and irrational, it becomes a phobia. Phobias involve strong, irrational fears of specific things or situations, often unrelated to real danger. When phobias start to affect daily life, they become a health concern, impacting work, relationships, and self-esteem.

Triggers of Claustrophobia

Claustrophobia is triggered by various situations, such as:

• Tunnels
• Elevators
• Trains
• Airplanes
• Small cars
• Caves
• MRI machines
• Cellars
• Windowless or sealed rooms
• Even thoughts of confinement can spark it.

Symptoms of Claustrophobia

Claustrophobia falls under specific phobias, exhibiting these symptoms:

1. Intense Fear or Anxiety:
   • Focused on small or enclosed spaces, often fearing suffocation or restriction.
2. Consistent Provocation:
   • Almost any encounter with the fear-inducing situation triggers anxiety.
3. Avoidance or Endurance:
   • Either avoiding or enduring it with intense fear, disproportionate to real danger.
4. Extended Duration:
   • Lasts for at least six months, causing significant distress.

Types of avoidance behaviours may involve:

• Checking exits in rooms and feeling uneasy when all doors are closed.
• Avoiding heavy traffic while traveling in vehicles.
• Opting for stairs over elevators in buildings.
• Staying near the door at parties, even in spacious rooms.
• Avoiding MRI or CT scans, especially severe for some.

Claustrophobia symptoms vary, from panic attacks to physical and psychological effects. These includes:

Physical Symptoms:

• Sweating or trembling.
• Chest tightness or rapid heartbeat.
• Breathing difficulties or rapid breaths.
• Chills or flushed face.
• A choking sensation.
• Upset stomach or “butterflies” in your stomach.
• Dizziness, faintness, or lightheadedness.
• Dry mouth.
• Confusion or disorientation.
• Numbness or tingling.
• Ringing in your ears.
• In children, crying, tantrums, freezing, or clinging may manifest.

Emotional Symptoms:

• Fear of losing control.
• Fear of fainting.
• Overwhelming dread.
• Intense anxiety.
• Urgent need to escape.
• Recognizing the irrationality but unable to conquer it.
• Fear of dying.

Causes of Claustrophobia

1. Childhood trauma: adults who experienced being trapped in tight spaces as kids.
2. Triggering events later in life: Incidents like elevator entrapment or turbulent flights.
3. Parental influence: Growing up with a claustrophobic parent can lead to its development, as children associate confined spaces with their parent’s anxiety, feeling helpless to provide comfort.
4. Genetic predisposition: A single gene mutation may elevate the risk of claustrophobia if present.

Prevalence of Claustrophobia

Claustrophobia affects around 12.5% of the population. Typically, individuals with specific phobias, including claustrophobia, experience fear  towards three objects or situations. Surprisingly, 75% of them fear multiple objects or situations. It’s more prevalent among females than males. While anyone can develop this specific phobia regardless of age, most cases originate in childhood or adolescence.

Diagnosing Claustrophobia

The diagnoses of claustrophobia involves few steps:

1. Identifying the Problem:
   • If you fear enclosed spaces and take extreme precautions to avoid them, you might have claustrophobia.
2. Medical Assessment:
   • Healthcare providers aim to distinguish it from normal fears and rule out underlying medical or psychiatric conditions.
   • You may be asked about how your claustrophobia impacts daily life, its intensity, frequency, social interactions, and coping mechanisms.
   • Questions might cover recent life changes, stressors, and medications or supplements.

Diagnostic Criteria of Claustrophobia

• Marked Anxiety or Fear: Intense fear arises from a specific object or situation.
• Immediate Anxiety Response: Anxiety or fear quickly follows exposure to the trigger.
• Disproportionate Anxiety Response: Fear exceeds the actual threat posed by the trigger.
• Avoidance or Extreme Distress: Avoidance or enduring it causes extreme distress.
• Life-Limiting: The phobia significantly disrupts daily life, work, or personal affairs.
• Six Months Duration: Symptoms must persist for at least six months in children and adults.

Treatment of Claustrophobia

Without treatment, you might cope with claustrophobia by avoiding the feared situations. Taking stairs over elevators, walking instead of subway rides, scanning crowded rooms for exits, or clinging to the door are common behaviors.

Severe cases may lead to home confinement. However, avoiding feared situations won’t cure your phobia. Seeking help is crucial. First step in the treatment process is consulting a psychologist or mental health specialist.

Cognitive Behavioral Therapy (CBT)

• Focuses on changing thoughts, feelings, and behaviors.
• Discuss symptoms, explore phobia, reevaluate thinking, develop coping strategies, and face fears.
• Promotes calmness of mind and body.
• CBT teaches you to control and change negative thoughts triggered by claustrophobic situations.
• Altering your thoughts can lead to better reactions in such scenarios.

Rational Emotive Behavioral Therapy (REBT)

• A proactive form of CBT focused on the present.
• Targets unhealthy attitudes, emotions, and behaviors by challenging irrational beliefs.

Relaxation and Visualization Methods

• Therapists provide techniques like counting down or imagining safe spaces during claustrophobic moments.
• These methods aim to alleviate anxiety and panic.

Virtual reality (VR)

It involves computer-generated simulations of confined spaces, such as elevators or MRI machines. Experiencing these tight spaces in a virtual environment can aid in overcoming your fear within a secure setting.

Exposure Therapy

• Confronts and conquers claustrophobia by placing you in non-dangerous triggering situations.
• Repeated exposure helps reduce fear over time.
• Gradual exposure to feared situations.
• Aim: Comfort in the specific feared scenario.
• Approaches: Real-time confrontation, recalling and describing the fear, using pictures or virtual reality.
• Customized pacing, including relaxation and breathing exercises.

Medication Treatment of Claustrophobia

• Antidepressants or anti-anxiety meds may be prescribed to alleviate panic and physical symptoms.
• Medications are typically used alongside therapy for comprehensive treatment.
• Common options include benzodiazepines (Xanax, Klonopin, Valium) and selective serotonin reuptake inhibitors (Paxil, Lexapro).

Claustrophobia. Summary

Claustrophobia counts to specific phobias manifesting as an excessive fear of confined spaces. The affected individuals experience disproportionately high levels of anxiety in elevators, subways, shoping malls, etc. Although sufferers recognize the irrationality of their fear, they struggle to control it.

The intensity of anxiety varies from discomfort to panic, accompanied by physical symptoms like rapid heartbeats, sweating, breathlessness, and hyperventilation. In fear of these physical and psychological symptoms, individuals with claustrophobia develop avoidant behaviour worsening further their condition.

The course of claustrophobia varies. Many individuals with claustrophobia can avoid triggering situations and do not feel much restricted in their daily lives. However, in the majoroty of cases claustrophobia left untreated, tends to escalate growing in intensity and fequency.

Increasing claustrophobic fears restricts individuals social and professional performance. Some individuals with phobias turn to alcohol to cope with anxiety-inducing situations, putting them at risk of developing dependency.

With proper treatment, the prognosis of claustrophobia is good. The most promissing treatment is combination of pharmacotherapy (treatment with medication) and psychotherapy (counselling).