Claustrophobia Overview

An unreasonable fear of being in confined spaces is known as claustrophobia, and is thought to be experienced by up to 10% of the US population.

Small confined space - a fear called claustrophobia - by NUMAX3D

NUMAX3D | Shutterstock

While it is fairly normal to experience fear when trapped in a situation where there is a genuine threat, this is not the case in persons who are claustrophobic. Persons with this psychological condition experience unbearable anxiety in circumstances when there are no realistic and/or obvious sources of danger.

As a result of their condition, claustrophobic individuals tend to go to extreme lengths to avoid placing themselves in confined spaces. Some examples of spaces that would trigger anxiety in claustrophobic individuals include, but are not limited to, revolving doors, elevators, public transport and toilets, as well as MRI scanners. In addition to these, claustrophobic individuals may even experience unrealistic anxiety in crowded places, and tend to avoid them, which paradoxically may only reinforce the fear.

What causes claustrophobia?

The precise etiology  of claustrophobia is, to date, unknown. However, there is compelling evidence that implicates the noradrenergic system in claustrophobia, as well as in other anxiety disorders. Claustrophobia in one’s life may have arisen as a result of a traumatic experience in one’s childhood, or it may have emerged as one matured.

In general, there are many theories that have been postulated with regards to phobic-disorder pathogenesis. These theories mainly focus on endogenous biogenic amine dysregulation. The sympathetic system plays a role in elevating both the heart rate and blood pressure, as well as a myriad of other symptoms. Furthermore, genetic and environmental factors also seem to be implicated in claustrophobia, as they are with other anxiety and specific phobia disorders.

What are the signs and symptoms of claustrophobia?

When placed in a situation that may trigger a claustrophobic response, persons may develop a wide range of signs of symptoms. Furthermore, sometimes just the thought of being restricted or in a confined space can elicit the fear of not being able to breathe properly, as well as running out of air to do so.

Signs and symptoms of claustrophobia include, but are not limited to, sweating, shaking, light-headedness, fainting, tightness in the chest, shortness of breath, nausea, confusion, and disorientation, as well as elevated blood pressure, and accelerated heart rate.

How is claustrophobia diagnosed and treated?

Many people living with claustrophobia are aware that they have the condition, but many of them do not seek medical help and are thus never formally diagnosed. A qualified healthcare professional can establish a diagnosis by taking a thorough patient anamnesis and ruling out other anxiety disorders. The latter may be done with the help of a questionnaire, and the use of specific criteria:

  • The patient must have excessive and unreasonable fear when placed into or anticipating a specific circumstance.
  • Stimulating the patient by exposure to the circumstance should trigger a claustrophobic-anxiety response.
  • The patient should be able to recognize that their fear is irrational.
  • The patient must have employed certain measures to avoid the circumstance when possible, or if impossible, experienced it with great anxiety or distress.
  • The patient’s quality of life must be affected by their fear.
  • The patient should have been experiencing claustrophobia for at least 6 or more months.
  • The patient’s symptoms must not be attributable to another psychological disorder.

The successful treatment of claustrophobia (i.e. cure) is possible. This can be achieved by self-exposure therapy, also known as desensitization. It is done by gradually exposing the individual to the circumstance that elicits fear. It can be done independently or with the help of a trained professional.

Cognitive behavioral therapy (CBT) may be employed to help treat individuals affected by claustrophobia. CBT, which is also used to treat other phobias, allows patients to explore their behavior, feelings, and thoughts as they develop practical means by which to overcome their fear.

Further Reading

Last Updated: Dec 12, 2018

Damien Jonas Wilson

Written by

Damien Jonas Wilson

Jonas is a medical doctor from St. Martin in the Carribean. He recently graduated with a Medical Degree (MD) from the University of Zagreb Teaching Hospital. His training in general medicine and surgery compliments his degree in biomolecular engineering (BASc.Eng.) from Utrecht, the Netherlands. During this degree, he completed a dissertation in the field of oncology at the Harvard Medical School/ Massachusetts General Hospital

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