People with claustrophobia can find the disorder hard to live with, as they will go to great lengths to avoid small spaces and situations that trigger their panic and anxiety. They will avoid certain places like the subway/underground and will prefer to take the stairs over using a lift/elevator no matter how many floors they need to ascend/descend.
According to the book "Phobias: A Handbook of Theory, Research
and Treatment," between 15% and 37% of people worldwide are affected by
claustrophobia. Even though many of them have severe symptoms, a very small percentage ever receive some kind of treatment for the disorder.
What are the Symptoms of Claustrophobia?
A symptom is something the patient feels or reports, while a sign
is something that other people, including the doctor detects. A headache may be
an example of a symptom, while a rash may be an example of a sign.
Claustrophobia typically develops during the individual's childhood or teenage years.
Claustrophobia is an anxiety disorder. An afflicted person has symptoms of anxiety that are triggered by being in a confined space, or the thought of it. The sufferer dreads not being able to breathe properly, running out of oxygen, along with distress at being restricted. When anxiety levels reach a certain level, the following physical signs are
◾Accelerated heart rate
◾Increased blood pressure
◾Hyperventilation, or 'over-breathing'
◾Shaking or trembling
◾Butterflies in your tummy
◾Fear of actual harm or illness
◾Tightness in the chest, sometimes chest pain
◾An urge to go to the toilet
◾Confusion and/or disorientation
It is not necessarily the small spaces that trigger the anxiety but the fear of what can happen to the person if confined to that area, hence the fear of running out of oxygen. Examples of small spaces that could trigger anxiety are:
◾shop changing rooms
◾hotel rooms with windows that do not open
◾cars - especially if they have central locking
◾some medical devices, such as MRI (magnetic resonance imaging) scanners
As claustrophobia is also defined by the phobia of being restricted, being confined to one area can also trigger the anxiety, for example, having to wait in line at a checkout/cash
As the above situations can trigger severe anxiety and panic attacks in people with claustrophobia, they will try their best to avoid them.
The following examples are how people with claustrophobia may behave or react:
◾As soon as they enter a room they may urgently check out where the exits are and position themselves near them. When all the doors are closed they may feel more anxious.
◾In a crowded party, even if the venue is a large and spacious room, they will try to position themselves near the door.
◾Avoid driving during peak times, when traffic is likely to be congested
◾Avoid traveling as a passenger in a car during the rush hour
◾In severe cases, some individuals with claustrophobia may panic when a door is closed
◾Avoid using elevators and use the stairs, even if this means getting tired, out of breath and sweating a lot
What Causes Claustrophobia?
Claustrophobia is generally the result of an experience in the person's past (usually in their childhood) that has led them to associate small spaces with the feeling of panic or being in imminent danger. Examples of these kinds of past experiences are:
◾falling into a deep pool and not being able to swim
◾being in a crowded area and getting separated from parents/group
◾crawling into a hole and getting lost/stuck
As the experience will have dealt some kind of trauma to the person, it will affect their ability to cope with a similar situation rationally. The mind links the small space/confined area to the feeling of being in danger and the body then reacts accordingly (or how it thinks it should.
This type of cause is known as classic conditioning and can also be a behavior inherited from parents or peers. If for example, a claustrophobic person has a child, the child may observe their parent's behavior and develop the same fears.
There are other theories behind the causes of claustrophobia, these are:
The amygdalae (red areas) were found to be smaller in people with panic disorders.
◾Smaller Amygdalae - the amygdala (plural: amygdalae) is a tiny part of the brain that is used to control how the body processes fear.
In a study published in Psychiatry and Clinical Neurosciences, it was discovered that people who suffered panic disorders had smaller amygdalae than average.
This smaller size could interfere with how the body processes panic and anxiety.
◾Prepared Phobia - there is also a theory that phobias develop on the genetic level rather than psychologically. The research behind this theory suggests that claustrophobia and some other phobias are dormant evolutionary survival mechanisms. A survival instinct buried within our genetic code that was once crucial to human survival but is no longer needed.
A team from Germany and the United Kingdom wrote in the journal Translational Psychiatry that a single gene defect probably contributes to the development of
How is Claustrophobia Diagnosed?
Claustrophobia is diagnosed by a licensed clinician such as a psychologist or psychiatrist. The patient may be seeing the clinician because he or she is experiencing the symptoms of claustrophobia, or the consultations could be originally about another anxiety problem or phobia.
The clinician will ask for a description of the symptoms and what triggers them. This helps determine the type and severity of the patient's phobia.
The clinician needs to rule out other anxiety disorders or phobias, such as cleithrophobia (fear of being trapped).
There are methods put in place to help decide if the patient is suffering claustrophobia and to what extent. These methods are:
◾Claustrophobia questionnaire - Originally developed in 1993 and modified in 2001, this has been a helpful way of identifying the symptoms of claustrophobia. It is especially useful in determining whether the patient's anxiety is driven by a fear of suffocation or restriction.
◾Claustrophobia Scale - Developed in 1979, this method is made up of 20 questions that when answered can help establish the levels of anxiety when diagnosing claustrophobia. An article published in Behavior Research and Therapy reported "The CS (Claustrophobia Scale) is useful both as a state, and as an outcome self-report measure of claustrophobia."
How is Claustrophobia Treated?
After diagnosis has been made, the clinician may recommend one or some of the following methods to help the patient deal with his or her fear:
◾CBT (Cognitive Behavioral Therapy) - This is a well-recognized treatment method for most anxiety disorders. The goal of CBT is to retrain the patient's mind to no longer feel threatened by the places they fear. This may involve slowly exposing the patient to small spaces and helping them deal with their fear and anxiety (in vivo exposure).
◾Drug Therapy - This type of therapy can help manage the anxiety
symptoms, however, it does not deal with the problem itself. Health care
professionals may use drug therapy if other interventions have not provided
◾Relaxation Exercises - Taking deep breaths, meditating and doing
muscle-relaxing exercises are effective at dealing with negative thoughts and
◾Alternative/Natural medicine - There are some natural products
and homeopathic medicines that some patients say help them manage panic and
Resource: Psychology Today